Accessing Safe Deliveries in Tanzania (IMCHA)
Programs and partnerships
Lead institution(s)
Summary
This project aims to address Tanzania's critical need for reducing maternal and newborn deaths.Read more
This project aims to address Tanzania's critical need for reducing maternal and newborn deaths. It will build on the country's comprehensive emergency obstetrical and newborn care strategy by implementing proven intervention strategies: training on emergency obstetrical care and post-training mentorship and support.
Maternal and newborn mortality in Tanzania
Tanzania has placed a priority on improving access to obstetrical and neonatal care in health facilities. This is currently a major barrier to reducing deaths. Few healthcare workers are trained to offer emergency obstetrical care, so timely access to services for safe birthing is a challenge. There is also insufficient support and mentorship from senior staff, lack of motivation to participate in training courses, and limited equipment to support obstetrical interventions.
To reduce some of these gaps, associate clinicians, midwives, and nurses need training and skills upgrading. This will help meet the demand for life-saving emergency obstetrical procedures for mothers and their newborns. This promising training approach is often referred to as task shifting and forms part of the Tanzanian Ministry of Health's comprehensive emergency obstetrical and newborn care strategy.
Toward improved health on a national scale
The project will rank barriers and highlight factors that support a national scale-up process. With better access to skilled care and emergency services, the project aims to improve maternal and newborn health outcomes throughout Tanzania. It will also identify and improve activities that increase community members' access to comprehensive care.
The project team will publish evidence on the effectiveness of the comprehensive emergency obstetrical and newborn care training program as it relates to health service delivery and health outcomes. Researchers will submit policy briefs to government officials and use a Web-based reporting tool to share lessons learned. They will organize training workshops to enhance collaboration among researchers and decision-makers.
Project partners
This project is part of the Innovating for Maternal and Child Health in Africa program. The program is a seven-year $36 million initiative funded by Foreign Affairs, Trade and Development Canada (DFATD), Canada's International Development Research Centre (IDRC), and the Canadian Institutes of Health Research (CIHR).
Research outputs
Access full library of outputs Opens in new tab
One of the key strategies to reducing maternal mortality is provision of emergency obstetric care services. This paper describes the results of improving availability of, and access to emergency obstetric care services in underserved rural Tanzania using associate clinicians. A prospective cohort study of emergency obstetric care was implemented in seven health centres in Morogoro region, Tanzania from July 2016 to June 2019. In early 2016, forty-two associate clinicians from five health centres were trained in teams for three months in emergency obstetric care, newborn care and anaesthesia. Two health centres were unexposed to the intervention and served as controls. Following training, virtual teleconsultation, quarterly on-site supportive supervision and continuous mentorship were implemented to reinforce skills and knowledge. When emergency obstetric care services are made available the proportion of obstetric complications treated in the facilities increases. However, the effort to scale up emergency obstetric care services in underserved rural areas should be accompanied by strategies to reinforce skills and the referral system.
The article reviews a training programme/workshops dedicated to increasing knowledge through “training of trainers” in childbirth education. There has been a push to improve the ability of healthcare providers in low resource areas where the majority of neonatal deaths occur. The Helping Babies Survive (HBS) suite of programs are intensive, structured courses over 1-3 days, developed by the American Academy of Pediatrics and its partners. HBS consists of Helping Babies Breathe (HBB), Essential Care for Every Baby (ECEB) and Essential Care for Small Babies (ECSB). The HBS training improved the knowledge of healthcare providers. However, knowledge of breastfeeding was inadequate or limited.
