In Zambia, health indicators remain poor, with an estimated 2,600 maternal deaths annually, and a neonatal mortality rate of 30 deaths per 1000 live births. The average rate of delivery by skilled birth attendants has remained stagnant at below 50% for over 20 years.
The Mobilising Access to Maternal Health Services in Zambia (MAMaZ) programme, operating from 2010 to 2013, was implemented in six districts in Central, Western, Southern and Muchinga provinces in rural Zambia and reached a population of over 250,000.
The programme aimed to address at household and community level the factors that affect access to maternal, newborn and child health (MNCH) services, in particular Emergency Obstetric Neonatal Care (EmONC), and develop appropriate home-based care of women who are pregnant or have recently delivered, as well as for their babies.
This was done by working directly with communities to build wide social approval for behaviour change and to assist communities to develop their own emergency response systems. The programme worked through existing structures, and the change process was community-led and managed by community health volunteers.
Reducing maternal mortality
Over the programme timeframe of 2 ½ years:
- skilled attendance at birth across the 6 districts increased from 43% to 70%, exceeding the agreed target
- the proportion of pregnant women who knew to attend antenatal care in the first trimester increased from 47% to 71%
- the proportion of those women who attended at least 4 antenatal care visits in total increased from 30% to 43%
- use of modern family planning methods increased from 21% to 33%, exceeding the programme target
- uptake of postnatal care within six days increased to 48%
- the retention rate of volunteers was 95%
MAMaZ End of Programme Report is available to download along with the Community Discussion Guide for Maternal and Newborn Health Care in Zambia and other materials available in our Resources section.
The MAMaZ programme was funded and supported by UK aid from the UK Government. The programme was managed by Health Partners International, in association with Oxford Policy Management and Mailman School of Public Health, Columbia University, and in partnership with Development Data and Transaid, working with the Ministry of Community Development and Mother and Child Health and District Health Management Teams in Choma, Chama, Mkushi, Mongu, Kaoma and Serenje districts.