PROGRAM EVALUATION OF A STRUCTURAL INTERVENTION AIMED AT IMPROVING MATERNAL HEALTH OUTCOMES IN RURAL ZAMBIA
The maternal mortality ratio of Zambia is one of the highest in the world at 480 per 100,000 live births, and only 47% of deliveries are performed by a skilled attendant (UNICEF, 2011). Knowing the possible negative consequences of home deliveries, the Mufungu Community of Southern Zambia decided to address this issue by adding on to the existing Chiyumbabeenzu Health Post to accommodate more attended births. Mufungu, comprised of 11 villages and 2,670 people, collaborated with the author and the Peace Corps Partnership Program to raise funds for the construction of a three-room birthing center and mother’s shelter. The villages contributed local building materials in the form of pit and river sand, crushed stone, water, and brick. Coupled with volunteered labor, Mufungu’s contributions accounted for over 35% of the monetary value of the project. The project involved over 180 key stakeholders, including Mufungu community members, traditional leaders, Ministry of Health officials, and the Peace Corps Volunteer. After eight months of construction, the building was completed and opened on January 26, 2016. Outcomes include that the Chiyumbabeenzu Health Post’s Mother’s Shelter has provided a safe haven and sanitary birthing conditions for its anticipated 144 deliveries per year. In addition, it has built community capacity by creating jobs, strengthening stakeholders’ finance management skills, empowering women with a private place specific for delivery needs, and freeing up more space at the existing health post for other outpatient treatments. This approach to addressing the needs of pregnant women in resource poor settings can serve as a model for other parts of Zambia as well as countries with similar health systems and challenges to improve maternal health and to engage communities in solving local problems through partnerships and collaboration.