30/09/2026
MIDWIVES AND CHOLERA: PROTECTING MOTHERS, NEWBORNS AND CHILDREN
A call for vigilance, early detection and timely action during the 2026 cholera outbreak
Zambia is currently responding to a new cholera outbreak, with the Ministry of Health reporting 304 cases across seven districts in five provinces as of 29 September 2026. Of these, 62 cases have been laboratory confirmed, 35 patients were receiving treatment, 230 had been discharged, and 11 people had died. Importantly, eight of the deaths occurred in the community, highlighting the danger of delayed care-seeking. The affected districts are Lusaka, Chilanga and Chongwe in Lusaka Province; Chibombo in Central Province; Chiengi in Luapula; Nsama in Northern; and Chikankata in Southern Province.
Lusaka and Chibombo are currently reporting the largest number of cases, with 130 cases reported in Lusaka and 109 in Chibombo. The Ministry has particularly identified the Mwanjuni Health Facility catchment area around 10 Miles in Chibombo as an area of concern.
For midwives, these figures are more than statistics. They are a reminder that pregnant women, breastfeeding mothers, newborns and children may present to maternity, ANC, PNC, child-health and community services during an outbreak.
🩺 MIDWIVES: BE ALERT FOR CHOLERA
Midwives should maintain a high index of suspicion when a woman or child presents with:
Sudden-onset profuse watery diarrhoea.
Vomiting, particularly together with diarrhoea.
Excessive thirst.
Weakness, lethargy or dizziness.
Sunken eyes or dry mouth.
Reduced urine output.
Signs of severe dehydration or shock.
In children, inability to drink or breastfeed, unusual sleepiness, irritability or reduced urination.
Do not wait for laboratory confirmation before responding to signs of severe dehydration. Rapid assessment, rehydration and referral can save lives.
🤰 PREGNANT WOMEN REQUIRE PARTICULAR ATTENTION
Pregnancy does not protect a woman from cholera. Severe diarrhoea and dehydration can rapidly compromise maternal wellbeing and may also affect fetal wellbeing.
Midwives should:
Assess dehydration immediately.
Initiate appropriate rehydration according to the current national cholera management protocol.
Monitor vital signs and urine output.
Assess fetal wellbeing according to gestational age and available resources.
Continue essential antenatal and obstetric care.
Refer urgently when severe dehydration, shock, persistent vomiting or obstetric complications are present.
Apply appropriate infection prevention and control measures.
A pregnant woman with profuse watery diarrhoea should be treated as a priority for assessment and appropriate management.
🤱 BREASTFEEDING MOTHERS: DO NOT STOP BREASTFEEDING
Breastfeeding should generally continue during cholera illness.
Midwives should encourage mothers to:
Continue breastfeeding frequently.
Take safe fluids and oral rehydration solution as advised.
Seek treatment immediately if diarrhoea develops.
Practise thorough hand hygiene before caring for the baby.
Use only safe water for drinking, preparing ORS and cleaning.
Follow the treatment and referral instructions provided by health workers.
Stopping breastfeeding unnecessarily can place the infant at additional risk.
👶 NEWBORNS AND CHILDREN
Children can become severely dehydrated quickly. Midwives should therefore assess every child with acute diarrhoea promptly.
Pay particular attention to:
Ability to drink or breastfeed.
Level of consciousness and general condition.
Sunken eyes and other signs of dehydration.
Urine output.
Persistent vomiting.
Weakness or lethargy.
Rapid deterioration.
Children showing severe dehydration or other danger signs require urgent treatment and referral.
🧼 INFECTION PREVENTION STARTS WITH THE MIDWIFE
Maternity and child-health areas must remain safe environments during the outbreak.
Midwives should reinforce:
Safe water • Hand hygiene • Safe sanitation • Environmental cleaning • Safe food • Appropriate disinfection
Handwashing with soap and safe water is particularly important:
Before preparing food or feeding a child.
Before breastfeeding or handling expressed breast milk.
Before and after patient contact.
After using the toilet.
After cleaning a child who has defecated.
After contact with vomit or faeces.
Ensure that contaminated materials, linen, equipment and surfaces are handled and disinfected according to facility infection-prevention protocols.
🚨 MIDWIVES ARE PART OF THE EARLY-WARNING SYSTEM
The Ministry of Health has highlighted that eight of the 11 reported deaths occurred in the community. This is an important warning about delayed recognition and delayed care-seeking.
Midwives can help change this situation.
During ANC, PNC, immunisation, child-health services, maternity care and community outreach, use every opportunity to educate families about the danger signs of cholera and the importance of seeking care early.
Families should know:
Profuse watery diarrhoea + vomiting + dehydration = ACT EARLY.
Begin oral rehydration as appropriate using safe water and the correct ORS preparation, while arranging prompt assessment at an oral rehydration point or health facility.
💙 A MESSAGE TO ZAMBIA'S MIDWIVES
Cholera is preventable and treatable. The Ministry of Health reports that the facility case-fatality ratio is 0.98%, while the number of community deaths demonstrates why early recognition and treatment remain critical.
As midwives, we have a unique opportunity to protect two generations at once: the mother and her baby.
Let us remain vigilant in every ANC room, maternity ward, postnatal ward, newborn corner, child-health clinic and community.
RECOGNISE EARLY. REHYDRATE EARLY. REFER EARLY. PREVENT TRANSMISSION.
Every mother. Every newborn. Every child. Every time.
Source: Ministry of Health, “Update on Cholera Outbreak in the Country,” presented by the Acting Minister of Health, Hon. Dr. Gilbert Siame, 30 September 2026.
Ministry of Health Zambia
