ZAMBIA

Our Progress

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0

Decrease in Institutional Maternal Mortality Ratio

%

0

Increase in Women Target Districts Giving Birth in a Facility

%

0

Decrease in Stillbirths and Newborn Deaths in Facilities

In Zambia, Saving Mothers, Giving Life is putting in place key interventions to improve maternal and newborn health across 16 districts. Working hand-in-hand with the Zambian government, the initiative has set out to make high-quality, safe childbirth services available and accessible to women and their newborns, focusing on the critical period of labor, delivery and the first 48 hours postpartum.

The Situation

Every year, there are an estimated 608,000 births, 1,400 maternal deaths and 13,000 newborn deaths in Zambia. While Zambia has had modest improvements in maternal health since 1990, a woman's lifetime risk of maternal death — the probability that a 15-year-old girl will eventually die from a maternal cause — is 1 in 79, dozens of times greater than that of a high-income country like Norway or the United States.

Our Target Districts

PHASE 1

1

Kalomo

2

Zimba

3

Mansa

4

Chembe

5

Nyimba

6

Lundazi

PHASE 2

7

Samfya

8

Lunga

9

Kabwe

10

Choma

11

Pemba

12

Chipata

13

Petauke

14

Sinda

15

Vubwi

16

Mambwe

Our Approach

Our Results3

Key results include:

Indicator Zambia
  Baseline Endline % Change
Institutional maternal mortality ratio 311 144 ↓ 53%
Community-level maternal mortality ratio N/A N/A N/A
Institutional delivery rate 63% 90% ↑ 43%
Direct obstetric case fatality rate 3.1% 1.7% ↓ 46%
Cesarean section rate 2.7% 3.6% ↑ 32%
Perinatal mortality rate 37.9 27.0 ↓ 29%
Total stillbirth rate 30.5 19.4 ↓ 37%
Institutional neonatal mortality rate 7.7 7.8 ↑ 2%
Women who received ARVs for PMTCT 930 1687 ↑ 81%
  1. Countdown to 2015: Maternal, Newborn & Child Survival, UNICEF and WHO. “Fulfilling the Health Agenda for Women and Children: The 2014 Report”
  2. Ibid.
  3. In the baseline period, Zambia data were available from hospitals for 5 of the 12 months and for 6 of the 12 months for health centers and health posts. Therefore, the initial adjustment for Mansa District was to multiply all events (not just maternal deaths) by 12/5 for hospitals and by 2 for health centers/health posts. This meant increasing the maternal deaths for Mansa baseline from 3 to 7 for hospitals and from 3 to 6 for health centers. This adjustment for Mansa increased total maternal deaths (all districts) for the baseline period from 50 to 57, before there was any consideration given to using the census-reported verbal autopsy deaths.

    For verbal autopsy deaths in the community in the baseline period, there were 65 institutional maternal deaths during the baseline period - identified by the verbal autopsies (VA) following the census. Of these 65, there were 18 that could not be matched to deaths from facility reports. The adjustment for the baseline period was to add the unmatched 18 deaths to the original 50 deaths. Therefore, if we were to use an adjustment based on the baseline VA it would be by a factor of 68/50 = 1.36 instead of by a factor of 68/57 = 1.19. If we were to use the 1.36 for 2014 it would yield an MMR of 203 per 100,000.

    In the endline period, the adjustment was from 53 to 62 maternal deaths. A full 12 months of data were available for all 4 Zambia districts in the endline and 9 additional deaths were added from Community Key Informants (CKI) reports.

Resources

View the Saving Mothers, Giving Life Initiative Infographic

Watch the Video

New video from Saving Mothers, Giving Life partner Communications Support for Health on the importance of behavior change to improve maternal and newborn health.