Zambia, like many other Sub-Saharan African countries, is faced with a high burden of disease, especially maternal, child and adolescent health problems; communicable diseases (Malaria, HIV/AIDS, Sexually Transmitted Infections (STIs), Tuberculosis (TB), COVID-19, among others, and a growing burden of noncommunicable diseases.
Even though there has been progress in selected health indicators, particularly for maternal and child health, this progress has been inadequate and below the targets.
In order to contribute to the improvement of health services, Restless Development with support from the Swedish International Development Cooperation Agency (SIDA)has been running the Ishiwi ”My Voice” a project that builds the skills the skills of young people to understand their democratic rights and hold decision makers accountable.
The project is implemented in collaboration with BBC Media Action and uses a combination of media and interpersonal communication to to prove that young people can effectively participate and bring about change and development in their society, given the correct knowledge, skills and guidance.
In Kabwe, young people’s demand for accountability on the Ishiwi project has led to construction of a maternity wing at a local clinic. Before the Ishiwi project was introduced, Nakoli Helath Centre had poor health services ranging from drug stock outs and a lack of health personnel to attend to patients. Among the many challenges was the lack of a maternity wing for women to give birth. This forced women to prefer giving birth from home over visiting the clinic.
Expectant mothers were also forced to walk long distances to the next hospital – Kabwe General Hospital about 10 km away. The situation led to expectant mothers giving birth while on their way to the clinic and sometimes while standing in long queues.
The person-in-charge at the rural health centre, Philis Hamambo, notes:
Women used to give birth while waiting to be attended to because the old maternity wing is too small and can only accommodate one bed.We used to have situations where some women were giving birth on the floor, and even when one gives birth without complication, they would immediately be discharged because the space was not enough for them to be kept for observation. Additionally, the same maternity annex was used for family planning, so there was no privacy for women in labour.Philis Hamambo
Consequently, this led to high home-based deliveries, because women shunned coming to the health centre as a result of the insufficient space”, she adds.
Without a doubt, this situation needed to change. With the introduction of the Ishiwi My Voice Project in Nakoli, young people began to demand for better and improved health services at the clinic.
21-year-old Peter, a young volunteer who received training from Restless Development, began training other young people on holding decision makers accountable.
Together, with other young people, they formed the Ishiwi Community Group tasked to advocate for the construction of the maternity wing and improvement of health services. Mwamba, a young person who was trained by Peter, narrates how the group organized numerous community dialogue meetings with the local authorities and officials from the Ministry of Health, ward development committee and the Mayor’s office.
During the dialogue meeting, we lobbied for the construction of the maternity wing so that expectant mothers could deliver in conducive and respectable places. We appealed to theMayor and the District Health Officials to attend to this urgently.
Following the continued dialogue meetings, the local authorities in Kabwe resolved to construct a maternity wing at Nakoli Health Centre. The new maternity wing has encouraged a lot of women to visit the health facility for maternal services.
Previously, we only had a small annex that accommodated one bed for delivery, and no prenatal or postnatal rooms”, says 28-year-old Margret Mwila, a mother of two. “But now, women have stopped home deliveries due to the well-equipped facility. I gave birth to my second child in the new annex two months ago.
Philis Hamambo, the person-in-charge notes that the coming of the new maternity annexe has helped improve their service delivery to women, and other services seekers.
It is very spacious and can accommodate more women. We have three labour rooms, prenatal and postnatal spaces. This has led to increased demand from women around the community. The health centre is now receiving a significant number of women coming to seek family planning and maternal health services.
This is as a result of Ishiwi. Without young people standing up to speak, this would have not been possible.