Improving mother and child health
Project description
Title: Improving mother and child health
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Country: Tanzania
Lead executing agency: Ministry of Health, Community Development, Gender, Elderly and Children
Overall term: 2015 to 2017
Context
Tanzania has made significant progress towards improving child and, to a lesser extent, maternal health. Despite significant progresses, neonatal and maternal mortality rates remain unacceptably high by international standards. This is primarily due to severe deficits in obstetric care. Many positions as health care provider are lying vacant, especially in rural areas, and health personnel are poorly trained. Insufficient technical expertise and management skills in the health sector, inefficient budget planning and the absence of civil society involvement, particularly of women and girls, all contribute to the inadequate obstetric care. Consequently, pregnant women have no confidence in the quality of care and make little use of the obstetric health services.
Objective
The overwhelmingly poor and disadvantaged women and girls in the regions of Lindi and Mtwara make use of the improved obstetric services.
Approach
The project focuses on improving obstetric services in 208 selected health facilities in the regions of Mtwara and Lindi. It works in the following areas:
- Strengthening the human resources and institutional capacities for maternal and newborn obstetric care. These activities are carried out in close cooperation with KfW Development Bank and with contributions from other partners such as Voluntary Service Overseas (VSO) and Elizabeth Glaser Pediatric AIDS Foundation (EGPAF).
- Improving the availability of operational medical equipment for obstetric services, with advisory services provided by EPOS Consulting.
Around 55,000 women become pregnant each year in Mtwara and Lindi. Most of them belong to the poorer sections of the population and are particularly disadvantaged when it comes to their socio-cultural status, political participation and opportunities for personal development. Improved quality of obstetric services is essential for convincing the women to give birth in health facilities, where they will benefit from emergency care in the event of complications.
An institutionalised quality improvement system provides an example of how the programme promotes the improvement of health care in decentralized facilities: a quality improvement team monitors obstetric care using evidence-based quality management instruments making it possible to learn from mistakes.
Results
The staff of 213 selected health facilities have received training. Management and advanced training courses have been conducted in areas such as neonatal treatment, obstetric anaesthesia, blood products’ use and on quality management of neonatal wards and delivery rooms, as well as on auditing of deaths.
Monthly mentoring visits have regularly taken place in six hospitals equipped with specialised neonatal wards. During these visits, the health personnel have received on-the-job training comprising practical exercises and case discussions. The percentage of health facilities with staff trained to deliver basic and emergency obstetric care in line with national standards has already increased significantly in both Lindi and Mtwara thanks to the measures implemented to date.
A baseline data survey conducted in all 213 health facilities showed that only 18 per cent had the medical equipment needed for basic and emergency obstetric care. Based on the data, a procurement plan was drawn up. Financing of the equipment is being provided by the partner, KfW Development Bank and to a limited extent by the programme.