Availability, Coverage and Geographical Distribution of Emergency Obstetric and Neonatal Care Services in Tanzania Mainland

Muganyizi, Projestine

doi:10.11648/j.jgo.20170501.11

Cited by 7 publications

(10 citation statements)

References 13 publications

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“…e current study buttresses this evidence, as we found out that postpartum hemorrhage and hypertensive disorders are the major leading causes of MD among women with SMO in Tanzania. e persistent high number of women dying due to these conditions might be due to the inadequate availability and readiness of the lower-level and public facilities in Tanzania to provide basic emergency obstetric and newborn care (BEmONC) [29,30]. Similar findings have been reported in other previous studies conducted in Tanzania [14,15] and other areas with similar setting [25,31,32].…”

Section: Discussionsupporting

confidence: 75%

“…is might be explained by the fact that there is no separate adult ICU for critically ill obstetric patients at DRRH. Together with the reported inadequate availability of BEmONC among Tanzania health facilities [29,30], these might compromise the provision of ICU services. Equally, in majority of health facilities in Tanzania, adult ICUs have a limited number of patients' beds and only those who are critically ill are admitted.…”

Section: Discussionmentioning

confidence: 99%

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Incidence and Predictors of Maternal and Perinatal Mortality among Women with Severe Maternal Outcomes: A Tanzanian Facility-Based Survey for Improving Maternal and Newborn Care

Lilungulu

Bintabara

Mujungu

et al. 2020

Obstetrics and Gynecology International

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Introduction. Maternal and perinatal mortality is still a major public health challenge in Tanzania, despite the ongoing government efforts to improve maternal and newborn care. Among the contributors to these problems is the high magnitude of severe maternal outcomes (maternal near-miss). The current study, therefore, aimed to identify the magnitude and predictors of maternal and perinatal mortality among women with severe maternal outcomes admitted to Dodoma Regional Referral Hospital. Methods. A retrospective cross-sectional study was conducted from October 2015 to January 2016 at Dodoma Regional Referral Hospital in Dodoma City. All maternal deaths and maternal near-misses based on WHO criteria were included in this study. Three outcome variables have been identified: maternal mortality, perinatal mortality, and neonatal complications. To examine the predictors for the three predetermined outcome variables, the three logit models each containing unadjusted and adjusted findings were fitted. A P-value less than 0.05 was considered indicative of statistically significant. Results. A total of 3600 pregnant women were admitted for obstetric reasons during the mentioned period. 140 of them were diagnosed with severe maternal outcomes; hence, they were included in this study. The severe maternal outcome incidence ratio was 40.23 per 1000 live births, the institutional maternal mortality ratio was 459.77 per 100000 live births, and the perinatal mortality rate was 10.83 per 1000 total births. Most of the maternal morbidity and mortality were due to direct causes in which postpartum hemorrhage and hypertensive disorders were the leading causes. In adjusted analysis, per-protocol management, maternal age, and mode of birth were predictors of maternal mortality, perinatal mortality, and neonatal complications, respectively. Conclusion. Establishing and strengthening obstetric ICUs will help reduce maternal mortality as the response time from the onset of obstetric complications, while the provision of high-quality care will be substantially reduced. Furthermore, the study recommends regular provision of in-service refresher training to emphasize the practice and compliance of per-protocol case management through a team approach in order to reduce the burden of maternal and perinatal mortality in Tanzania.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Incidence and Predictors of Maternal and Perinatal Mortality among Women with Severe Maternal Outcomes: A Tanzanian Facility-Based Survey for Improving Maternal and Newborn Care

Lilungulu

Bintabara

Mujungu

et al. 2020

Obstetrics and Gynecology International

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“…78 This led to only partial success, as the maternal mortality rate (MMR) and the perinatal mortality rate increased between 2010 and 2015 due to substandard care during labour and births. 79 As a part of the improvement of the quality of care, Direct Health Facility Financing (DHFF) was introduced. Also, some health facilities are linked to Results-Based Financing (RBF) and the Community Health Fund, giving them some degree of financial autonomy.…”

Section: National Health Policies and Programsmentioning

confidence: 99%

“…One of the aims of the RMNCAH is to reduce perinatal mortality by 20% by 2020. 79,84 This shows that there is still inadequate quality of care provision during labour and birth.…”

Section: Current Strategies For New-born Carementioning

confidence: 99%

Assessment of foetal heart rate monitoring devices in referral hospitals in Tanzania: Towards improved quality of intrapartum care

Kamala¹

2020

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“…Moreover, reports by the Ministry of Health Community Development Gender, Elderly and Children (MOHCDGEC) indicate a serious Human Resource for Health shortage in the country but being the poorest in all the regions of Lake and Western zones [ 12 , 15 ]. Apart from poor Human Resource for Health, a recent National survey has also reported the two zones as among three zones in the country with the lowest obstetric care facility densities in Tanzania Mainland with all the regions having lower obstetric care facility densities than the National average of 60 per 500,000 population [ 11 , 13 , 14 ]. Accordingly, the National policy under the Sharpened One Plan (2014–2015) had a special focus to address the Geographical inequity for women and children from the two zones [ 5 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Practice of emergency obstetric care signal functions and reasons for non-provision among health centers and hospitals in Lake and Western zones of Tanzania

Maswanya

Muganyizi

Kilima

et al. 2018

BMC Health Serv Res

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BackgroundThe Lake and Western Zones of Tanzania that encompass eight regions namely; Kagera, Geita, Simiyu, Shinyanga, Mwanza, Mara Tabora and Kigoma have consistently been reported with the poorest Maternal Newborn and Child Health (MNCH) indicators in the country. This study sought to establish the provision of Emergency Obstetric Care (EmOC) signal functions and reasons for the failure to do so among health centers and hospitals in the two zones.MethodsAll the 261 public and private hospitals and health centers providing Obstetric Care services in Lake and Western Zones were surveyed in 2014. Data were collected using questionnaires adapted from the Averting Maternal Deaths and Disabilities (AMDD) tool to assess EmOC indicators. Managers in all facilities were interviewed and services, medicines and equipment were observed. Spatial Mapping was done using a calibrated Global Positioning System (GPS) Essential Software for Android and coordinates represented on digitalized map with Arc Geographical Information System (GIS) software. Population data were according to the 2012 Housing and Population National Census.ResultsIn total 261 health facilities were identified as providers of Obstetric care services, including 69 hospitals and 192 health centres which constitute an overall facility density of 8 per 500,000 population. The three most common EmOC signal functions available in the 3 months preceding the survey were oxytocics (95.7%), injectable antibiotics (88.9%) and basic newborn resuscitation (83.4%). The lowest proportions of facilities performed Cesarean section (25.7%) and blood transfusion (34.6%). Policy restrictions were the most frequent reasons given in relation to nonperformance of blood transfusion and Cesarean section when needed. Lack of training and supplies were the most common reasons for non availability of assisted vaginal delivery and uterine evacuation. Overall the Direct Case fatality Rate for direct obstetric causes was 3%. The referral system highly depended on hired or shared ambulance.ConclusionThe provision of EmOC signal functions in Lake and Western zones of Tanzania is inconsistent, being mainly compromised by policy restrictions, lack of supplies and professional development, and by operating under lowly developed referral services.

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Availability, Coverage and Geographical Distribution of Emergency Obstetric and Neonatal Care Services in Tanzania Mainland

Cited by 7 publications

References 13 publications

Incidence and Predictors of Maternal and Perinatal Mortality among Women with Severe Maternal Outcomes: A Tanzanian Facility-Based Survey for Improving Maternal and Newborn Care

Incidence and Predictors of Maternal and Perinatal Mortality among Women with Severe Maternal Outcomes: A Tanzanian Facility-Based Survey for Improving Maternal and Newborn Care

Assessment of foetal heart rate monitoring devices in referral hospitals in Tanzania: Towards improved quality of intrapartum care

Practice of emergency obstetric care signal functions and reasons for non-provision among health centers and hospitals in Lake and Western zones of Tanzania

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