Mama na Mtoto: Barriers and enablers to gender, equity and scale-up in Tanzania (IMCHA)
In Tanzania, a project popularly known as “MamaToto” (mother-baby) is building local capacity to improve maternal, newborn, and child health (MNCH). It is testing a comprehensive MNCH package that builds on district-led implementation, evidence, and best practices from similar efforts in Uganda. It aims to reduce maternal and child mortality by increasing deliveries by skilled birth attendants, increasing antenatal and postnatal care attendance, developing an implementation model for MNCH districts, and establishing strategies for future scale-up in Tanzania, targeting the most vulnerable populations.
However, as this project demonstrates, barriers to scaling up population-based MNCH life-saving interventions must be removed to reduce maternal and child deaths and morbidity — including engaging men and community stakeholders. In the Misungwi district of Tanzania, where the project is being implemented, only 13% of pregnant women attended antenatal care in the first trimester and only 47% had four or more of the minimum recommended visits. Contraceptive prevalence rate is 17% and unmet need for family planning is 27%.
This project, a partnership between two Tanzanian institutions, the Catholic University of Health and Allied Sciences and the Mbarara University of Science and Technology, will enhance local capacity for qualitative research design, delivery, analysis, synthesis, and knowledge translation (moving from theory to practice). It aims to increase understanding of opportunities to foster male/adolescent/vulnerable population involvement, hence increasing access to antenatal care, delivery, and post-natal care. More generally, it will increase understanding of what factors encourage and discourage the scale-up beyond project-funded districts, based on similar experiences with MamaToto in Uganda. Finally, it provides opportunities for East African researchers working in a South-South partnership.
Qualitative methodology using focus groups and key informant interviews will be used to gather information on potential barriers and enablers to address current implementation gaps. Stakeholders and end users will be engaged throughout the research cycle using an integrated approach to translating this knowledge into action. Early input of research priorities will be sought through meetings with district health teams and district and national policymakers in the Ministry of Health.
This project is funded by the Innovating for Maternal and Child Health in Africa program. It is a seven-year $36 million initiative funded by Global Affairs Canada, IDRC, and the Canadian Institutes of Health Research.
Project ID
108547
Project Status
Completed
End Date
Duration
36 months
IDRC Officer
Sana Naffa
Total Funding
CA$ 480,730.00
Location
Tanzania
Institution Country
Uganda
Project Leader
Jerome Kabakyenga
Institution
Mbarara University of Science and Technology
Institution Website
Institution Country
Tanzania
Project Leader
MD Dr. Dismas Matovelo
Institution
Catholic University of Health and Allied Sciences
Institution Website
Outputs
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Context matters in understanding the vulnerability of women : perspectives from southwestern Uganda Article
The study examined healthcare utilization experiences of vulnerable women in relation to maternal newborn and child health (MNCH) services in rural southwestern Uganda. Findings show that traditional criteria of vulnerability were insufficient to identify categories of vulnerable women to properly target MNCH programming and service provision in resource-limited settings. The community’s own definitions of ‘vulnerable’ were more nuanced and context specific. Communities felt these categories could be recognized within their settings. Community members could identify who was vulnerable and who was not, based on their context. Author(s): Murembe, Neema, Kyomuhangi, Teddy, Manalili, Kimberly, Beinempaka, Florence, Nakazibwe, Primrose Language: English |
Adolescents in rural Tanzania : a qualitative study Article
Pregnant adolescents (ages 10-19) seeking antenatal services are compromised by a complex power imbalance that involves financial dependence, lack of choice, lack of personal autonomy in decision making, experiences of social stigma, judgement, violence and abuse. The study analyzed experiences of pregnant adolescents in accessing antenatal care in Misungwi district, Mwanza Region, Tanzania. Low and middle-income countries, including Tanzania, bear the largest proportion of adolescent perinatal deaths globally. Most adolescent girls in Tanzania do not access antenatal care at health facilities. Multi-level interventions are needed to empower adolescent girls, and to address policies and social constructs that may contribute to power imbalances. Author(s): Mweteni, Wemaeli, Kabirigi, Julieth, Matovelo, Dismas, Laisser, Rose, Yohani, Victoria Language: English |
Barriers to receiving the recommended standard care during pregnancy by illiterate women in rural, Northern Tanzania Article
Three key themes emerged from this research in relation to health care access by illiterate women who were pregnant: 1) they could not read their health care cards or public health messaging; 2) they spoke the local language, not Swahili, the language of care providers; 3) they endeavour to develop coping strategies to overcome these obstacles. Additionally, health care workers were unaware of those who are illiterate. This study explores the experiences related to care-seeking by illiterate, pregnant women in rural Tanzania. In 2017, 810 women died every day from pregnancy or childbirth related complications, most commonly in rural areas in low- and middle-income countries. Author(s): Matovelo, Dismas, Ndaki, Pendo, Yohani, Victoria, Laisser, Rose, Bakalemwa, Respicious Language: English |
Men perspectives on attending antenatal care visits with their pregnant partners in Misungwi district, rural Tanzania : a qualitative study Article
Cultural norms and socio-economics influence a pregnant woman’s access to health services and where delivery occurs. In African culture males are often the key family decision makers, including decisions related to whether, when and where a pregnant woman should begin antenatal care (ANC). This article describes the details of the study and traditional beliefs that are illuminated by interviews with pregnant women’s partners. Shame and discomfort were reported by men owing to being surrounded by women while waiting at the facility. Males’ perspectives of escorting their partners can be viewed as being dominated (“whipped”). Author(s): Boniphace, Maendeleo, Matovelo, Dismas, Laisser, Rose, Swai, Hadija, Yohani, Victoria, Tinka, Sylvia, Mwaikasu, Lusako, Mercader, Hannah, Brenner, Jennifer L., Mitchell, Jennifer Language: English |