Muchila is a vibrant village of approximately 20,000 people located in the Southern Province of Zambia. A Basic Rural Health Center was constructed in the village in 2004 that serves the community, but due to the constant demand for general health care at this small facility, maternal medical issues are not given priority. Further, the clinic is not equipped with running water, diagnostic equipment and staff with the expertise to perform many maternal health care procedures. Women must travel by foot or, if they are fortunate by bicycle, up to 30 miles to obtain clinical services. If they are fortunate to reach the clinic in time, they must be discharged almost immediately, faced with the same journey home postpartum. With the lack of privacy, facilities, equipment and trained staff, most women choose to remain in their huts during childbirth. If complications occur, they are often devastating to mother or child or both.
The loss of life and/or productive health on the part of women and children due to the lack of basic and oftentimes low cost preventive maternal health care touches almost every household in Muchila. The women of these rural households are not only the backbone of their own families, but they are also the caretakers of the countless orphans of HIV/AIDS that permeate every rural village in the region. When a mother dies from childbirth related causes, her children and adoptive children must be assumed by other struggling families.
In Zambia, only 47% of births are attended by a skilled health worker and home delivery is close to 53% (UNICEF, 2016). A woman in sub-Saharan Africa has a 1 in 16 chance of dying in pregnancy or childbirth, compared to a 1 in 4,000 risk in a developed country. Communities in rural areas, like Muchila, have even higher levels of maternal death and limited access to healthcare and life-saving resources. These deaths, caused most commonly by infection, obstructed labor and hemorrhage, are largely detectable and preventable with the most basic and inexpensive of pre-screening and birthing measures. While about 15% of pregnancies and child births in rural Africa need emergency obstetric care because of complications that are difficult to predict, the remaining deaths and complications are largely preventable with access to clean water, sterile supplies, basic tools and equipment and health care workers with training in basic obstetric care procedures.