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Only four out of ten women giving birth at healthcare facilities in Zambia’s Northern province have a skilled health worker present, according to national health authorities. The situation is worst in rural areas. Luwingu district, Northern province, is a remote and isolated place, where many deaths related to pregnancy and childbirth are preventable. Delays in referrals, long distances to health centers and a lack of qualified staff all contribute to loss of life.
A maternal health program was started by Doctors Without Borders/Médecins Sans Frontières (MSF) in Luwingu in 2010. Teams provide family planning, ante- and postnatal care and assist births at Luwingu district hospital and seven rural health centers. Emergency obstetric referrals are made from clinics to the hospital, where 163 caesarean sections were performed in 2012. A surgical team also offers fistula repair. Obstetric fistulas are injuries to the birth canal most often resulting from prolonged, obstructed labor. They cause pain and incontinence, which can lead to stigma and social exclusion.
Included in comprehensive sexual and reproductive health services is the prevention of mother-to-child transmission of HIV (PMTCT). The MSF team also conducts awareness and educational activities to reduce stigma regarding HIV – which often prevents people from seeking assistance – and encourages them to come to the centers for testing and treatment.
At the end of 2012 MSF had 76 staff in Zambia. MSF started working in the country in 1999.