Healthy mothers and babies
Tanzania ranks among the 10 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 recognise 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 fistulas, which 3 000 women in Tanzania develop each year. Moreover, healthcare providers may lack the appropriate skills, equipment or supplies.
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. This project supported by the Swiss Re Foundation – a key component of the programme – focused 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 was 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, trained and supported the community healthcare workers in maternal, neonatal and child health. In a three-week curriculum approved by the government of Tanzania, the workers learned to:
- Educate and inform women and their families about the importance of antenatal care and danger signs in pregnancy
- Identify women at high risk of complications during pregnancy and delivery
- Refer high-risk women to the appropriate level of health facility for care, whether the nearest health centre or the district hospital
As transport within the selected districts is scarce and expensive, the community health workers also received bicycles as a mode of transport, allowing them to expand their geographical range and thereby increase the number of households they could support.
The training programme was 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 was run on a deliberately tight budget to maximise the potential to continue the activities within existing local healthcare budgets in future.