The status of maternal and newborn health care services in Zanzibar

Abstract

BackgroundIt is estimated that 287,000 women worldwide die annually from pregnancy and childbirth-related conditions, and 6.9 million under-five children die each year, of which about 3 million are newborns. Most of these deaths occur in sub-Saharan Africa. The maternal health situation in Tanzania mainland and Zanzibar is similar to other sub-Saharan countries. This study assessed the availability, accessibility and quality of emergency obstetric care services and essential resources available for maternal and child health services in Zanzibar.MethodsFrom October and November 2012, a cross-sectional health facility survey was conducted in 79 health facilities in Zanzibar. The health facility tools developed by the Averting Maternal Death and Disability program were adapted for local use.ResultsOnly 7.6 % of the health facilities qualified as functioning basic EmONC (Emergency Obstetric and Neonatal Care) facilities and 9 % were comprehensive EmONC facilities. Twenty-eight percent were partially performing basic EmONC and the remaining 55.7 % were not providing EmONC. Neonatal resuscitation was performed in 80 % of the hospitals and only 17.4 % of the other health facilities that were surveyed. Based on World Health Organisation (WHO) criteria, the study revealed a gap of 20 % for minimum provision of EmONC facilities per 500,000 population. The met need at national level (proportion of women with major direct obstetric complications treated in a health facility providing EmONC) was only 33.1 % in the 12 months preceding the survey. The study found that there was limited availability of human resources in all visited health facilities, particularly for the higher cadres, as per Zanzibar minimum staff requirements.ConclusionThere is a need to strengthen human resource capacity at primary health facilities through training of health care providers to improve EmONC services, as well as provision of necessary equipment and supplies to reduce workload at the higher referral health facilities and increase geographic access.

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

“…Being an EmONC facility reassures the readiness of the facility to effectively manage women with direct obstetric complications that claim majority of maternal deaths. The current results are comparable or better than the results reported in other African countries including Ghana (7.7%), Zanzibar (7.6%), Nigeria, South Africa and Zambia [8,[11][12][13][14]. In contrast to most these studies, the 90% obstetric care facilities that could not provide the full set of EmONC functions renders a huge potential for promotion into EmONC facilities.…”

Simulation Training Program of Pediatric Appropriate Technology Improves Knowledge for doctors and nurses in Zanzibar: A Quasi-experimental Study

“…The level of their pediatric care was relatively low as our previous study found [31][32][33] and make the score of fluid therapy had the biggest passing population in this study. Fakih and colleagues [6] pointed out that according to the minimum staffing requirements of Zanzibar, the human resources of the surveyed among 79 medical institutions were inadequate, qualified staffs including medical doctors, nurses and general surgeons were limited. These findings were consistent with our study.…”

“…Zanzibar belongs to Tanzania with a population of 1.3 million. Although the help babies breathy (HBB) training program and the Integrated Management of Childhood Illness (IMCI) Strategy for Children Under Five [4] has been performed across over hospitals of Tanzania [4][5] there is still high mortality rate of children in that country [5], The reason why this condition occurred in Zanzibar are due to its insufficient human resources and lack of medical facilities and equipment [6], thus leading to an urgent requirement for systematic and standardized appropriate pediatric care technology training of medical staffs, so as to improve children health and decrease mortality rate in children under 5 years old.…”

Progress Made in Addressing Emergency Obstetric and Newborn Care Challenges in Zanzibar

“…Facility-based data show an increase of maternal deaths from 187 per 100,000 live births in 2014 to 276 per 100,000 live births in 2016. Differently to another context, most of such deaths in Zanzibar occur within the health facilities owing to close proximity to health facilities for the 95% of the population (8). With such good access to health facilities, the main challenge was the quality of health services, particularly the emergency obstetric and neonatal care (EmONC) (9).…”

“…Monitoring the progress made with response to investment in maternal and newborn health, helps to E gauge the effectiveness of the interventions. In Zanzibar, the ministry of health in collaboration with UNFPA conducted the first EmONC assessment in 2012 (8). Addressing the burden of maternal health needs continuous monitoring of signal functions for EmONC.…”