Quality of care for mothers and babies in Tanzania

Photo Credit: FELM organization, Tanzania, 2012. Courtesy of Photoshare

Tanzania is making progress in reducing maternal and newborn mortality through improvements in the healthcare provided. However, the number of women and babies dying during and immediately after delivery is unacceptably high, as is the unmet need for emergency obstetric and newborn care.

Through this programme, the Centre for Maternal and Newborn Health (CMNH) will use the EmOC&NC “Skills and Drills” package to develop the capacity of existing healthcare providers to recognize and effectively manage women and babies requiring EmOC&NC. We will also revitalise quality of care in selected facilities where Quality Improvement teams will be put in place or strengthened/reactivated.

This programme will be implemented in collaboration with the Ministry of Health Community Development Gender Elderly and Children (MOHCDGEC) and UNICEF in Mbeya, Njombe and Songwe regions of Tanzania.

Activities
Under this programme, CMNH will:

  • Train 300 maternity staff in emergency obstetric and newborn care skills
  • Train 130 facility staff on quality improvement approaches
  • Train district and regional reproductive and child health coordinators in supportive supervision
  • Map out target facilities to assess whether QI committees are in place and functional, and to review their roles and performance. QI Committees have been established in facilities where unavailable and revitalised where already available.

Outcomes to date
All targets for the programme have been achieved. Staff from CMNH have made visits to the 44 target facilities every month for 12 months. Using a checklist for obstetric and newborn care key skills (developed by CMNH), they conducted skills assessment, identified gaps and provided refresher training in EmOC&NC. On average, this was delivered to 60 healthcare providers every month.

Participants found the monthly visits for mentoring and supportive supervision to be very helpful. They also found the quality improvement approaches very useful; this included a structured way of reviewing both maternal and perinatal deaths with members from every department in the facility taking part in the process. 

Data collection was carried out at 3, 6, 9 and 12 months after the initial EmOC&NC training was provided, to monitor availability of signal functions for maternal and newborn care. Data analysis is in progress and dissemination will be completed before end of 2018.

At the end of the programme, CMNH handed over a full EmOC&NC training set to two health Midwifery training institutions.

Related programmes
Between 2012-2015, CMNH implemented the ‘Making it Happen’ programme in Tanzania in the Kagera and Pwani regions. The two regions had relatively bad health indicators. Through this programme, a reduction in still birth and an improvement in data collection and use in the target facilities was observed.