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, Edward; Muganyizi, Projestine; Kilima, Stella; Mogella, Deus; Massaga, Julius J.

doi:10.1186/s12913-018-3685-6

Cited by 11 publications

(14 citation statements)

References 11 publications

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“… 17–19 A recent study in Tanzania has shown that there are large regional differences in health intervention coverage and these variations are related to differences in socioeconomic development and the strength of health systems among the regions of Tanzania. 64 …”

Section: Discussionmentioning

confidence: 99%

Trends, patterns and cause-specific neonatal mortality in Tanzania: a hospital-based retrospective survey

Mangu

Rumisha

Lyimo

et al. 2020

International Health

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Background Globally, large numbers of children die shortly after birth and many of them within the first 4 wk of life. This study aimed to determine the trends, patterns and causes of neonatal mortality in hospitals in Tanzania during 2006–2015. Methods This retrospective study involved 35 hospitals. Mortality data were extracted from inpatient registers, death registers and International Classification of Diseases-10 report forms. Annual specific hospital-based neonatal mortality rates were calculated and discussed. Two periods of 2006–2010 and 2011–2015 were assessed separately to account for data availability and interventions. Results A total of 235 689 deaths were recorded and neonatal deaths accounted for 11.3% (n=26 630) of the deaths. The majority of neonatal deaths (87.5%) occurred in the first week of life. Overall hospital-based neonatal mortality rates increased from 2.6 in 2006 to 10.4 deaths per 1000 live births in 2015, with the early neonates contributing 90% to this rate constantly over time. The neonatal mortality rate was 3.7/1000 during 2006–2010 and 10.4/1000 during 2011–2015, both periods indicating a stagnant trend in the years between. The leading causes of early neonatal death were birth asphyxia (22.3%) and respiratory distress (20.8%), while those of late neonatal death were sepsis (29.1%) and respiratory distress (20.0%). Conclusion The majority of neonatal deaths in Tanzania occur among the early newborns and the trend over time indicates a slow improvement. Most neonatal deaths are preventable, hence there are opportunities to reduce mortality rates with improvements in service delivery during the first 7 d and maternal care.

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Section: Discussionmentioning

confidence: 99%

Trends, patterns and cause-specific neonatal mortality in Tanzania: a hospital-based retrospective survey

Mangu

Rumisha

Lyimo

et al. 2020

International Health

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“…Maswanya and al. found out that policy restrictions, lack of supplies and professional development, and operating under lowly developed referral services were mentioned as the some of the drivers for low and inconsistent use of obstetric care services in western zones of Tanzania [47].…”

Section: Discussionmentioning

confidence: 99%

Magnitude and trends in socio-economic and geographic inequality in access to birth by cesarean section in Tanzania: evidence from five rounds of Tanzania demographic and health surveys (1996–2015)

Shibre

Zegeye²,

Keetile

et al. 2020

Arch Public Health

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Background Majority of maternal deaths are avoidable through quality obstetric care such as Cesarean Section (CS). However, in low-and middle-income countries, many women are still dying due to lack of obstetric services. Tanzania is one of the African countries where maternal mortality is high. However, there is paucity of evidence related to the magnitude and trends of disparities in CS utilization in the country. This study examined both the magnitude and trends in socio-economic and geographic inequalities in access to birth by CS. Methods Data were extracted from the Tanzania Demographic and Health Surveys (TDHSs) (1996–2015) and analyzed using the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software. First, access to birth by CS was disaggregated by four equity stratifiers: wealth index, education, residence and region. Second, we measured the inequality through summary measures, namely Difference (D), Ratio (R), Slope Index of Inequality (SII) and Relative Index of Inequality (RII). A 95% confidence interval was constructed for point estimates to measure statistical significance. Results The results showed variations in access to birth by CS across socioeconomic, urban-rural and regional subgroups in Tanzania from 1996 to 2015. Among the poorest subgroups, there was a 1.38 percentage points increase in CS coverage between 1996 and 2015 whereas approximately 11 percentage points increase was found among the richest subgroups within same period of time. The coverage of CS increased by nearly 1 percentage point, 3 percentage points and 9 percentage points among non-educated, those who had primary education and secondary or higher education, respectively over the last 19 years. The increase in coverage among rural residents was 2 percentage points and nearly 8 percentage points among urban residents over the last 19 years. Substantial disparity in CS coverage was recorded in all the studied surveys. For instance, in the most recent survey, pro-rich (RII = 15.55, 95% UI; 10.44, 20.66, SII = 15.8, 95% UI; 13.70, 17.91), pro-educated (RII = 13.71, 95% UI; 9.04, 18.38, SII = 16.04, 95% UI; 13.58, 18.49), pro-urban (R = 3.18, 95% UI; 2.36, 3.99), and subnational (D = 16.25, 95% UI; 10.02, 22.48) absolute and relative inequalities were observed. Conclusion The findings showed that over the last 19 years, women who were uneducated, poorest/poor, living in rural settings and from regions such as Zanzibar South, appeared to utilize CS services less in Tanzania. Therefore, such subpopulations need to be the central focus of policies and programmes implemmentation to improve CS services coverage and enhance equity-based CS services utilization.

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“…The target area, Shinyanga, is one of the regions which had higher maternal mortality than the national average (432/100,000 live births) in 2015 [ 38 ]. Shinyanga is one of eight regions – alongside Kagera, Geita, Simiyu, Mwanza, Mara, Tabora, and Kigoma – with the poorest reported maternal newborn and child health (MNCH) indicators in Tanzania [ 39 ]. Shinyanga is located in the northwestern part of Tanzania and consists of five Councils: three district councils (DC; Shinyanga, Kahama, and Kishapu); one municipal council (MC; Shinyanga), and one town council (TC; Kahama) [ 40 ].…”

Section: Methodsmentioning

confidence: 99%

Facilitators and barriers to effective supervision of maternal and newborn care: a qualitative study from Shinyanga region, Tanzania

Nyamhanga

Frumence

Hurtig

2021

Global Health Action

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Background: Despite routine supportive supervision of health service delivery, maternal and newborn outcomes have remained poor in sub-Saharan Africa in general and in Tanzania in particular. There is limited research evidence on factors limiting the effectiveness of supportive supervision in improving the quality of maternal and newborn care. Objective: This study explored enablers of and barriers to supportive supervision in maternal and newborn care at the district and hospital levels in Shinyanga region in Tanzania. Methods: This study employed a qualitative case study design. A purposeful sampling approach was employed to recruit a stratified sample of health system actors: members of the council health management team (CHMT), members of health facility management teams (HMTs), heads of units in the maternity department and health workers. Results: This study identified several barriers to the effectiveness of supportive supervision. First, the lack of a clear policy on supportive supervision. Despite the general acknowledgement of supportive supervision as a managerial mechanism for quality improvement at the district and lower-level health facilities, there is no clear policy guiding it. Second, limitations in measurement of progress in quality improvement; although supportive supervision is routinely conducted to improve maternal and newborn outcomes, efforts to measure progress are limited due to shortfalls in the setting of goals and targets, as well as gaps in M&E. Third, resource constraints and low motivation; that is, the shortage of resources -CHMT supervisors, health staff and funds -results in irregular supervision and low motivation. Conclusion: Besides resource constraints, lack of clear policies and limitations related to progress measurement impair the effectiveness of supportive supervision in improving maternal and newborn outcomes. There is a need to reform supportive supervision so that it aids and measures progress not only at the district but also at the health facility level.

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

Cited by 11 publications

References 11 publications

Trends, patterns and cause-specific neonatal mortality in Tanzania: a hospital-based retrospective survey

Trends, patterns and cause-specific neonatal mortality in Tanzania: a hospital-based retrospective survey

Magnitude and trends in socio-economic and geographic inequality in access to birth by cesarean section in Tanzania: evidence from five rounds of Tanzania demographic and health surveys (1996–2015)

Facilitators and barriers to effective supervision of maternal and newborn care: a qualitative study from Shinyanga region, Tanzania

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