By Dayo Yussuf
This year's Labour Day in Tanzania was not just a routine May 1 celebration of working-class solidarity. It was a significant milestone in the country's journey towards improving maternity benefits, marked by the government's in-principle acceptance of a proposal to grant additional leave to mothers with preterm babies.
The long-awaited announcement by the country's Vice President, Dr Philip Mpango, was met with a wave of relief and joy from activists and trade and workers' unions, underscoring its impact on employees countrywide.
An even more heartening feature of the development was the government's acknowledgement of the difficulties that parents with premature babies face, and for which they might need extra support.
Preterm babies are placed under special care in intensive care units for round-the-clock monitoring by specialists until they are stable enough to either go home or be released to the general ward.
This can take weeks or sometimes months, and most employment terms do not include extra maternity leave for such situations.
"I would like to emphasise that maternity leave is one of the rights of employees, and is provided for a period of 84 days to someone who gives birth to one child, and 100 days if she gives birth to more than one child," Dr Mpango said in a Labour Day statement to workers.
"If an employee gives birth to a child or children who are premature, the mother’s leave will not commence until the doctors are fully satisfied with the child's health. We are amending the Employment and Work Relations Act to clearly state that maternity leave commences once a premature child has completed the special care period, as confirmed by doctors."
Cause close to her heart
Doris Mollel, an activist involved in the campaign for special additional leave for mothers caring for premature babies, knows firsthand what it means for such parents to get some leeway as they experience the pangs of realisation and acceptance. She, too, was born premature, forging a deep connection with the cause.
"We have been fighting a very long time for this," Doris tells TRT Afrika. "We are happy that we have moved on from the activism stage, and the ball is now in the government's court to pass this law for the sake of the premature babies and their parents."
Existing maternity laws do not consider premature babies, so parents are often forced to deal with the trauma and difficulties alone. Sometimes, they must choose between their jobs and caring for their babies.
"It is sad that even in the definition of a newborn, the law does not count a preterm baby as one. That is where the change needs to begin so that mothers giving birth before term can be considered for special-case welfare," says Doris.
Complexities of childbirth
The medical definition of a preterm baby is one born before completing 37 weeks of gestation.
The closest to term, between 34 to 36 weeks, are called "late preterm" and may be less at risk of complications after birth. Those born between 25 to 34 weeks are considered slightly more fragile and termed either "moderately preterm" or "very preterm".
The most high-risk babies are the ones born below 25 weeks, medically considered "extremely preterm".
A typical full-term pregnancy lasts about 40 weeks. Premature babies often have underdeveloped organs and may face health challenges that require special medical attention.
"You do not plan to give birth prematurely. The baby comes accidentally. So, for such women, the normal three months of maternity leave is used up while still in hospital. Some would stay in hospital for three, four or even six months," explains Doris.
"A mother who has a normal birth can go home the next day, and she gets her three months of maternity leave. It is not the same for a premature birth."
The biggest challenge with premature babies is handling the medical complications that invariably follow.
The most common ones are developmental challenges, including respiratory problems due to immature lungs, feeding difficulty because of underdeveloped sucking and swallowing reflexes or digestive systems, struggle to maintain body heat, infections due to weaker immune systems, and potential for developmental delays or cerebral palsy.
Safety net for employees
Trade unions say that the new maternity leave arrangement, once implemented, would go a long way in securing parents' jobs.
"Babies at full term usually weigh 2-5kg or above. Premature babies are 1.5kg or less than that. So, the mother must bring the baby back to the hospital or be admitted with the child until the weight increases. Sometimes, these parents are forced to take unpaid leave, and they get fired from their jobs," Doris tells TRT Afrika.
According to the World Health Organisation (WHO), out of every ten babies, one is born premature. Every 40 seconds, one of such children dies.
The report includes updated estimates from WHO and UNICEF on the prevalence of preterm babies, prepared by the London School of Hygiene and Tropical Medicine.
Overall, it finds that preterm birth rates have not changed in any region of the world over the past decade, and 152 million at-risk babies were born prematurely from 2010 to 2020
Premature birth is the leading cause of child mortality, accounting for more than one in five child deaths before the age of five.
The proposed Tanzanian bill is now awaiting parliamentary reading and approval for implementation.
The good news is that President Samia Suluhu Hassan has expressed her support for it, so the bill's passage is likely to be expedited.
Other proposed changes in the bill include half-day work for parents with premature babies for a period of six months upon returning to work after completing their maternity leave and a paternity leave extension to seven to 14 days from the current three days provided in employment terms.
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