Breaking Silence, Saving Lives

Journalists Join Safe Motherhood Fight and are challenging taboos to protect women’s health.

By Francis Maingaila

Lusaka, Zambia24 — (20-05-2025) - The Ministry of Health convened a critical media orientation in Lusaka to commemorate Safe Motherhood Week and the International Day to End Obstetric Fistula, emphasizing renewed efforts to improve maternal health outcomes across Zambia.

The event brought together media professionals, health experts, and key stakeholders to amplify messages on safe maternal health services and the urgent need to end obstetric fistula.

In his keynote address, Dr. Aspha S. Choonga stressed the pivotal role of the media in advocating for women’s rights to safe, dignified, and respectful maternal health care.

“Your presence here today is not just appreciated—it is vital,” Dr. Choonga said, urging media practitioners to break taboos and inform the public on these critical issues.

He outlined the four pillars of Safe Motherhood: family planning, antenatal care, clean and safe delivery, and essential obstetric care.

These pillars form the foundation of efforts to reduce maternal morbidity and mortality by ensuring comprehensive care from pregnancy to delivery and beyond.

Highlighting the International Day to End Obstetric Fistula, Dr. Choonga described obstetric fistula as a devastating childbirth injury caused by prolonged or obstructed labor, leading to incontinence and serious physical, emotional, and social consequences.

He called for concerted media engagement to raise awareness and support prevention and treatment efforts.

Adding to the discourse, Mr. Seth Broekman, United Nations Population Fund (UNFPA) Country Representative, called for empowerment of communities and strengthening of Zambia’s healthcare systems to achieve universal access to maternal and newborn health services and eliminate obstetric fistula.

Speaking at the same media engagement, Mr. Broekman emphasized the need for stronger collaboration among stakeholders, the media, and communities.

The 2025 Safe Motherhood Week is themed “Empowering Communities and Strengthening Health Care Systems in Accessing Maternal and Newborn Health Services,” while the International Day to End Obstetric Fistula carries the theme “Her Health, Her Right: Shaping a Future Without Fistula.”

Mr. Broekman highlighted Zambia’s progress since the landmark 1994 International Conference on Population and Development (ICPD), where the country pledged that no woman should die giving birth.

“Since then, the global rate of unintended pregnancies has decreased by nearly 20%, and Zambia’s maternal mortality ratio has declined by 75%, reaching 187 per 100,000 live births in 2024,” he noted.

However, he acknowledged that Zambia did not meet its 2021 target to reduce maternal mortality to 100 per 100,000 live births.

“Too many expectant mothers and newborns continue to die from preventable causes. Too many girls face unintended pregnancies, gender-based violence, and lack access to life-saving reproductive health services,” Mr. Broekman said.

He shared the inspiring story of Charity, a young mother who contracted obstetric fistula during a complicated childbirth in 2020 while sitting for his final Grade 12 exams.

Isolated and hopeless, Charity learned about a UNFPA-supported fistula repair program via a radio broadcast, underwent successful surgery, returned to school, passed his science exams, and is now training to become a midwife.

“Charity’s story is not only one of resilience but also a powerful reminder of the media’s role in transforming lives,” Mr. Broekman said.

Obstetric fistula predominantly affects vulnerable women, especially adolescents. A 2015 Ministry of Health study found that 63% of fistula patients in Zambia were abandoned by partners or spouses, reflecting the profound social stigma linked to the condition.

Globally, nearly half a million women live with obstetric fistula, and for every maternal death, 20 to 30 women suffer serious childbirth injuries, with 90% of fistula cases resulting in stillbirths.

Mr. Broekman identified three critical delays contributing to maternal mortality and fistula in Zambia: delays in seeking care, delays in accessing care due to geographic and infrastructural challenges, and delays in receiving adequate medical care caused by shortages of skilled health workers and supplies.

He stressed the importance of increasing access to Caesarean sections, a vital lifesaving intervention.

While the World Health Organization recommends a 10%–15% Caesarean section rate, Zambia’s rate in public hospitals was only 7.2% in 2018, hindered by cultural, geographic, and economic barriers.

To address these challenges, UNFPA supports Zambia’s maternal health goals through interventions such as midwife training in selected provinces, revising midwifery curricula to meet international standards, updating Safe Motherhood Action Groups (SMAGs) manuals to include fistula detection and referrals, and providing surgical repair training for obstetricians and midwives in emergency obstetric and newborn care.

UNFPA’s support has also contributed to a 63% increase in domestic funding for reproductive health, from $2.7 million in 2023 to $4.4 million in 2024, ensuring sustainable procurement of essential reproductive health commodities.

Since 2005, UNFPA and the Ministry of Health have facilitated over 4,200 successful fistula repair surgeries in Luapula and North-Western Provinces alone, with 62 survivors receiving surgery in 2024. Globally, UNFPA has supported nearly 150,000 fistula repair procedures between 2003 and 2024 and provided reintegration support to over 12,000 women.

Mr. Broekman emphasized the media’s vital role in raising awareness, destigmatizing fistula, and promoting survivors’ reintegration into communities. “The media is not just a messenger—it is a catalyst for change, influencing communities and decision-makers alike,” he stated.

He concluded by urging for strong political leadership, strategic investments, community education on sexual and reproductive health rights, and collaborative efforts among government, partners, healthcare workers, and the media to end obstetric fistula and reduce maternal mortality. “Let us unite to ensure that no girl or woman is left behind. Her health is her right—and our shared responsibility,” Mr. Broekman said.

Safe Motherhood Week and the International Day to End Obstetric Fistula remain critical global observances aimed at accelerating efforts to ensure every pregnancy is safe and every woman can give birth with dignity and support.

Meanwhile, Dr. Angel Mwiche, a senior assistant director health reproductive, identified excessive bleeding and hypertensive disorders as the top two contributors to maternal deaths in Zambia.

He stressed that these conditions are preventable and treatable if identified early and managed properly.

"Every woman deserves a safe childbirth experience. Many women die simply because vital information is not shared widely enough," Dr. Mwiche said.

"Bleeding is the biggest contributor to maternal deaths. While all women bleed during childbirth, some are at a higher risk of bleeding to death—and we can identify these women during antenatal care."

He emphasized that early detection and proper preparation can save lives and urged the media to help disseminate life-saving information.

"If the entire population is informed, very few women will continue to die from preventable causes during childbirth," he added.

Dr. Mwiche noted that hypertensive disorders in pregnancy, commonly known as high blood pressure, are the second leading cause of maternal deaths.

He called for widespread blood pressure monitoring among pregnant women.

“On Thursday, September 22, we expect all stakeholders to focus their messages on high blood pressure in pregnancy, to ensure every woman knows the risks and the importance of regular checkups,” he said.

The ministry is also using the commemorative week to raise awareness about obstetric fistula, a condition resulting from prolonged, obstructed labor.

Women affected by fistula often suffer from incontinence and are frequently abandoned by their spouses and communities.

“These women become social outcasts after losing their babies and developing this painful condition. It’s a hidden crisis that demands national attention,” said Dr. Mwiche.

He called on journalists to help break the silence around maternal health issues and ensure the public is well-informed about the dangers, preventive measures, and support available.

"This is not just a health issue—it's a national development challenge. Reducing maternal and newborn mortality is critical for Zambia’s progress," he said.

Dr. Mwiche encouraged the media to seek clarity on any medical or technical terms to ensure accurate and impactful reporting.

The launch of Safe Motherhood Week comes as Zambia continues to battle high maternal mortality rates, despite government and partner efforts to improve reproductive health services