Mpilo to open specialised ante-natal clinic

Mpilo Hospital in Bulawayo will become the first medical institution in sub-Saharan Africa to introduce a specialised ante-natal clinic to cater to pregnant women who previously suffered a stillbirth.

Currently, Zimbabwe has a national rate of 24 deaths per 1 000 babies born while at Mpilo hospital, the rate stands at 30 deaths per 1 000 babies born.

The specialist clinic, named Thembani is to be housed at the ante-natal care unit of Mpilo and is a brainchild of a multidisciplinary team led by midwives from the University of Manchester in the United Kingdom (UK).

In an interview with CITE, Professor of Midwifery at the University of Manchester, Prof. Dame Tina Lavender said the programme was part of the Lugina Africa Midwives Research Network (LAMRN) funded by the UK’s National Institute of Health Research programme to try and tackle the high burden of stillbirths.

“We know that 2.6 million babies die every year globally and 98 percent of those deaths are in low-income countries, such as sub-Saharan Africa. We know about 50 percent of those babies die in labour,” she said.

Prof. Lavendor – knighted as a Dame by the British Queen for her work on midwifery, added that her team has conducted research in six countries in Africa in Zimbabwe, Zambia, Uganda, Tanzania, Malawi and Kenya to identify predictors of stillbirth plus develop interventions to address those problems

“For example, in Zimbabwe, we found that women who have had one stillbirth are highly likely to have a subsequent stillbirth and 80 percent of women have a repeat of stillbirth. This tells us we need to closely monitor those women who suffered a stillbirth in the antenatal period.

“So we are implementing a specialist clinic in Mpilo for those women where they will access the usual antenatal care as recommended by the World Health Organisation but they will receive additional care in terms of continuity,” she said.

The feasibility study will go for 12 months and Prof. Dame Lavender said once done, they would know if the specialist clinic was doable and whether it improved outcomes and prevented stillbirths.

“First stage is can we implement this clinic, can it work and can we do research around it and following that, we can do a much larger study of different sites and see whether they will bring the stillbirth rate down and by how much.”

The specialist clinic will also provide psychological support, where pregnant women will also receive social support from a specialist group of midwives and obstetricians.

“We are looking at providing better care during labour for women and also supporting women who have lost their baby to better bereavement care. We want to address better management in labour, better antenatal care and better bereavement care because most women and their partners or families in sub-Saharan Africa do not have adequate support when they have lost a baby,” said Prof. Dame Lavender.  

At the moment, the team from Manchester is conducting a feasibility study of the clinic.

“We are going to start the clinic on November 1, 2019 and in Zimbabwe, it will be led by Principal Tutor of the Mpilo Midwifery School, Kushupika Dube and Dr Rebecca Smyth, senior lecturer of Midwifery at Manchester University with help from rest of clinical team,” said Prof. Dame Lavender.

She added that training was necessary for the staff to deliver interventions.

Dr Smyth said two midwives, two obstetricians were part of the training.

The Principal of Mpilo’s Midwifery school noted her team was excited to be hosting the team from Manchester for collaborative work and “hoped for a reduction in stillbirths.”

Mpilo Clinical Director, Dr Solwayo Ngwenya also expressed gratitude that the local hospital was identified to pilot the specialist ante-natal centre.

“I am very grateful and privileged to have such a high powered team from the UK. As low resources areas, we are always battling with stillbirths. This project is God-sent for us as it will help reduce stillbirths and provide respectable care for women. The setup will go a long way in reducing that number of recurrence,” he said.

Dr Ngwenya lamented that at 30 deaths per 1 000 babies, Mpilo’s stillbirth rate was too high and had to be reduced.

“I am sure the recurrence will come down. I look forward to this and I don’t think such has been done in Zimbabwe, as Mpilo is the first of its kind to have a specialised ante-natal clinic for women with a specific condition,” he said. 

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