A community-led project in Kwekwe, Zimbabwe: implementing self-care and respectful maternity care

Abstract

Background Most (90%) maternal deaths occur in sub-Saharan Africa and south Asia. Self-care and respectful maternity care strategies are effective in reducing maternal and newborn mortality and morbidity. This article discusses a community-led project to train members of the community in self-care and respectful maternity care. This project aimed to contribute to the reduction of maternal and newborn deaths in Kwekwe, Zimbabwe. Methods Using a six-phase approach, 51 women and their families were trained in birth preparedness, complication prevention and readiness and respectful maternity care practices. Quantitative and qualitative data were collected before and after implementation of the training project using a checklist for quantitative data and guided in-depth interviews via focus group discussions and face-to-face interviews with the district nursing officer, two in-charges and two chairmen of the health centre committees. Comparative descriptive analysis and qualitative content analyses for the two sets of data was done for impact evaluation. Results Since the inception of self-care and respectful maternity care practice standards (January–December 2017) in the project sites, there have been no maternal deaths, compared to four maternal deaths in the previous year (January–December 2016). Antenatal care bookings within the first 12 weeks of pregnancy increased from 3−5 to 28 per month by the end of the project. Conclusions A reduction in maternal and neonatal deaths can be realised when a community of practice and a self-care and respectful maternity care model are supported by a well-equipped healthcare system.