Saving Newborns in Tanzania

Tanzania

State of Tanzania's Newborns

In Tanzania, 56,000 newborns die their first month of life, accounting for 30 percent of all under-five child deaths in the country. While under-five mortality has dropped by a third in the past five years, neonatal mortality has seen no measurable decline in the past decade. If additional effort is focused on reducing newborn deaths, Tanzania could meet Millennium Development Goal 4 for child survival.

Tanzania’s health system includes a network of government and NGO-operated facilities that reaches the village level. While most women visit an antenatal clinic at least once during pregnancy, the majority of births occur at home without skilled assistance. Postnatal care is almost non-existent; even women who give birth in health facilities are often discharged within 24 hours, with no plan for follow-up until the six-week immunization visit. To address this problem, reproductive health and safe motherhood strategies have been integrated in government policy. The National Health Policy for the United Republic of Tanzania states that maternal and newborn health will continue to be a top health priority in Tanzania. With Ministers of Health in other African countries, Tanzania’s Ministry of Health is an active partner in the effort to develop and implement the regional and country-specific “Road Map” for accelerated maternal and newborn mortality reduction.

Tanzania’s Ministry of Health has an active interest in improving newborn survival, which is evidenced through its active membership in the Partnership for Maternal, Newborn and Child Health. During the first Global Partner’s Forum, which took place in Dar es Salaam in April 2007, the Tanzanian Government, NGOs including Save the Children, partners from the research community, health professionals and UN communities, established and launched the Tanzanian Partnership for Maternal, Newborn and Child Health (Tanzanian PMNCH). The Partnership was formed to accelerate the national drive for improved maternal, newborn and child health, with one voice and one plan. Ambassador Gertrude Mongella, President of the Pan-African Parliament was appointed as its champion.

In partnership with Save the Children UK and the Tanzanian Ministry of Health, Save the Children’s Saving Newborn Lives program supports a portfolio of activities to improve newborn health in Tanzania. These activities started with a newborn health situation analysis, conducted by Save the Children and the Department of Reproductive and Child Health Services within the Ministry of Health. Meanwhile, the Ministry of Health is driving the process to pilot Kangaroo Mother Care in five districts in Tanzania. Save the Children also supports the Ministry of Health in expanding training of health workers in essential newborn care. These activities are led by the Newborn Health Desk Officer position—a key advocacy and leadership role within the Ministry of Health that is supported, in part, by Save the Children.

Save the Children also supports a leading Tanzanian research institution—the Ifakara Health Research & Development Center (IHRDC)—to conduct a four-year randomized control trial in rural southern Tanzania to evaluate the cost and impact of a scalable package of interventions at community level with health system strengthening. The study will evaluate an integrated newborn health care package with two components: 1) antenatal, childbirth and postnatal services provided by existing health facilities and outreach services and 2) community care-giving practices through behavior-change communication.

brings together data from two qualitative studies in different parts of Tanzania. The results of this formative research found that access to care is limited by lack of demand for services and a perception of poor quality of care at health facilities. Further, cost was found to be a barrier to accessing care for many families despite the fact that health care is free at point of use in Tanzania. The recommendations from the study highlight the need for different approaches to increase access to care—family and community education to improve health-seeking behavior as well as quality improvement at health facilities through better equipment and better stocking of supplies. The results of the formative research will be used to inform the development of newborn health care packages being evaluated.

Tanzania

Tanzanian Ministry of Health

Save the Children UK

Ifakara Health Research and Development Center

London School of Hygiene and Tropical Medicine

Swiss Tropical Institute

World Health Organization

UNICEF