Committee on the Elimination of Discrimination against Women Pre-session working group – Zimbabwe 9 3.1 PROHIBITIVE HEALTH CARE COSTS Most people generally cannot afford healthcare fees in Zimbabwe. According to the 20052006 Zimbabwe Demographic and Health Survey, some 58 per cent of Zimbabwean women were unable to access healthcare because they did not have money to pay for treatment.9 Lack of access to healthcare, because of an inability to raise funds for treatment, rises to 75 per cent for women in the lowest of five wealth groups, the group to which women living at Hopley and other Operation Garikai settlements are likely to belong.10 Most pregnant women and girls at Hopley are deprived of the benefits of antenatal care because they cannot afford the fees charged. The nearest maternity clinic, run by the Harare city council, charges USD 30 to register for both antenatal care and delivery. Before December 2010 the council was charging USD 50. The reduction was a positive step towards broadening the accessibility of maternal health care. However, for many women the USD 30 fee is still prohibitive because of the destruction of livelihoods which took place during Operation Murambatsvina and the continued targeting of informal markets by police. At present the formal unemployment figure in Zimbabwe stands at over eighty per cent and the community at Hopley are reliant on food aid. The inability to afford antenatal fees forces pregnant women and girls at Hopley to delay seeking care, quite often until they are in labour or experiencing complications, increasing the risk of death or damage to health. Antenatal care can help to reduce maternal and neonatal mortality by alerting women and their families to symptoms that signal medical care is urgently needed. Antenatal care also serves numerous other critical functions; for example, it can help to ensure the prevention of HIV transmission from mother to child. The inadequate access to antenatal care services in Hopley contributes to the risk of preventable death and ill-health for women and newborns. Several of the women interviewed by Amnesty International gave birth on their own, in conditions which may have put both the lives of the woman and the baby at risk. Some of the women were unaware at the time of delivery that they were carrying twins and suffered complications, including breech deliveries, and the babies died. Zimbabwe’s Deputy Prime Minister Thokozani Khupe who is also the Chair of the Parliamentary Cluster on Social Services, visited Hopley settlement in December 2010, a week after Amnesty published its findings on neonatal mortality at the settlement and in response to lobbying by Amnesty International. During the visit the Deputy Prime Minister made a public commitment to the community to scrap the registration fee for maternal health care. However, this is yet to be implemented. 3.2 DIFFICULTIES IN ACCESSING HEALTH CARE FACILITIES: SAFETY AND TRANSPORT In order to access maternal health services women at Hopley travel to a municipal maternity 9 Central Statistical Office (CSO) [Zimbabwe] and Macro International Inc. March 2007. Zimbabwe Demographic and Health Survey 2005-06. Calverton, Maryland: CSO and Macro International Inc, p. 133, accessible at: http://www.measuredhs.com/pubs/pdf/FR186/FR186.pdf 10 Ibid. Index: AFR 46/014/2011 Amnesty International June 2011