BackgroundTanzania has a maternal mortality ratio of 556 per 100,000 live births, representing 21% of all deaths of women of reproductive age. Hemorrhage, mostly postpartum hemorrhage (PPH), is estimated to cause at least 25% of maternal deaths in Tanzania. In 2008, the Ministry of Health, Community Development, Gender, Elderly and Children launched interventions to improve efforts to prevent PPH. Competency-based training for skilled birth attendants and ongoing quality improvement prioritized the practice of active management of the third stage of labor (AMTSL).MethodsA cross-sectional study was conducted in 52 health facilities in Tanzania utilizing direct observations of women during labor and delivery. Observations were conducted in 2010 and, after competency-based training and quality improvement interventions in the facilities, in 2012. A total of 489 deliveries were observed in 2010 and 558 in 2012. Steps for AMTSL were assessed using a standardized structured observation checklist that was based on World Health Organization guidelines.ResultsThe proportion of deliveries receiving all three AMTSL steps improved significantly by 19 percentage points (p < 0.001) following the intervention, with the most dramatic increase occurring in health centers and dispensaries (47.2 percentage point change) compared to hospitals (5.2 percentage point change). Use of oxytocin for PPH prevention rose by 37.1 percentage points in health centers and dispensaries but remained largely the same in hospitals, where the baseline was higher. There was substantial improvement in the timely provision of uterotonics (within 3 min of birth) across all facilities (p = 0.003). Availability of oxytocin, which was lower in health centers and dispensaries than hospitals at baseline, rose from 73 to 94% of all facilities.ConclusionThe quality of PPH prevention increased substantially in facilities that implemented competency-based training and quality improvement interventions, with the most dramatic improvement seen at lower-level facilities. As Tanzania continues with efforts to increase facility births, it is imperative that the quality of care also be improved by promoting use of up-to-date guidelines and ensuring regular training and mentoring for health care providers so that they adhere to the guidelines for care of women during labor. These measures can reduce maternal and newborn mortality.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-1873-3) contains supplementary material, which is available to authorized users.

The coronavirus disease pandemic has highlighted the need to establish and maintain strong infection prevention and control (IPC) practices, not only to prevent healthcare-associated transmission of SARS-CoV-2 to healthcare workers and patients but also to prevent disruptions of essential healthcare services. In East Africa, where basic IPC capacity in healthcare facilities is limited, the US Centers for Disease Control and Prevention (CDC) supported rapid IPC capacity building in healthcare facilities in 4 target countries: Tanzania, Ethiopia, Kenya, and Uganda. CDC supported IPC capacity-building initiatives at the healthcare facility and national levels according to each country’s specific needs, priorities, available resources, and existing IPC capacity and systems. In addition, CDC established a multicountry learning network to strengthen hospital level IPC, with an emphasis on peer-to-peer learning. We present an overview of the key strategies used to strengthen IPC in these countries and lessons learned from implementation.

Background The COVID-19 pandemic has potentially caused disruptions in provision of routine, regular essential health services in different ways; through overwhelming the health system in responding to COVID-19; some of the intervention used to slow transmission of COVID-19 may inhibit access to essential services; and through supplies of medicine being interrupted.. In Tanzania, unlike many other countries, which did not follow strict lockdown measures, disruption of access to and utilization of EHS due to anxiety and fear of contact with the infection while seeking medical care was observed. Method This was a cross-section study conducted in October 2022 to evaluate trends of utilizing essential health services before and after implantation of continued essential services (CES) project among 297 Amref supported facilities from Mainland Tanzania and Zanzibar. It involved the use of secondary data from the district health information system 2 (DHIS2), and extracted variable included; facility type and name, number of individuals using the antenatal, post-natal, immunization and delivery services. Through using STATA version 14, the data was cleaned, and quarterly and yearly average number of clients using either of the services was computed for the period between 2019 and 2021. Findings were presented in form of graphs, and comparison were made for the period before and after the implementation of the project. Results It was found that all key indicators that were assessed were maintained following the implementation of the project interventions that aimed at maintaining EHS during the COVID-19 pandemic. Conclusion The study found that project interventions have remained relevant to the needs of communities as demonstrated by the maintenance of the essential MNCH services, as seen in a number of the key EHS indicators which were tracked. This calls for joint efforts between the government and partners on resource mobilization for scale-up so that the EHS is maintained and the country is prepared for these pandemics.

Tanzania reported its first COVID-19 case on 16 March 2020. We conducted event-based surveillance of COVID-19 suspect cases among pharmacy clients presenting with respiratory symptoms and influenza-like illness to increase early and rapid detection of COVID-19 cases and mitigate transmission. We conveniently sampled 103 pharmacies from Dar es Salaam, the epicentre for the COVID-19 pandemic in Tanzania at the time. Between 23 April 2020 and 18 May 2020, 67% of the pharmacies (69/103) reported an observed increase in the number of clients presenting with respiratory symptoms and influenza-like illness compared with the 1 month before the COVID-19 outbreak. In the 1-month surveillance period, the participating pharmacies recorded 75 alerts of COVID-19 suspect cases and referred all suspected COVID-19 cases to rapid response teams for additional symptomatic screening and SARS-CoV-2 testing. A key implementation challenge was that some clients identified as COVID-19 suspected cases were hesitant to provide follow-up information for linkage to rapid response teams. Addressing concerns among drug dispensers in the participating pharmacies and informing them of the benefits of the surveillance activity were important implementation components. Our approach demonstrates the overall feasibility of rapidly implementing an event-based surveillance system for an emerging health threat through an existing network of pharmacies within the community. The approach and tools used in this surveillance activity could be adapted in similar settings to detect and generate alerts of disease outbreaks in the community that other surveillance systems may otherwise miss.

Background Health professionals are in short supply worldwide, with nurses and midwives accounting for more than 50% of the current shortage. The World Health Organization predicts that by 2030, there will be a shortage of 10 million health workers primarily in low- and lower-middle income nations including South East Asia and Africa having the greatest needs-based shortages of nurses and midwives.[1] . eLearning for nurses and midwives is an alternative and innovative mechanism of reducing their reported shortage. eLearning programs increase the knowledge transfer, knowledge retention, upgrade in skills and competencies among nurses and midwives. Despite of the benefits of eLearning programs, there is still inadequate information on the extent to which such programs have influenced the parameters since eLearning programs were introduced in Tanzania. This study aimed to determine the extent to which eLearning has affected the knowledge transfer, retention, upgrading skills, and competencies among nurses and midwives in Tanzania. Methods The cross-sectional study design where by quantitative methods approach was used . Quantitative data were collected through a structured questionnaire and Likert scaled, with a sample size of 189 respondents[2]. Descriptive results were generated and multivariable logistic regressed whereby odds ratio was used as measure of effects, 95% confidence interval and 5% significance level. SPSS was used in conducting analysis. Results Majority of participants were female (60.4%, n=64) and 97.2% of all respondents aged less than 40 years old. About half of participants (48.1%, n=51) were working in hospitals. The majority of the nurses and midwives (95.3%, n=101) were students in the eLearning. There was strong consensus on knowledge transfer with eLearning being an accurate source (sCns>79.8%) except on entertainment (sCns=65.8%). The degree of consensus ranged between 65.8% and 79.8% as well as in the system quality (sCns=71.6% to 74.9%). The overall rate score on knowledge transfer was 79.7%. The knowledge retention was high with score marks from 64% to 99% except in diagnostic (28%) and problems of new babies (48%). The rate of skills and competencies was high (sCns=82.6% to 88.8%), but with insignificant higher odds of consensus that “eLearning helps knowledge transfer, increases skills and competencies” across exposures and demographic characteristics except gender variable. Conclusions eLearning has succeeded to transfer and retain knowledge, skills, and competencies to eLearning-trained nurses and midwives. Peer students’ support and use of multimedia emerged with insignificant higher consensus of odds in explaining knowledge transfer in the eLearning program. Retention of knowledge, skills and competencies have great effects on the health services quality. There was low retention in diagnostic and recognition of new-born babies’ problems. Henceforth, efforts are needed to change negative perceptions among nurses and midwives. [1] World Health Organization, information available at: https://www.who.int/health-topics/health-workforce#tab=tab_1 [2]Respondents are Nurses/Midwives, Principals/Coordinators, Mentor /Health Facility In charge and Tutors