3 May 2014

Tanzania: Alarm As Traditional Midwives Shun Gloves

OLDER traditional midwives in rural Southern Tanzania refuse to wear hand gloves alleging that they were slippery and might let the baby slip through, health researchers can report.

Demystification of slippery gloves was necessary and experts propose intensive awareness campaign among traditional birth attendants (TBAs) on the need to wear gloves for their own safety and that of a new born and the mother during delivery.

The latest findings unveiled this week by experts from Ifakara Health Institute (IHI) who surveyed 225,000 households in five districts in Lindi and Mtwara regions, under the theme 'Newborn care behaviours and newborn survival (Mtunze Mtoto Mchanga), underscored the need for improved hygiene during delivery to prevent maternal mortality.

The study revealed that deaths in pregnancy and childbirth were due to infections, the situation that calls for integrated approach to manage infected women for safe delivery.

Presenting the findings, the Principle Investigator from IHI, Dr Joanna Schellenberg, said it was surprising that deaths among expecting mothers at the point of delivery remained high in Tandahimba, Newala, Lindi rural, Ruangwa and Nachingwea despite an increase of delivery facilities from 41 per cent to 78 per cent since 2007 to date.

"Reduction of maternal deaths is one of the main goals of the Tanzanian Poverty Reduction Strategy and the health sector reform programme, but progress has been slow.

According to the 1996, 2004 and 2010 Demographic and Health Surveys, maternal mortality ratios were 529 and 454 deaths per 100,000 live births respectively for the 10-year period prior to the surveys," Joanna explained during stakeholders' facts presentation in Dar es Salaam recently.

She said the statistics were different in the specified districts in Southern Tanzania, as maternal mortality remained high in all five districts at 712 deaths per 100,000 live births and the highest was in Lindi Rural District at 959 and lowest in Tandahimba (573) per 100,000 live births.

Another researcher from IHI, Elibariki Mkumbo explained that mortality was only around 27 per cent lower in the relatively wealthier group compared to the poorest families.

"This was surprising against the background that 57 per cent of women from better off families delivered in a health facility and six per cent delivered by caesarean section.

Deaths was almost twice as high in women if the household head has no education compared to those who had completed secondary education," Mkumbo explained.

Dr Fatma Manzi (IHI) said maternal mortality in the areas was higher than the national average of 454 deaths per 100,000 live births in those districts. The main causes of deaths were hemorrhage, malaria, anemia, eclampsia (epilepsies during pregnancy), tuberculosis and AIDS.

"Deaths were common even among women close to a hospital and in settings where most women gave birth in a health facility.

But among women who lived far from a hospital, the chance of death was three times greater than those living nearby," Fatma clarified.

The professionals concluded that the quality of care in hospitals was an important factor determining women's survival and therefore should be prioritised.

The Acting Director of Prevention Services in the Ministry of Health and Social Welfare, Dr Neema Rusibamayila commended the IHI for training and deployment of community health volunteers who have done impressive work.

The volunteers reached out households and shared valid information to both expecting and lactating mothers on the basics of health.

"IHI has shown the way. We have seen the importance of including in the training syllabus, lessons on community health services and the finalists will be employed just like many others," Neema said.

However, Dr Ahmed Hingora reminded policy implementers on the need to take seriously the findings by researchers and implement the proposed solutions for the welfare of the nation, instead of leaving piles of valid reports decaying in shelves.

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