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Picha

Children don’t thrive in large families

But this trend is no longer fashionable. Ironically, it is in rural Tanzania where medical facilities and trained health workers are seriously lacking. Pregnant women in remote rural villages rely mostly on traditional birth attendants and medicinal herbs. Many of the births remain unregistered. Surprisingly, however, child mortality and morbidity rates for children born in urban centers and those for children born in rural areas are nearly the same.

Mortality rates for infants who are hardly one week old have increased from seven to ten deaths for every 1,000 live births. A recent Dodoma regional report indicates that maternal mortality rates have increased from 188 deaths per every 100,000 child deliveries in 2005 to 189 last year. Whatever the case, the accent in this country for the moment is on smaller, easily manageable families.

Gynaecologists say raising fewer children will also help their mother maintain a better health status. Women who bear children too frequently are generally weaker - their poor health translating into higher medical costs for the family. This goes a long way into weakening the family’s financial muscle. Children born in close succession are mostly frail and have higher death mortality rates than those whose births were spaced rationally, say two or more years apart.

Now, let us take a keener look at the national maternal and child mortality rates. The current maternal mortality rate stands at a whooping 530 deaths for every 100,000 live deliveries. This indicates that about 9,000 women die each year from pregnancy complications and childbirths.

Midwives believe that with any pregnancy there is a possibility that something may go wrong. Pregnancy complications cannot be predicted, especially when the pregnant woman is a new mother. This explains why most new mothers are referred to competent, reputable hospitals. First pregnancies are the most dangerous, especially when they involve teenagers. Dangerous problems can arise without warning during pregnancy or childbirth.

This means all families need to know the location of the nearest dispensary or health centre ahead of time. If a birth is likely to be difficult, it should take place in a competent hospital or health clinic. In fact, all births, especially the first births, are safer in a maternity hospital. Families need to know about risk factors and should be able to recognize the warning signs of possible problems. Such signs are numerous -- often varying from person to person.

The major signs include failure, on the part of the pregnant woman, to gain weight (at least six kilos should be gained during pregnancy); Anaemia; paleness inside the eyelids (healthy eyelids are red or pink). Unexplained fatigue is a common ominous factor. A pregnant woman is not necessarily a weak person. Other bad signs include pronounced swelling of legs, arms or face; inability on the part of the foetus to stir; bleeding during pregnancy or profuse or persistent bleeding after delivery.

Pregnant women can also experience nagging headaches or stomachaches and severe or persistent vomiting. Traditionally, birth attendants in rural areas tackle these problems with medicinal herbs. But some signs can defy intervention with herbs. Such signs include high fever, a water break before due time for delivery, convulsions and severe pain. I must mention here that prolonged labour can easily lead to obstetric fistula and even death for the infant or the mother or both.

Every pregnancy deserves close attention as there is always a risk of something going wrong. Many dangers can be avoided if the woman sees a health worker when she suspects she is pregnant. She should have at least four check-ups during pregnancy. Check-ups that are more thorough should be conducted inside 12 hours after delivery and six weeks later.

If there is bleeding or abdominal pain during pregnancy she should be taken to a good maternity hospital promptly. Pregnant women in rural Tanzania have another setback - poor diet. A pregnant woman needs nourishing foods. She needs enough nutritious foods such as milk, green leafy vegetables, meat, fish, eggs, grains, peas, beans and red, orange and yellow fruits. Some people in rural tribal settings underfeed their pregnant women so that they give birth to tiny infants.

The warped belief here is that a properly fed pregnant woman is likely to give birth to a plump baby who is likely choke the birth canal and complicate the birth process. This is arrant nonsense. A pregnant woman needs the best nourishing food available. Women will feel stronger and look healthier during pregnancy if they eat foods that are rich in iron, vitamin “A” and folic acid.

Pregnant women need iron tablets to prevent or treat anaemia and a dosage of vitamin “A” to help prevent infection. They advise that salt used to improve food taste should be iodized. Women who do not have enough iodine in their diet are more likely to have miscarriages and risk having infants who are mentally or physically disabled. Goitre, a swelling in the neck, is a clear sign that a woman is not getting enough iodine.

If anaemia, malaria or hookworms are suspected, the pregnant woman should consult a heath worker. A pregnant woman can damage her own health and the health of the foetus by smoking. Even living in an environment where other people smoke can be catastrophic. Drinking alcohol or abuse of narcotic drugs are other pitfalls. If a pregnant woman smokes, her child is likely to be born underweight.

The infant is also more likely to have coughs, colds, croup, pneumonia, or other respiratory problems. To ensure good physical growth and mental development of the child, pregnant women and young children need to be protected from all types of smoke. It is also important to avoid taking medicines during pregnancy unless they are absolutely necessary and prescribed by a competent health worker.

If a pregnant woman is abused, she and the foetus could be seriously harmed. Pregnant women who are physically abused may be unable to have any more children. A pregnant woman should never be beaten or abused in any way. Husbands who batter their pregnant wives commit a felony.

spmwita@yahoo.com

TODAY is a critical day both for Zanzibar ...

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Author: SOSTHENES MWITA

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