This two-year project was carried out in Tanzania’s Bunda and Tarime Districts. It was designed to address the leading causes of maternal and newborn mortality and to demonstrate the feasibility and cost-effectiveness of implementing a distribution system of safe birth kits to pregnant women.
Why this project is important
Globally, nearly 300,000 women died during pregnancy or childbirth in 2012. With one of the world’s highest rates of maternal and child mortality, Tanzania is at the centre of this international health challenge. It is one of ten countries in Sub-Saharan Africa that, combined, account for over 60 per cent of maternal and newborn deaths.
Death from childbirth is one of the greatest challenges facing African women today, particularly in rural communities. Women who deliver outside of a health care institution are most at risk as they do not have access to life-saving medications or skilled attendants. As a consequence, it is estimated that 454 women per 100,000 (2010) in Tanzania die during childbirth, and nearly 50,000 Tanzanian babies are stillborn, almost half of them dying during childbirth. The leading causes of maternal and newborn mortality in Tanzania’s Mara Region are post-partum haemorrhage (35 per cent) and infections (15 per cent).
The death of mothers has a catastrophic impact on families, and is directly related to neonatal and childhood deaths because the absence of a mother compromises the care of infants and children.
Improved Maternal and Newborn Health Services with an Enhanced Role for Community Health Workers:
Through the Saving Mothers Project, 118 Community Health Workers (CHWs) and 42 Dispensary Nurses participated in specialized Maternal, Newborn and Child Health training. Topics included the care of pregnant women, safe delivery, identification of potential high-risk pregnancies and recognizing “danger signs”, pre- and post-natal nutrition, ante-natal and post-natal care, community integrated management of childhood illness, HIV and how to prevent vertical transmission of the virus, and human rights.
One of the most important roles of CHWs is to encourage women to visit health facilities and avail themselves of the full range of pre- and post-natal medical care available and, whenever possible, to have their baby delivered at a health facility.
- Increased the Availability of Subsidized Clean Delivery Kits that contain Misoprostol:
Though women are encouraged to give birth at a health factility, the reality is that in the Mara Region as many as 60 per cent of births take place in the home with the assistance of a family member or a traditional birth attendant.
Providing free or subsidized clean delivery kits to pregnant women is an effective way to reduce sepsis (infections) that can affect both the mother and the newborn. The birth kits’ instructions stress the importance of hygiene and sanitation throughout the birthing process and they contain Misoprostol, a World Health Organization (WHO) endorsed anti-haemorrhage drug.
- Enhanced real-time data collection using mobile tools
Community Health Workers and dispensary staff were trained on mobile technology that is now being used to collect data on pregnant women in their communities. This includes tracking the number of pregnant women, ante-natal and post-natal care visits, and expected due dates to help monitor and coordinate the treatments provided to women. The mobile technology also helps ensure there is a ready supply of clean delivery kits available for every woman who needs one.
During the project’s two years of implementation, CPAR has helped:
- Support over 3,000 women access antenatal and post-natal care.
- Distribute 1,800 Safe-Birth kits.
- Train 118 community health workers on safe birthing practices, identifying high-risk pregnancies and labour, and the importance of post-natal care.
- Safely deliver over 2,500 babies.
- Provide 160 mobile phones to community health workers and nurses. This has allowed them to alert local health clinics and hospitals about pregnant women, their expected delivery date and any risks associated with the pregnancy, ensuring that these women are provided with the care they need to deliver a healthy baby.