Tanzania ranks among the ten countries with the highest risk of maternal mortality, with 454 maternal deaths per 100,000 live births in 2010. Many of these deaths result from preventable or treatable complications that require emergency obstetric care.
A key contributor to maternal mortality in Tanzania is the local preference for home deliveries, which are typically attended only by family members or unskilled birth attendants. When complications occur, expectant mothers often do not make it to a hospital due to failure to recognize complications, women’s limited decision-making power, lack of emergency transportation or a combination of these factors.
Even women who manage to get a health facility to give birth often experience delays in receiving the care needed to save their lives or to spare them lasting complications such as obstetric fistula, which affects 3,000 women in Tanzania each year. Moreover, healthcare providers may lack the appropriate skills or equipment, or necessary supplies may not be available.
Led by the Vodafone Foundation and supported by public and private partners, the Mobilising Maternal Health programme seeks to make childbirth safer by acting at the level of communities as well as health systems. The project supported by the Swiss Re Foundation – a key component of this programme – focuses on interventions to inform women and their communities about birth preparedness and risks and to train healthcare providers in high-quality antenatal and emergency obstetric services. The project’s two-year objective is to train 100-120 community health workers in two rural districts of Tanzania – Sengerema and Shinyanga – in the timely detection, management and referral of high-risk obstetrical cases.
Pathfinder International, one of the Mobilising Maternal Health programme’s key implementation partners, will train and support the community healthcare workers in maternal, neonatal and child health. In a three-week curriculum approved by the government of Tanzania, the workers will learn to:
As transport within the selected districts is scarce and expensive, the community health workers will also receive a bicycle as a mode of transport, allowing them to expand their geographical range and thereby increase the number of households they can support.
The training programme is underpinned by the Vodafone Foundation’s ‘Text-to-Treatment’ transport programme, which seeks to facilitate village-to-district healthcare referrals by employing local private transport providers (paid and incentivised via Vodafone’s MPESA mobile money system) and providing tailored SMS and app-based mobile health solutions.
The project is being run on a deliberately tight budget to maximise the potential to continue these activities in future within existing local healthcare budgets.
Educating women and their communities and training 100-120 community health workers is expected to benefit up to 31,000 women in Sengerema and Shinyanga Districts by averting pregnancy-related complications and enabling the timely treatment thereof.