The Women Filling Rural Zimbabwe’s Maternal Care Gap

Outside Zimbabwe’s capital, women known as traditional birth attendants have helped deliver more than 50,000 babies, stepping in when the health system fails to support pregnant teens.

Credit: Minority Africa

This story was co-published with Minority Africa.

In the dusty streets of Epworth, a densely populated settlement just east of Harare, Zimbabwe, a group of women who are neither nurses, doctors, nor midwives are often the only hope for exiled teen mothers such as Rutendo Ndaba*. Known as Women in Action Traditional Birth Attendants, this community group has stepped in where the formal health system has closed its doors.

Ndaba first encountered them in 2023, just after feeling as though her world had collapsed: At just 15, she had left her rural home in Honde Valley, hundreds of kilometers away to seek opportunity in the city, only to find herself pregnant, abandoned by her boyfriend, and disowned by her family. With no money to pay the $25 antenatal care fee charged in public clinics — a cost that can be double in private institutions — she faced pregnancy in isolation. That is, until she met Rumbidzai Nyakudanga, a second-generation birth attendant who listened, comforted, housed and eventually guided her through safe motherhood.

Since its founding in 2003, Women in Action told More to Her Story it has assisted more than 50,000 childbirths in Epworth. In 2022, the group began keeping separate records of teenage mothers and, in just three years, they have supported at least 70 girls like Ndaba. 

Their work is rooted in the ethics of the Ubuntu community, which emphasizes collective responsibility, dignity, and care beyond the purely medical. The TBAs primarily handle home deliveries in emergency cases, especially for women who can’t afford the steep antenatal booking fees. But their role doesn’t end there: soon after delivery, they accompany mothers and newborns to nearby facilities for postnatal attention and even help arrange housing for new mothers if needed, bridging a critical gap in Zimbabwe’s overstretched maternal health system.

Their efforts come at a time when the country faces an urgent crisis. Zimbabwe’s teenage pregnancy rate currently stands at 24 percent, according to a 2025 UNFPA report. Across Sub-Saharan Africa, more than six million girls are out of school due to early pregnancy and parenting, and about 21.6 million girls give birth unattended yearly, UNICEF notes. 

In Zimbabwe, where stigma and high costs push young mothers away from formal healthcare, the work of traditional birth attendants are silently changing the narrative for rejected and abandoned pregnant girls.

“We believe no woman deserves to suffer; we should help each other in all aspects regardless of background and that support can make a difference in someone's life,” Nyakudanga told More to Her Story.

Ndaba’s survival story is set against an increasingly bleak backdrop: Zimbabwe’s sexual and reproductive health services remain chronically underfunded, pushing many girls into unintended pregnancies and unsafe births. In April, the Zimbabwe Coalition on Debt and Development warned that crumbling infrastructure, medication shortages, and severe staff deficits in public clinics have deepened the crisis nationwide. The consequences are dire: the country has documented 212 maternal deaths per 100,000 live births, with adolescents and young women making up a quarter of those deaths.

“Teenage pregnancies come with a package of problems, which include stillbirth and even death of the mother due to hypertension or eclampsia as their bodies are not mature enough to carry a baby,” said Themba Sibanda, Vice Secretary for Zimbabwe Confederation of Midwives (ZICOM). Sibanda argues that proper medical training and equipping TBAs with the proper tools could prevent many of these avoidable deaths. But with about 10 percent of Zimbabwe’s national budget going to health, which falls short of the Abuja Declaration's recommended 15 percent, the resources for such programs remain scarce.

Calls to integrate TBAs into the formal health sector are growing louder. “Rather than sidelining TBAs, [the] government should focus on integrating them into the health system through targeted training and certification,” said Dr. Thokozani Khupe, Chairperson of Parliament’s Health and Child Care Committee. “This would allow them to work alongside skilled birth attendants, bridging cultural gaps, fostering trust, and ensuring no woman is forced to choose between dignity and safety.”

Some steps have already been taken. Since the 1980s, the Zinatha National Traditional Healers Association has run six-month certification programs in pre- and post-natal care, while groups like St John Association Zimbabwe have trained TBAs in safe delivery practices.

“We no longer use bare hands or tie umbilical cords with thread,” Nyakudanga told More to Her Story. “Now we keep gloves and cord clamps. We’ve also learned to recognize danger signs like preeclampsia or diabetes and refer women quickly.”

Advocates say more investment could transform their reach. “With proper training, TBAs can share accurate sexual and reproductive health information, provide safe maternal care, and refer young mothers to health facilities,” said women’s health advocate Rumbidzai Yasini. “Supporting their work through training, integration, and community sensitization can greatly amplify their impact.”

*Names have been changed to protect identities.