1. Improving Access to Health Services and Quality of Care for Mothers and Children in Tanzania

This project is implemented by the Dar es Salaam University Institute of Development Studies in collaboration with HealthBridge Foundation in Canada and the Iringa Region Health Department in Tanzania.

In the Iringa region of Tanzania, only one of every four to six women has access to early antenatal care. In order to reduce maternal mortality, it is essential to understand and address the barriers that women face in accessing essential health services. Common barriers identified by women as limiting care early in pregnancy include the cost of health care, long distance to health care services and cultural factors.

This project uses Participatory Action Research to address  barriers preventing access to maternal and child health services at community level. Women, men and other key stakeholders are actively engaged in defining challenges and establishing locally adapted solutions. Interventions also include strengthening local health management committees and sensitizing health providers to provide respectful services to women and children.

2. Replicating the MamaToto Program in Rural Tanzania

This project is implemented by Catholic University of Health and Allied Sciences (CUHAS) in collaboration with University of Calgary in Canada and Mwanza Region Health Department in Tanzania.

Timely access to quality emergency care has been estimated to reduce maternal mortality by 45%. In Western Tanzania, life-saving care including interventions, like caesarean delivery and blood transfusions, reach less than 60 % of the population, with one quarter of the population being greater than 2 hours from emergency health services. Health facilities struggle with a variety of infrastructure, equipment and human resource gaps – with less than one in five health facilities having a staff member who is trained in Basic Emergency Obstetric and Newborn Care. 

This project implements and evaluates a district-led, policy-based maternal and newborn health intervention package. It draws on the low-cost Mama Toto programme implemented in Uganda, where substantial gains in maternal and child health were achieved. These gains took place through an approach that strengthened services at health facilities and within communities. Cascading emergency obstetrical services to community level fills a critical gap for women to access skilled delivery care. The project research team is exploring how to expand Basic and Emergency Obstetrical and Newborn Care districtwide by addressing critical challenges in health service delivery, including the specific needs of adolescent mothers.  

 

3.Quality Improvement for Maternal and Newborn Health in Mtwara region, Tanzania

This project is implemented by the Ifakara Health Institute in collaboration with Canada’s Sick Kids Centre for Global Health and the Mtwara Region Health Department in Tanzania.

In Tanzania, the majority of women visit a health facility during their pregnancy, but many do not receive the optimal care that can be provided through early and regular antenatal clinic visits. Further, the poor quality of care is known to contribute to sub-optimal maternal and newborn health outcomes.

This research project addresses gaps in the quality of care and ensures a mother receives care that she needs to promote the best outcomes during pregnancy. One critical intervention during these antenatal visits focuses on monitoring a mother’s blood pressure and identifying related signs of pre-eclampsia – a life threatening and treatable condition. Interventions include training, mentoring and coaching of mid-level health service managers and setting standards for identifying where performance needs to be strengthened. The project team has tested and applied quality improvement interventions for mothers and newborns across six districts in southern Tanzania. It explores if these interventions, for higher quality maternal and newborn health care services, better care-seeking, and improved health outcomes,  an be scaled up and integrated into district-level health systems as well as examine whether they can be sustained at the regional level.

5. Bridging the gap among healthcare workers and decision-makers through improved routine measurement of the quality of maternal and newborn care

This project is implemented by the Ifakara Health Institute in collaboration with Canada’s Sick Kids Centre for Global Health and the Mtwara Region Health Department in Tanzania.

Progress in maternal, newborn, and child health (MNCH) outcomes in low-income countries has been slow. In Tanzania, data suggests that although significant progress has been made in increasing coverage of essential services, the lack of data on quality of care is a major impediment to the achievement of the desired progress in MNCH outcomes.

This project focuses on improving the quality of data and enhancing the use of this data by decision makers in order to strengthen health services and improve related policy guidance. Furthermore,  the project works to develop and validate a novel electronic tool for measuring the quality of maternal and newborn care. The use of this information, integrated in the existing Health Management Information System, by decision-makers provides timely feedback for planning and organizing services that fosters improvements in maternal and newborn health outcomes in the region.

5. Mama na Mtoto: Barriers and enablers to gender, equity and scale-up in Tanzania

This project is implemented by Catholic University of Health and Allied Sciences (CUHAS) in collaboration with University of Calgary in Canada and Mwanza Region Health Department in Tanzania.

In Tanzania, a programme popularly known as “MamaToto” (Mother-Baby) is building local capacity to improve maternal, newborn, and child health (MNCH). It is testing a comprehensive Maternal Neonatal and Child Health 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 services, and establishing strategies for future scale-up in Tanzania, targeting the most vulnerable populations.

This project builds on the Mama na Mtoto programme. It focuses on Interventions that improve the understanding of how to better address most vulnerable populations needs and how to engage men in women’s health care. This project also strengthens the capacity of research institutions in Tanzania and Uganda to better assess these needs using qualitative community-centered approaches.

An mHealth strategy to reduce eclampsia and maternal and infant death in Tanzania

This project is implemented by the Ifakara Health Institute in collaboration with Queen’s University in Canada, the Tanzanian Ministry of Health, Community Development, Gender, Elderly and Children, and the Pamoja Tunaweza Womens’ Centre Company Limited.

According to the World health Organization, in 2017, Sub-Saharan Africa alone accounted for roughly two-thirds, or 196,000, of maternal deaths. Although one of the main drivers of maternal deaths in Tanzania is high blood pressure – one of the warning signs for a condition known as pre-eclampsia or eclampsia, delays remain in detection and timely access to critical treatment.

This project is utilizing mobile technology to identify women with the life-threatening problems at the community and health facility levels. Training of health providers using clinical modules and other job aids strengthens the ability for early detection and treatment of pre-eclampsia or eclampsia. Early identification of high blood pressure as well as related symptoms of pre-eclampsia promote timely access to life-saving treatment for women. A mobile health (mHealth) intervention using Bluetooth technology provides real-time referencing for the diagnosis of pre-eclampsia/eclampsia among pregnant women in rural areas and timely transfer for women needing urgent treatment. This project also focuses on better use of data in health systems to capture essential information on mothers in order to effectively plan for their care.