Last Wednesday, Zimbabwe joined the rest of the globe in commemorating World Population Day, a day set aside to spread information about population-related issues around the world.
with Moses Mugugunyeki
For nearly 30 years, the United Nations has recognised World Population Day as an annual awareness day and this year, the event runs under the theme Family Planning is a Human Right.
The theme explores women and girls’ rights protecting them from exhaustion, danger and depletion owing to too many pregnancies too close together.
In many rural areas of Zimbabwe, a woman gives birth to an average of four children and with every pregnancy and birth, her risk of dying increases.
There is a clear connection between areas that have a high fertility rate and high maternal mortality rates, and rural areas are no exception.
According to the World Health Organisation (WHO), pregnancy and childbirth complications are among the leading causes of death among women living in developing countries, Zimbabwe included.
Zimbabwe’s maternal mortality rate stands at 651 deaths per every 100 000 deliveries and, according to WHO, this remains unacceptably high.
Florence Chandiwana* is a 34-year-old woman who lives in Maware village in Sadza district, Mashonaland East province.
She has given birth to four children in the past 16 years and is expecting a fifth in a few weeks.
Because of previous painful experiences, she is scared of the day she goes into labour. She has had several miscarriages already.
“My husband insists I should bear him seven children.
I pray every day for successful delivery and I am hopeful this will be a successful one.
However, I feel weak and without energy to carry more pregnancies after this one,” she said.
Chandiwana looks frail and vulnerable, yet she says her husband has threatened to marry another woman if she does not give him the seven children that he wants.
“I have allowed my husband to marry someone who can bear him more children, but sometimes he insists he wants me to give him those children because he paid lobola for me to do just that,” she said.
However, the couple is having difficulties looking after the four children that they have and Chandiwana wonders how the situation would be like with seven offspring.
Chandiwana was among several expecting mothers who were housed at a maternity waiting shelter at Sadza District Hospital.
She had travelled several kilometres from her home to Sadza because health personnel at her local health centre feared her situation was complex.
Zimbabwe’s high maternal mortality rate has been attributed to inadequate financing of health programmes, illiteracy among women as well as tradition and culture usually enforced by men to disadvantage women.
Experts believe that having pregnancies too close to each other doesn’t give the mother time to recover after losing nutrients such as iron and folate during pregnancy and breastfeeding. This is called maternal depletion syndrome.
Back-to-back pregnancies can deplete essential nutrients, puting mothers at high risk of anaemia and other complications such as uterine rupture.
It also puts their babies at risk of low birth weight and pre-term birth.
Chandiwana, like most women in Zimbabwe, has little control over her reproductive health.
“I have spoken about family planning to my husband, but he does not want to hear it,” she said.
Zimbabwe National Family Planning Council executive director Munyaradzi Murwira said there was need to increase access to family planning for young people, unmarried sexually active women and strengthen the availability of a broad range of family planning methods, including long-acting ones.
“Family planning is, therefore, not about limiting couples, but allowing couples the choice on when to have children, the number of children and how to space them,” said Murwira.
“There is overwhelming evidence suggesting that family planning can be a development strategy for improving health and well-being, reducing poverty and empowering women.
We must, therefore, work hard to fulfil the unmet need for family planning.”
In a statement to mark World Population Day, United Nations Family Planning Council country representative Esther Muia said women and young girls with information on family planning were empowered them to make sound decisions that save their lives.
“Access to voluntary family planning enables women to space their births, benefiting both mothers’ and children’s health,” she said.
“Family planning also reduces the risks of death and disability from pregnancy and childbirth too early or too late in a woman’s productive life.”
Zimbabwe’s contraceptive prevalence rate — that is, the proportion of women aged 15-49 using family planning — is 67%, an improvement from 59% in 2010.
This is one of the highest on the continent, but there remains unmet need among women and girls of reproductive age, the majority of them in rural settings and often young.
Director of family health services in the Health and Child Care ministry, Bernard Madzima, said government was committed to the provision of family planning for women and girls.
“Zimbabwe’s contraceptive prevalence rate standing at 67% is one of the highest on the continent; this is a sign of our government’s commitment to the provision of family planning,” said Madzima.
“We are very grateful to all our partners who have supported us to achieve this success and we will continue to work with them to end the unmet need for family planning.”
However, WHO estimates that about 200 million couples in developing countries, Zimbabwe included, would like to delay or stop child-bearing, but do not use any method of contraception because of lack of access, limited choices, fear and cultural or religious reasons.
The global population is about 7,6 billion people and growing, according to Worldometers.
*Not her real name.