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Postpartum hemorrhage: incidence, risk factors, and outcomes in a low-resource setting
No full textThis work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php
and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/).,Background: Primary postpartum hemorrhage (PPH) is defined as blood loss from the genital tract of 500 mL or more following a normal vaginal delivery (NVD) or 1,000 mL or more following a cesarean section within 24 hours of birth. PPH contributes significantly to maternal morbidity and mortality worldwide. Women can rapidly hemorrhage and die soon after giving birth. It can be a devastating outcome to many young families. Women giving birth in low-resource settings are at a higher risk of death than their counterparts in resource-rich environments. PPH is a leading cause of maternal deaths globally, contributing to a quarter of the deaths annually.
Aims: This study aims 1) to document the incidence, risk factors, and causes of PPH in a low-resource setting and 2) to document the maternal outcomes of PPH in low-resource setting.
Methods: This was a retrospective descriptive cohort study carried out at Mpilo Central Hospital, a tertiary referral government hospital in a low-resource setting in Bulawayo, Zimbabwe. Data were obtained from the labor ward birth registers for patients who had a diagnosis of PPH during the period from January 1, 2016 to June 30, 2016. The case notes were retrieved and the demographic, clinical, and outcome data were gathered. Blood loss was estimated postdelivery by the attending clinician – either a midwife or a doctor. At this maternity unit, blood loss is not measured but estimated owing to prevailing resource constraints. The SPSS Version 21 statistical
tool was used to calculate the mean and standard deviation (SD) values. Simple statistical tests were used on absolute numbers to calculate percentages.
Results: There were 4,567 deliveries at the institution during the period from January 1, 2016 to June 30, 2016. There were 74 cases of PPH during the study period. The incidence of primary PPH was 1.6%. The mean age was 27.7 years (SD ±6.9), mean gestational age was 38.6 weeks gestation
(SD ±2.2), and mean birth weight was 3.16 kg (SD ±0.65) for the studied group of patients. Three-quarters (75.7%) of the cases had NVD. The majority of the cases (77.0%) had an identifiable
risk factor for developing primary PPH. The most identifiable risk factor for primary PPH was pregnancy-induced hypertension followed by prolonged labor. Uterine atony was the most common cause of postpartum hemorrhage (82.4%). The women who delivered by NVD, who were diagnosed with a PPH, and who lost an estimated 500–1,000 mL of blood were 73.2%; 25% lost 1,000–1,500 mL of blood, and 1.8% lost more than 1,500 mL of blood. The women who delivered by lower-segment cesarean section, who were diagnosed with a PPH, and who lost an estimated 1,000–1,500 mL of blood were 77.8%, and 22.2% bled an estimated 1,500 mL of blood or more. The majority of the cases of primary PPH (94.6%) survived the condition and 5.4% died.
Conclusion: The incidence of PPH at Mpilo Central Hospital was 1.6% during the study period, lower than that reported elsewhere in similar setting in the literature. This study, therefore, is important
as it documents for the first time for this maternity unit and for a Zimbabwean setting, the incidence of one of the most important causes of global maternal deaths. Future studies should involve the effect on maternal outcomes of PPH following widespread introduction of misoprostol therapy into practice. This data can help in mobilizing global efforts to improve women’s health
Assessment of small to medium enterprises’ (SMEs) role towards livelihoods of marginalized Harare women: case of Harare city center
No full textThis study sought to evaluate the extent to which the SMEs sector has contributed towards the livelihood options of marginalized women in Harare. This group was chosen firstly because women world over have the greatest burden of taking care of the family but are sidelined in the development process as they have limited access to opportunities compared to men preventing them from fending for their families. Focus was put on Harare because past research seems to be mostly biased towards rural women at the expense of urban women. Harare being the capital would represent activities carried out by women in other provinces too. The study focused on an area within town because most women within the sector operate in town. Results indicated women within the sector have become empowered through their participation and their lives have changed for the better showing strategies within the sector seem to have a great significance in their lives. However, women remain limited in certain jobs like Information Technology and Repairs amongst others which also seem to bring better remuneration compared to the areas that the majority of women are involved in
The influence of organizational learning dimensions on the performance of haulage companies in Harare province, Zimbabwe
No full textThe purpose of this study was to examine the influence of organizational learning practices
on company performance in the case of the haulage sector in Zimbabwe. It sought to provide
valuable insights into the effects of the identified causal elements (information acquisition,
information interpretation, information sharing, information quality and behaviour and
cognitive changes) on employee productivity and organizational performance in Zimbabwe
haulage companies. Using a cross-sectional survey design amongst 120 employees from
haulage companies in Harare, registered with the Zimbabwe Transport Association, the study
established a model with an explanatory power of 27.3%. The results indicate that not all
the five constructs are individually significant in enhancing organizational performance.
The study has important managerial and academic implications for the management and
resource deployments in a developing country such as Zimbabwe
The role of the environmental management agency (EMA) in promoting sustainable environment management in Harare South
No full textThe study focused on the role of EMA in promoting sustainable environment management in Harare South. In most developing countries, the increase in urbanization has exceeded the development of urban infrastructure and this has led to the multiplying of informal settlements, illegal dumping sites and uncontrolled vending in cities like Harare. The environment has currently become a topical issue globally with climate change, environment degradation and biodiversity loss among the major difficulties. Several Conventions have been ratified and Zimbabwe has also took part in those Multilateral Environment Agreements (MEA) such as the Ramsar Convention and Kyoto Protocol. However despite these efforts the country’s environment is increasingly becoming degraded. The research aimed at the environmental challenges in Harare and how EMA has monitored and regulated environment issues as well as the programs carried out and their impact and effectiveness in improving the environment. A qualitative research method was used to gather information on several environmental issues in the study area. Interviews and observations were carried out to gather informatio
The link between Access to Renewable Energy and Development in Gutu District.
No full textEnding poverty and underdevelopment in rural areas of Zimbabwe has been a challenge for quite a long time. Government and other development partners have come up with various policies, programmes and projects to address the various forms of poverty manifesting in rural areas. As the process of development is dynamic and ongoing, this research paper on the link between access to renewable energy and rural development seeks to examine the feasibility of harnessing renewable energy for rural development drawing its inspiration from the Rural Sustainable Energy Development programme in Gutu District. The paper seeks to promote the use of renewable energy as a solution to energy poverty and poverty in general by examining some of the benefits that access to renewable energy can offer towards the development of rural communities in Zimbabwe. This is a qualitative research providing a clear picture of the various economic, social and political development effects to society as well as environmental sustainability issues as well as Challenges faced by rural communities in Zimbabwe in adopting renewable energy technologies. Recommendations to these problems are also part of the research
Southern African Development Community's preparedness to deal with terrorism and extremist: The case of Zimbabwe 2008-2016
No full textThe study is an investigation on the concern by some section of the Western European
social commentators that sub-Sahara, including Zimbabwe, offers a conducive environment
for terrorists’ safe haven’. Further complicating this predicament is these accusers, allege
that region’s security sector, does not have an effective counter-terrorist strategy. In fact,
their conclusion was that African Union’s (AU) counter-terrorism policy is not working. It
is on this background that the enquiry was interested in establishing Zimbabwe’s prepared
to combat the threat of terrorism and extremism.
An understanding of the concept of terrorism, albeit the failure by historians on terrorism to
come up with a standard definition, was identified by many authors, falling mainly into what
they termed ‘sub-state terrorism’ which is divided into five categories: (a) social
revolutionary terrorism, (b) right-wing terrorism, (c) nationalist-separatist terrorism, (d)
religious extremist terrorism, and (e) single-issue terrorism. According to the proponents of
sub-state terrorism, each type tends to be associated with its own social-psychological
dynamics.
Regarding the objectives of the study, the enquiry was to: (a) analyse the international
counter-terrorism legal instruments, African Union’s Counter-Terrorism Strategy, and that
of SADC; (b) determine the level of extremist/terrorist threat facing SADC countries vis-Ã vis
the region’s capacity to effectively respond to such threats; and lastly (c) establish
Zimbabwe’s preparedness to counter terrorism and extremism.
The AU’s guiding policy framework on counter-terrorism was established to be the Algiers
Convention on the Prevention and Combating of Terrorism, 1999, which the majority of the
African states ratified. The threat of terrorism and extremism besides being a destabilising
factor in the Equator regions of Africa namely; Western, Sahel/Maghreb, and Eastern
regions, similar threat developments have been reported in the SADC region especially
Zambia and South Africa where the Muslim jihad-led terrorism is instigated by al-Qaeda
and al-Shabaab terrorism gangs.
Zimbabwe, together with the rest of the member states of SADC, are reported to have
sought to fight all facets of terrorism through regional cooperation. The regional body has
thus identified the international dimensions of terrorist being the ones among others, which
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range from terrorist recruitment and training, financing, and operations that include sleeper
cells operatives and human traffickers. As a result, the region’s combat posture necessitated
the formation of regional statutory bodies like; Migration Dialogue for Southern Africa
(MIDSA), Inter-state Defence and Security Committee (ISDSC), Inter-state Politics and
Diplomacy Committee (ISPDC), Ministerial Committee Organisation (MCO) and the
Committee of Intelligence and Security Services for Africa (CISSA) Southern Region
among a host of other counter combat initiatives which Zimbabwe is a member.
Regarding Zimbabwe’s preparedness in terms of institutional and legal frameworks, it was
established that the country has since enacted laws that help curb the threat of terrorism and
extremism-related activities. The laws are; Foreign Subversive Organisations Act Chapter
11: 05, Emergency Powers Act, Unlawful Organisation Act Chapter 11: 13 (1980), and ‘the
Post and Telecommunication Services Act Chapter 12:02 (1988), mentioning these few. The
study also established that the SADC Harmonised Regional Strategy to curb extremism and
terrorism emanating from the illegal migration, smuggling of migrants and trafficking of
persons was being mooted whose operationalisation will help Zimbabwe’s combat
readiness. Zimbabwe is established to have further shown some resolve in its fight against
the threat of terrorism and extremism, by its institutionalisation of Inter-Ministerial and
Inter-Security Services Committees. These Committees meet regularly to strategise on the
way forward to combat the alluded threat(s)
Can restorative justice be an alternative form of justice to retributive justice in the criminal justice system in Zambia? A critical analysis of Section 8 of the Criminal Procedure Code Chapter 88 of the laws of Zambia
No full textIn view of the growing prison population and the government’s inadequate budgetary funding to the Prisons Service, various options have been explored to find solutions to the problem. The study focuses specifically at the failure by most Magistrates to effectively operationalize Section 8 of the Criminal Procedure Code of Chapter 88 of the Laws of Zambia. The failure comes in the realization that the law under Section 8 of the CPC is a misdemeanor which allows for victim offender reconciliation to avoid incarceration and consider alternative sentencing options like community sentence, suspended sentence and compensation. Furthermore, although Restorative
Justice seems to be a new concept in Zambia, it has been identified worldwide as a new form of effective justice system that promotes reconciliation as opposed to Retributive Justice that increases crimes of revenge. Currently, the United Nations Basic Principles on the use of Restorative Justice are not binding on member countries. This means that any country can adopt these rules if it so wishes. This infringes on the rights of the victim who has decided to reconcile because this is not supported by any compelling law or international instrument. The writer studied samples of women (and some men) who have been victims of this law. Although several methodologies were employed, the women’s law approach which highlights various dynamics in the law that adversely affects women was instrumental. Data collected for the study include a review of the law, policy and literature on the subject and oral evidence obtained from interviews with respondents and key informants within the Criminal Justice System and a Non-Governmental Organization working with the Zambia Prisons Service on
Care and Counselling (PRISCCA) of prisoners. In essence, the study finds that: (1). Lack of effective implementation of Section 8 of the CPC by the Magistrates has defeated the spirit of the objective of this law (2). Excessive reliance on custodial sentencing as opposed to other sentencing options has contributed to high prison population and women are the most affected because they are perceived to commit minor offences. Therefore, the writer’s suggested solutions to this problem include policy and law reform that should incorporate principles of Restorative Justice in the Criminal Justice System on all minor offences in Zambia. This requires political will on the part of the government to successfully implement this.,NORA
“Just living togetherâ€: An analysis of rights and obligations of women in cohabitation when such relationships break down: A case study of Mufakose and Marimba suburbs in Harare
No full text“Just living together’ or cohabitation in Zimbabwe is a non legislated area in Zimbabwe.
Cohabitation is neither recognized as a form of marriage in Zimbabwe nor is there a specific law that protects the rights of persons in such unions, yet it is increasing and has become common There lacks adequate legal framework on how the courts should distribute property for persons in cohabitation. The silence of the law has affected women as they tend to lose out on sharing of property. Our courts have therefore resorted to general law principles such as tacit universal partnership, unjust enrichment and joint property to resolve property disputes of persons in cohabitation unions. These principles are difficult for women to prove in court which usually results in them being taken advantage of. The writer was motivated to do this study from the Second Semester’s Family Law and Social Realities course during the Masters in Women’s Law
programme 2015 -16 .She realized that in the area of family, marriage has been discussed a lot neglecting other forms of family that have emerged. The writer being a lawyer in the Ministry of Justice and Parliamentary Affairs and having worked for the department of Constitutional and Parliamentary Affairs for several years is strategically positioned to influence the alignment of marriages laws to the constitution as well as total reform of such laws. The methodological framework was informed by understanding how women are discriminated upon termination when their property rights are not protected. To investigate the lived realities of woman in cohabitation relationships, she started by interviewing women using the women’s law approach
which explore the connections between law and gender and which are sometimes hidden and identify the bias involved, her main objective being to expose the inadequacies of the current legal framework. She also employed the Grounded approach where she engaged with empirical knowledge and the data she managed to collect on women’s lived experiences on law and sharing of property disputes upon dissolution of cohabitation unions are resolved. As she incorporated her findings into the legal framework, it became apparent that the Zimbabwean legal framework is inadequate and it exposes women in cohabitation unions to discrimination as
their property rights are violated at dissolution of such unions. The sex and gender analysis also assisted her to get the masculinity voice and understand how men view cohabitation and investigate how they would want the law to regulate such unions especially when it comes to distribution of property at separation. Both men and women suffer because of this uncertainty but women suffer more. In order obtain data the writer had to use less structured in-depth interviews. Her major findings revealed that certainly there is no clear law that can be used by our courts to distribute the property of persons in cohabitation when such unions break down. It becomes a paradox when women in cohabitation are being discriminated when Zimbabwe has one of the best and modern constitutions that prohibit discrimination on the basis of marital status under section 56. Maybe it is high time we consider the scope and meaning of discrimination on the basis of marital status in Zimbabwe. Does section 56 imply that the matrimonial causes act should apply to all marriages and unions that exist in Zimbabwe? Having
done this research and in the light of other decided cases on cohabitation, it looks like we have to recognize cohabitation and protect the property rights of women in such unions, but obviously there are problems that must be anticipated in trying to operationalise this. Variety of attitudes towards cohabitation is apparently going to persist but policy makers should not fail to pay attention to the voice of increasing number of women who find themselves in cohabitation
families. The fact that women in such de facto unions have their property rights not protected under law is tantamount to discrimination. Zimbabwe is a party to many international conventions that protect women from discrimination and Zimbabwe should honor its international obligations. A constitutional challenge as was with the Mudzuru and another v Ministry of Justice Legal and Parliamentary Affairs CC12/15 case on child marriages, highlighting the paramount provisions of the constitution that provide that all persons are equal before the law and have the right to equal protection and benefit of the law, every person has a right not to be treated in an unfairly discriminatory manner on grounds marital status ,and that every person has the right to access the courts or some other tribunal or forum established by law for the resolution of any dispute, will declare that women in cohabitation unions need to be protected as well under the law just like everyone else in Zimbabwe. Test case litigation to define what is meant by discrimination on the basis of marital status would also help in determining the contemporary scope and meaning of marital status discrimination in this new
constitutional era. The writer would advocate for a wider interpretation that would not only
protect people from discrimination because they are married or unmarried, but would also protectpeople because they are in non- marital relationships.,NORA
Beyond the rhetoric: A critical analysis of the women’s access to justice in Malawi in relation to the right to equitable distribution of matrimonial property upon the dissolution of marriage
No full textThis dissertation, written by a judicial officer from Malawi, examines the women’s
right to access justice in matters concerning distribution of matrimonial property after
a judicial dissolution of a marriage. The study was provoked by many complaints and
misgivings by women over decisions by courts concerning distribution of property
after divorce. The study adopted women’s law approached to investigate the women’s lived realities with the legal system in accessing justice in matters of distribution of matrimonial property. The investigation was through case studies, interviews and focus group discussions which enabled the researcher to uncover legal and customary dynamics that influence court’s decisions and women’s approach to the courts. The study unearths that most women hardly know their rights to a fair share of matrimonial
property upon divorce. It was discovered that women have problems to come to terms
with claims of their rights in the courts. Apart from that, even where women have
been awarded a share in property there were several impediments by the judicial
system that hamper women’s enjoyment of the judgments by the court. The study
found that problems that render women unable to access the legal remedies range
from insufficient mechanisms of enforcement of the judgment, anti-women cultural
perspectives and indifferences, and evasiveness of the men who might still be in the
custody of the property. The study unearths observable traditional patriarchal tendencies of regarding some property as belonging to men at the expense of women’s rights and expectation. Therefore, much as the law provides for the rights of women to fair share in property and access to justice, some enforcement actualities obviously make women not to attain these rights in reality. There is a missing link in civic education thereby making Malawi failing to meet its international human rights obligations on the rights of
women to access justice and equitable distribution of the property. To remedy all this, the study suggests that there is need to address the mind-set of the society by incorporating gender-friendly judicial and legal processes, including provision of legal aid to women, and invoking civic education to all on the issues of rights of women, general human rights and non-discrimination. The dissertation also suggests that there should be deliberate steps to enable women access justice without many hurdles,NORA
Healing in ancient Israelite religion and Shona traditional religion: a comparative analysis
No full textHealth was an important concern in Ancient Israelite Religion; it is also a major concern in Shona Traditional Religion. This is seen in how the Ancient Israelites preserved health by observing the Mosaic Law and the sanitary code. In Shona Traditional Religion, health is preserved from conception up to adulthood. These two religions share much in common on how they perceive the causes of ill health as a punishment from disobedience. In both religions, there are important religious practitioners who play a significant role in safeguarding the health of people. The study explores why some people undermine the traditional medicine. It argues that this attitude is mainly because of Christian missionaries who undermined the Shona health delivery system. The Shona people are encouraged by the researcher to use traditional medicine which is cheaper and affordable. The Shona people are also exhorted to appreciate traditional medicine because healing was there even before the colonialists came