A community-Based Study on Utilisation in a Rural Zimbabwe

To estimate the degree and pattern of utilization of institutional maternity services in a rural area of Zimbabwe; a cross-sectional study was performed in Gutu district about 250 kilometers south of the capital Harare. In August; 1991; 12 out of 43 wards in the district were randomly selected and in each ward about 40 women (in total 520) who had delivered in the previous 12 months were randomly selected and interviewed. There was a high degree of utilization of institutional maternity services by the women (9679and 74) for antepartum; intrapartum and postpartum care respectively). Women sought this care from a multiplicity of sources depending on a variety of social; geographical and service factors. Very few women (17) had total pregnancy care at the rural health centre. There was a significant association between the actual place of delivery and nulliparity; whether the previous delivery took place at home; whether the family belonged to the Apostolic Faith sect; and whether the husband spent most time in urban area. For nulliparity; previous delivery at home and belonging to the Apostolic Faith sect the proportion of women delivering at home; at the rural health center/urban maternity clinic; and at hospital was statistically significant. The few maternity waiting shelters that were available lacked basic amenities and were unattractive to the mothers even though 65either used them or could have done so if they were available

Research and intervention issue concerning infant and child mortality and health

The Harare population birthweight for gestation standards were constructed using data from 5 872 singleton livebirths. A further 18 091 births were analysed to determine the relationship; if any; between birthweight for gestation centiles and risk of perinatal mortality. The results showed an overall perinatalmortality of 41.1/1000. The least perinatal mortality occurred at a gestation of39 weeks at a birthweight of 3 500 - 3 750 gms. The lease perinatal mortality occurred when the birthweight was between the 50th and 95th centiles at any given gestation. When the perinatal mortality for each week of gestation and birthweight cell of 250g size was calculated; this showed a pattern which could be represented graphically in zones of perinatal risk. Such zones form the basis for a simple method of determining perinatal mortality risk using both birthweight and gestation