Perspective on Africa
A Global View on Birth Asphyxia: Perspective on Zambia
Elwyn Chomba, of the University of Zambia, presented her observations on birth asphyxia in Zambia.
Dr. Chomba advised that Zambia’s population is approximately 11 million, mostly concentrated in Lusaka, the Copperbelt and along the line of rail (Figure 5.1). The neonatal mortality rate (40/1000 for the whole country) varies from region to region, with the highest perinatal and neonatal mortality in the Northwestern province (Figure 5.2).
Dr. Chomba provided a detailed description of the problems faced in a developing country in Africa, where resources are so limited.
Most health services are in the capital city and in the urban centres of the copper belt. The rest of the population have minimal or no health care services. Lighting and water are deficient in rural settings and there is a profound shortage of skilled health care providers (Figure 5.3). Those who are available are often limited in what they can do by the conditions (eg. no light, heat, or water, unhygienic surroundings and no medical supplies). Furthermore, distance is an obstacle since some areas are sparsely populated, roads are poor and there are inadequate transportation facilities (Figure 5.4).
Dr. Chomba also described some of the socio-cultural beliefs that interfere with proper health care and result in delay in seeking care (Figure 5.5).
All of these limitations also make it very difficult to obtain accurate statistics.
Dr. Chomba went on to speak about programs for training health attendants in neonatal resuscitation through the global network programme (GNP). Theoretically, this should have a significant impact on neonatal care; however many of the societal and infrastructure problems Dr. Chomba described will have to be tackled in order to reduce the high newborn death rate.