Pregnancy and childbirth complications remain among the leading causes of death, disease, and disability among women of reproductive age in Tanzania. Despite national strategies and programs to reduce maternal and neonatal deaths, a comprehensive national documentation of these interventions in Tanzania and their impacts has not been conducted. To address this gap, the Jakaya Mrisho Kikwete Foundation (JMKF) in collaboration with the Ministry of Health (MoH), Presidents’ Office – Regional Administrative and Local Government (PO-RALG), and the National Institute for Medical Research (NIMR) conducted a comprehensive national mapping of current and past interventions addressing maternal and newborn deaths in Tanzania mainland, which aligns with strategic objective 4, target 2.6 on the generation and use of evidence to improve Reproductive, Maternal, Newborn, Child, Adolescent Health (RMNCAH) services of the 2021-25 National Strategic Plan for RMNCAH and Nutrition in Tanzania.
This mapping aimed to establish a national baseline report on the Maternal and Newborn Health (MNH) landscape in Tanzania, identifying interventions, gaps, and opportunities in MNH that will guide planning at all levels.
The mapping was conducted in 184 councils across 26 regions of Tanzania mainland from January 2016 to June 2021. Data were collected using an online self-administered questionnaire completed by the Reproductive and Child Health Coordinators (RCHCOs) at the Regional and District levels and the MNCH Implementing Partners (IPs). Data were uploaded to NIMR Mwanza’s file transfer protocol server using the Census and Survey Processing System (CSPro). Descriptive statistics and proportions were analyzed using Stata version15. Qualitative data were analyzed following a deductive approach.
A total of 8,341 health facilities with different levels of ownership were reported. The majority (72.9%) of health facilities reported are owned by the government. 11 (6.0%) councils reported having no hospitals. RCH services were reported in 86.3% of all health facilities. Availability of BEmONC services was reported at 53.7% of all dispensaries and 69.5% of all health centers. About 63.0% of all councils reported having at least one Community Health Worker (CHW) in each village/street.
8,789,714 deliveries were documented, with 87,136 (1.0%) stillbirths (2016-2020). Most of the deliveries occurred in dispensaries (39.1%) and health centers (24.9%). A total of 8,320 maternal deaths and 44,393 neonatal deaths were reported (2016-2021). Obstetric hemorrhage (43.2%) was reported as a major cause of maternal deaths while birth asphyxia (40.6%) was reported to be a major cause of neonatal deaths.
From 2016 to 2021, 182 (98.9%) of all councils reported receiving health basket funds to implement different MNH interventions, and 119 (64.7%) councils reported allocating funds generated from their sources to implement MNH interventions. 44 IPs had 84 MNH interventions implemented in different councils in Tanzania Mainland. The majority of the MNH interventions implemented by both councils and IPs were targeted to address delay 3 in receiving adequate care.
Conclusion & Recommendation:
This mapping recommends;