Background Clear evidence exists that perinatal audit and feedback can lead to important improvements in practice. The death audit can lead to the identification of existing potential delays which are the decision to seek medical care, reaching an appropriate facility, and receiving timely adequate care at the facility. Such an audit potentially initiates a positive discussion, which may foster the implementation of changes that aims at saving more lives. Objective To review the perinatal deaths case notes and identify potential gaps in care provision and health-seeking behavior to foster best practice. Methods The stillbirths and neonatal death case notes that occurred between January 2019 and May 2020 at the hospital were reviewed using an adapted WHO checklist. The completed review case notes were entered into an electronic system and a quality control check-up was done. Data were analysed descriptively, and findings were presented in tables. Results There were 4,898 births, and 1,175 neonatal admissions, out of these there were 135 recorded stillbirths (2.8%) and 201(4.1% of the total hospital births) early neonatal deaths. Out of the 1,175 neonates, 635 (54%) were born within the hospital and 540 (46%) were admitted from other facilities and home deliveries. In total 86 stillbirths and 140 early neonatal deaths case notes were retrieved and audited. Out of 86 stillbirths’ case notes audited, 30 (34.9%) seemed to have died during labor, and of these 5 had audible fetal heart rate during admission. Apgar scores less than 7 at 5 minutes, prematurity, and meconium aspiration were the top three recorded causes of neonatal deaths. Inadequate/late antenatal care visits and home delivery were the maternal factors likely to have contributed to perinatal deaths. Inadequate labor monitoring (12%) and documentation (62%) were among the providers’ factors likely to have contributed to perinatal deaths. Conclusion This audit shows that there are high rates of preventable intrapartum stillbirths and early neonatal deaths. Both women and providers’ factors were found to have contributed to the stillbirths and neonatal deaths. There is a need to encourage women to adequately attend antenatal care, utilize health facilities during birth, and improve maternity and neonatal care at the health facilities.

Caregivers at an institution for motherless infants in rural Tanzania participated in focus group interviews and participant observations. This paper aims at describing how they perceive infancy, caring and sensitivity in their everyday context. It adds knowledge from Tanzania about institutional infant care and the concept of sensitivity in caregiving, based on an approach sensitive to culture and context. The main result is that the caregivers are most concerned with fulfilling the infants’ physical needs. They defined infants’ social and emotional needs in a variety of ways and gave accounts about what sensitivity in caring for infants meant in their context. They also described their workload, their burdens and their strengths, and demonstrated shortcomings in fulfilling the infants’ social and emotional needs. Interventions to promote emotional and social support in addition to fulfilling physical needs are crucial.

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Background: Sensitive and supportive interactions are keys to healthy development in the early years of life. Parents and other caregivers can promote social and emotional functioning through Marte Meo Counselling. Objectives: The present study aimed to investigate whether Marte Meo Counselling was applicable in an African institutional context. Method: We chose a qualitative research design, using participant observation and focus group interviews with caregivers before, right after and one year after Marte Meo Counselling. Findings: The main finding is that the caregivers are more aware of the various infants' cues. They describe new practices in their daily work as well as a change in their attitudes and behaviours towards the infants. Conclusion: We found that Marte Meo Counselling facilitated social and emotional development for the institutionalised infants, and thus it is applicable in this African context. Implications for Practice: Caregivers of vulnerable infants should be offered Marte Meo Counselling or similar methods focusing on enhancing emotional and social development.