For any pregnant woman, the rhythmic thump of the baby's movement means everything.
As her belly grows, the movements become a sure way of knowing that the baby inside her is thriving.
But every minute, somewhere on our planet, women of reproductive age die from problems linked to pregnancy.
The major reason for this enormous problem is failure to access antenatal care services, particularly in developing countries.
Women tend to delay accessing health services during pregnancy as a result of different challenges that they might encounter.
Zimbabwe has high maternal mortality rates at 363 per 100 000 live births.
This means that five women die every day during child birth!
The World Health Organisation recommends a minimum of eight antenatal visits for every pregnant woman.
However, global estimates indicate that only about half of all pregnant women receive this recommended amount of care.
Antenatal care is the medical care provided to pregnant women throughout their pregnancy and it is crucial for ensuring a healthy pregnancy and delivery. Antenatal care visits allow healthcare professionals to monitor the development of the foetus, identify and address potential health risks for both mother and baby, and provide essential education on nutrition, childbirth, and new-born care.
Lack of proper antenatal care is a major contributor to maternal mortality and without regular check-ups, potential complications during pregnancy may go undetected, leading to serious health problems for both mother and baby.
Early detection and treatment of pre-existing health conditions like HIV or diabetes is also crucial for a healthy pregnancy because if they are left untreated, they can lead to increased risk of infant mortality.
Government has over the past years worked to increase the access to antenatal care as part of efforts to reduce the maternal mortality rates as well as the transmission of diseases from mother to child.
Through the Prevention of Mother to Child Transmission (PMTCT) of HIV, Syphilis and Hepatitis B, a lot of progress has been made to ensure positive outcomes for both mothers and children.
And it worked.
According to the Multiple Indicator Cluster Surveys (MICS) and the Zimbabwe Demographic Health Survey (ZDHS), Zimbabwe's antenatal care attendance had reached 94 percent before the Covid 19 pandemic.
But last year, antenatal care attendance went down to 86 percent.
This is a major decline!
According to National Prevention of Mother to Child Transmission (PMTCT) and Paediatric HIV care and treatment coordinator in the Ministry of Health and Child Care, Dr Angela Mushavi, the decline in antenatal care attendance is worrying.
Among the most common barriers to access to maternity care was the burden of user fees at some health facilities as well as geographical barriers to accessing care.
"Could it be user fees? Some clinics are charging US$30, including areas like Bindura, which have farming and mining communities, but they want US$30 from a pregnant woman for her to be able to book. That is astronomical by any standards," she said.
The main goal of antenatal care is to promote and protect the health of both the mother and the baby through regular check-ups and tests to detect and prevent any potential risks or complications.
But if women feel that they cannot afford to pay for that service, they will wait until they get into labour to visit a health facility.
And the complications that may arise from such would be catastrophic.
Early detection of pregnancy complications like preeclampsia or gestational diabetes allows for timely intervention, significantly improving maternal and infant health outcomes.
What to do?
Experts point towards the urgent operationalisation of the country's National Health Insurance (NHI) scheme as a critical step towards reversing this trend.
Government has already set up a National Health Insurance Taskforce which has been working on modalities to operationalise the scheme.
The initiative seeks to provide equitable, affordable and high quality healthcare to all Zimbabweans, eliminating financial barriers to healthcare access.
By ensuring financial coverage for expectant mothers, the NHI would remove the financial barriers that prevent many women from seeking vital antenatal care. This, in turn, would lead to a rise in clinic visits, early detection of complications, and ultimately, healthier mothers and babies.
Health and Child Care Minister Dr Douglas Mombeshora says the National Health Insurance would definitely give more women access to antenatal care.
"We are working on the National Health Insurance and what we want is for anyone, irrespective of your social status, to be able to access medical services in a public health institution. We are now going to have the national health insurance pay for those who seek medical services in the public health institutions. If you want to go to the private sector, then that is your responsibility," he said.
"We have come up with the principles which I hope to present to Cabinet soon then it will go to Parliament. If everything goes as planned, the NHI should be operational at the beginning of 2025."
Public health experts argue that the economic and social costs of neglecting antenatal care are far greater than the investment required to fully implement the NHI.
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A functional NHI scheme will ensure that health services are accessible to all Zimbabweans in line with section 76 of the Constitution which stipulates that every citizen and permanent resident of Zimbabwe has the right to have access to basic healthcare services.
It will provide healthcare coverage for all citizens, ensuring that individuals and families have access to necessary medical services, regardless of their income levels, and socio-economic statuses.
This will protect the 90 percent of the population which is accessing healthcare services through out of pocket expenses since only 10 percent is currently on medical aid.
Once the NHI becomes operational, the attainment of universal health coverage will become a reality.
Not only that.
The future of Zimbabwe's mothers and babies will be guaranteed in line with Sustainable Development Goal 3 which seeks to reduce maternal mortality to less than 70 per 100 000 live births by 2030.
The National Development Strategy 1 and the National Health Strategy (2022-2026) also has a deliberate thrust to ensure provision of adequate healthcare for women and girls.
So by prioritising the swift operationalisation of the NHI scheme, the country can safeguard the health of its women and children, ensuring a brighter, healthier tomorrow for all.
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