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Government directive on delivery kits commendable
2006-07-06 09:14:45
By JOYCE MKINGA
The government has announced that it will take punitive measures against the medics and birth attendants who demand delivery kits from expectant mothers.
The kits are supposed to be free of charge but it is not the case on the ground.
The Deputy Minister for Health and Social Welfare, Dr Asha Kigoda, on Monday told the Parliament in Dodoma that the government would take severe measures against the medics and birth attendants who will demand delivery kits from expectant mothers.
She says the punishment would also go as far as the hospitals and dispensaries that would be involved in the practice of demanding delivery kits from pregnant women.
According to the Deputy Minister, delivery kits are supposed to be provided, free of charge to the expectant mothers and that, those who charge them violate government directives.
”The government will take stern measure against the medics and birth attendants who will demand delivery kits from expectant mothers. The government had agreed that delivery kits would be provided free of charge to all expectant mothers,” she says.
The Deputy Minister’s response was a reaction to a question from Amina Chifupa (Special Seat-CCM) whose concern was on steps the government was taking against those who demand delivery kits from expectant mothers.
The MP’s question was due to the fact that the government policy on pregnant women and children on medical services was very clear and that they were supposed to get free medical services.
However, the implementation of the policy that allows pregnant women for free maternal services all over the country has proved difficult in almost all hospitals in the past years.
The Ministry of Health and other top officials have been insisting that maternal services to all pregnant women and children in all hospital in the country must be free of charge but this is not the case.
Pregnant women are paying for the service from day one.
When a pregnant woman goes for antenatal clinic she is supposed to pay for the prescription card that costs 1,000/-.
In most of the hospitals not only in urban areas but also in villages hospitals and dispensaries pregnant women cannot get the service without 1,000/- that would allow her to get a card.
Not only are the women required to pay the services but also are required to come with their delivery kits for delivery.
”There is no free service because we pay from the start to the delivery day,” says Mwajuma Mwinyichande of Temeke.
She admits that after paying the 1,000/- the services become free until the critical time of delivery when the woman is directed to pay for her own delivery kit.
The delivery kit could cost up to 7,000/- for one is required to buy gloves, cotton, syringe, razor and other materials to make a delivery kit.
”If you don’t have the kit you will be required to bring with you some money for the nurses to buy for you,” says Jenista Mwogutu of Mwananyamala.
Mwogutu says every pregnant woman tries her best to ensure that she gets the kit before the D-day because the issues of having a delivery kit is emphasised every time one goes to the clinic.
Not only is the woman asked to prepare a delivery kit when going for delivery but also something to ’grease the hands” the nurse who will assist her on the day.
Although some do not openly ask for something but the abusive language they use tells you all.
”When you call her and place something in her hand saying that you want her to assist you, she will completely change and become a real friend,” she says.
James Kamanya says each time his wife goes for delivery he has to carry something to give the nurses who assist her.
”To be sincere nobody tells you to give them money but you surrender yourself to get better services from them otherwise the baby may be killed in the process,” he says.
Ashura Hussein who lost her kid in the process did not know that the nurses needed to be given ’something’ in order to provide her better services.
She says when the labour pain became serious she called the nurse to assist but everyone seemed to be busy with other things. By the time they came the baby was tired.
According to Ashura the baby showed a head for almost ten minutes when they came for her rescue but it was too late as after coming out the baby stayed hardly three hours before she died.
”To avoid such unnecessary death women prepare something to give to the nurses for better services,” she says.
Most of the women interviewed said the nurses could be given any amount of money between 3,000/- and 20,000/- depending on one’s ability to give out the money.
All these are contrary to government policy and the conduct of the nursing profession.
The Dar es Salaam City Regional Medical Officer, Deo Mtasiwa, says that the National Health Policy provides free maternal services including clinics for mother’s deliveries (normal and assisted deliveries).
The policy also provides free medical services to children less than five years of age.
According to Dr Mtasiwa, all the Dar es Salaam municipal hospitals are provided with funds that would, among other things, take care of delivery kits for expectant mothers.
Much as we support the government move to push for the implementation of a National Health Policy that provides free medical services to pregnant women and children, the question is whether the government has provided enough funds to support the hospitals or not.
A recent report shows that the Temeke Municipal Hospital has been allocated only half of the required budget.
Surely, this will hinder effective implementation of the government directive as provided for in the National Health Policy.
Some officers in many of the government hospitals say that implementation of the government policy on free medical service to pregnant women becomes difficult because of insufficient funds.
They say nobody wants to deny one’s right if the kits were available for their clients.
The government stand on the issue is welcome and commendable but it should go hand in hand with the allocation of enough funds to the hospitals and dispensaries.
The government declaration on the issue is very important to women and children.
This is because for those who cannot afford to buy a delivery kit, the situation becomes difficult.
In fact, women would be the happiest if the policy is effectively implemented..
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