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Director for Mother and Child Health at Zambia's Ministry of Community Development discusses maternity and child health issues and her work to counteract them

Maternal health is an issue that affects many women and children in developing countries. Zambia has a population of around 15 million people in a very large country of over 700,000 square kilometers. With few health workers in such a large area, Zambia faces numerous issues when it comes to its support for pregnant women and newborns.

Caroline Chibawe is the director for Mother and Child Health at Zambia’s Ministry of Communication Development in the Zambian capital, Lusaka. In her work, she looks at health prevention and promotion as well as curative and rehabilitation services at a district level.

“I look after maternal health such as antenatal care, family planning and reproductive health. I also cover immunization in children as well as nutrition to make sure children are breast feeding and generally improving new born care,” she explained to Salzburg Global Seminar while attending Hooked on Health Care: Designing Systems for Better Health. Chibawe also addresses primary health care for communicable diseases such as malaria, tuberculous and HIV prevention and treatment.

In Zambia, 591 maternal deaths occur per 100,000 live births. As Chibawe explained, a huge factor in this statistic is the fact that over a third of women in Zambia do not give birth in health facilities.

“There are only about 60% of women that give birth in the health facilities so when problems arise and they have complications it can result in issues and even death,” she said. “We lose a lot of women, and have a high maternal mortality rate in Zambia. The other challenge is we don’t have high family planning prevalence. Mainly it’s due to access; we have very few health workers. We find women have to come and travel long distances to receive family planning services.”

Chibawe has attempted to counteract these issues by focusing on training more health workers and educating community members in health. 

“We train and recruit a lot more. Clinics can face issues when there is too high of a patient load so we work with the community a lot to address this. We have community health workers that come and help the women to find these facilities and encourage them to go on antenatal care.” 

Another technique she implemented is task shifting to lighten the loads on trained health workers. 

“Some of the tasks a doctor or nurse is doing can actually be done from these community health workers, such as weighing babies and writing in the register, so that the trained health workers can have a lot more time and manage the patient better.

“We also use outreach services. We have mobile services to go out in the community and make sure we provide antenatal [care], immunization, treatments, working with the community and reorienting them and gathering them together.”

Chibawe reflected on her time at this session and the learning experiences she can take back to Zambia.

“I’ve had an opportunity to meet very different people.” She said.  “I’ve learnt about housing: ways to improve design and housing. We have a high TB prevalence and it’s mainly due to the way our sanitation and house planning is done. That’s something we can look at in Zambia and try to improve thanks to the experience I have gained here.”

She also felt that she has learnt more about how integration of the business sector could be used to help improve health facilities and general health.

“It’s been interesting to consider how to engage the private sector in order to help us provide health services better. Not only this, but also how to package our intervention and packaging our strategies. If we can approach the business sectors, identifying their problems in regards to health for their employees, we can offer to help them solve their problems and they can help us address these interventions.”

Caroline Chibawe was a participant at the session Hooked on Health Care: Designing Systems for Better Health.The session is part of the Salzburg Global series “Health and Health Care Innovation in the 21st Century” and was held in collaboration with the Robert Wood Johnson Foundation and the Health Foundation. More information on the session can be found here: www.salzburgglobalseminar.org/go/559