“Safer Births Bundle of Care” Implementation and Perinatal Impact at 30 Hospitals in Tanzania—Halfway Evaluation

Ersdal, Hege; Mdoe, Paschal; Mduma, Estomih; Moshiro, Robert; Guga, Godfrey; Kvaløy, Jan Terje; Bundala, Felix; Marwa, Boniphace; Kamala, Benjamin

doi:10.3390/children10020255

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…SBBC is designed to address the burden of maternal and perinatal mortality associated with inadequate quality of health care services at the facilities [5]. The halfway findings of the SBBC implementation have shown a steady increase in 24 h newborn and maternal survival in the five regions [18]. The halfway findings concur with the findings in our study that the SBBC is an appropriate intervention to address the burden of maternal and newborn deaths.…”

Section: Discussionsupporting

confidence: 86%

Healthcare Workers’ Perceptions on the “SaferBirths Bundle of Care”: A Qualitative Study

Mdoe,

Mduma,

Rivenes Lafontan

et al. 2023

Healthcare

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Background: SaferBirths Bundle of Care (SBBC) is a package of innovative clinical and training tools coupled with low-dose high-frequency simulation-based on-job training guided by local data. This bundle of care is a new initiative being implemented in 30 health facilities from five regions of Tanzania aiming at improving birth outcomes. Objective: To assess the perception of healthcare workers and facility leaders on the “SaferBirths Bundle of Care” towards saving women’s and newborns’ lives at birth. Method: We used a qualitative approach using focused group discussion (FGD) and individual interviews. A total of 21 FGD and 43 individual interviews were conducted between August and November 2022. In total, 94 midwives and 12 doctors were involved, some of whom were in leadership roles. The framework method for the analysis of qualitative data was used for analysis. Results: Healthcare workers and facility leaders received the bundle well and regarded it as effective in saving lives and improving healthcare provision. Five themes emerged as facilitators to the acceptance of the bundle: (1) the bundle is appropriate to our needs, (2) the training modality and data use fit our context, (3) use of champions and periodic mentorship, (4) learning from our mistakes, and (5) clinical and training tools are of high quality but can be further improved. Conclusion: The relevance of SaferBirths Bundle of Care in addressing maternal and perinatal deaths, the quality and modality of training, and the culture that enhances learning from mistakes were among the facilitators of the acceptability of the SBBC. A well-accepted intervention has huge potential for bringing the intended impact in health provision.

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Section: Discussionsupporting

confidence: 86%

Healthcare Workers’ Perceptions on the “SaferBirths Bundle of Care”: A Qualitative Study

Mdoe,

Mduma,

Rivenes Lafontan

et al. 2023

Healthcare

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“…It is important to note that HCWs training under SBBC may have contributed to the observed improvement in documentation enhancing data-driven feedback as well as the provision of more quality health care as it was documented in the recent SBBC halfway publication. In this publication, it was noted that there has been a steady reduction in early newborn and maternal mortality and a fluctuation in reported fresh stillbirths across times and regions [32].…”

Section: Discussionmentioning

confidence: 99%

Improvements in Obstetric and Newborn Health Information Documentation following the Implementation of the Safer Births Bundle of Care at 30 Facilities in Tanzania

Kamala,

Ersdal,

Moshiro

et al. 2024

Healthcare

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This paper examines changes in the completeness of documentation in clinical practice before and during the implementation of the Safer Births Bundle of Care (SBBC) project. This observational study enrolled parturient women with a gestation age of at least 28 weeks at the onset of labour. Data collectors extracted information from facility registers and then a central data manager summarised and reported weekly statistics. Variables of clinical significance for CQI were selected, and the proportion of non-documentation was analysed over time. A Pearson chi-square test was used to test for significant differences in non-documentation between the periods. Between 1 March 2021 and 31 July 2022, a total of 138,442 deliveries were recorded. Overall, 75% of all patient cases had at least one missing variable among the selected variables across both periods. A lack of variable documentation occurred more frequently at the district hospital level (81% of patient cases) and health centres (74%) than at regional referral hospitals (56%) (p < 0.001). Non-documentation decreased significantly from 79% to 70% after the introduction of the SBBC (p < 0.001). A tendency towards negative correlations was noted for most variables. We noted an increased attention to data quality and use which may have a positive impact on the completeness of documentation. However, halfway through the project’s implementation, the completeness of documentation was still low. Our findings support the recommendation to establish short-spaced feedback loops of locally collected data using one data platform.

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“…However, there has been a noticeable reduction in conflicts in recent years, indicating a move toward greater regional peace and stability [ 86 , 87 ]. Initiatives to improve the quality of maternal healthcare services, enhance access to education, and alleviate poverty may have played a key role [ 88 , 89 , 90 , 91 ]. However, the MMR remains relatively high, suggesting that challenges such as health system weaknesses, the low socioeconomic status of women, and limited access to healthcare services are still prevalent [ 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 ].…”

Section: Discussionmentioning

confidence: 99%

Trends, Projections, and Regional Disparities of Maternal Mortality in Africa (1990–2030): An ARIMA Forecasting Approach

Onambele,

Guillen-Aguinaga,

Guillen-Aguinaga

et al. 2023

Epidemiologia

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With the United Nations Sustainable Development Goals (SDG) (2015–2030) focused on the reduction in maternal mortality, monitoring and forecasting maternal mortality rates (MMRs) in regions like Africa is crucial for health strategy planning by policymakers, international organizations, and NGOs. We collected maternal mortality rates per 100,000 births from the World Bank database between 1990 and 2015. Joinpoint regression was applied to assess trends, and the autoregressive integrated moving average (ARIMA) model was used on 1990–2015 data to forecast the MMRs for the next 15 years. We also used the Holt method and the machine-learning Prophet Forecasting Model. The study found a decline in MMRs in Africa with an average annual percentage change (APC) of −2.6% (95% CI −2.7; −2.5). North Africa reported the lowest MMR, while East Africa experienced the sharpest decline. The region-specific ARIMA models predict that the maternal mortality rate (MMR) in 2030 will vary across regions, ranging from 161 deaths per 100,000 births in North Africa to 302 deaths per 100,000 births in Central Africa, averaging 182 per 100,000 births for the continent. Despite the observed decreasing trend in maternal mortality rate (MMR), the MMR in Africa remains relatively high. The results indicate that MMR in Africa will continue to decrease by 2030. However, no region of Africa will likely reach the SDG target.

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“Safer Births Bundle of Care” Implementation and Perinatal Impact at 30 Hospitals in Tanzania—Halfway Evaluation

Cited by 5 publications

References 22 publications

Healthcare Workers’ Perceptions on the “SaferBirths Bundle of Care”: A Qualitative Study

Healthcare Workers’ Perceptions on the “SaferBirths Bundle of Care”: A Qualitative Study

Improvements in Obstetric and Newborn Health Information Documentation following the Implementation of the Safer Births Bundle of Care at 30 Facilities in Tanzania

Trends, Projections, and Regional Disparities of Maternal Mortality in Africa (1990–2030): An ARIMA Forecasting Approach

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