Tanzania: Experts Advise Means for Reducing Maternal Deaths

HEALTH experts have called for adoption of the World Health Organisation (WHO) recommended heat-resilient carbetocin (HSC) and tranexamic acid (TXA) medicine for controlling excessive blood loss after giving birth (Postpartum hemorrhage) which has been a leading cause of maternal deaths.

Speaking during a meeting between journalists and scientists dealing with management of maternal health, experts delved into innovative ways to cut down maternal deaths in Tanzania by discussing current interventions.

"The practice of medicine is evolving and there is a need to improve how we treat patients. For many years, we have relied on the use of uterotonics such as Oxytocin but in recent years the WHO recommended the need to incorporate in the national guidelines to accelerate the efforts to cut down maternal deaths." said Dr Lilian Mnabwiru, a Specialist in Gynecology and former General Secretary of the Medical Association of Tanzania (MAT) said.

For 30 years, the Medicine has proved to be effective in management of excessive blood loss of 500 ml or more within 24 hours of birth - (Post-Partum Hemorrhage (PPH) which still accounts for the highest number of deaths.

Many countries in Sub-Saharan African countries, including Tanzania still face challenges in updating their national guidelines and essential medicines lists to include the WHO-recommended postpartum hemorrhage medicines.

She said healthcare providers can contribute significantly to curbing preventable maternal deaths in Tanzania if they adapt to innovative solutions and emerging global best practices in managing pregnancy-related complications.

The meeting was organised by RESEARCHCOM, a research communication organisation, aiming to bring together maternal health experts with journalists and build the capacity of the media to keep pace with evolving medical science on maternal health.

One of the notable developments which was highly discussed is the recent release by the World Health Organization (WHO) of a Roadmap to Combat Postpartum Haemorrhage between 2023 and 2030 which was released after realizing that global efforts to tackle PPH "have failed to gain traction" over the past decade, despite the clear need to deal with the leading cause of maternal death.

Dr Mnabwiru highlighted other major causes of maternal deaths in Tanzania as eclampsia, Infections of the female reproductive tract and abortion.

Maternal deaths have remained stubbornly high in Tanzania, with current data indicating that 524 deaths still occur per 100,000 live births, with most of them attributed to pregnancy-related complications, mainly PPH.

Experts believe current interventions and national treatment guidelines need to be improved, alongside generating more evidence with potential to significantly change policies and modify the landscape of Managing PPH.

According to the current Demographic and Health Survey which was last released in 2017 maternal death in Tanzania accounts for 524/100,000 live births.

In January 2023 the WHO released a global estimate of MMR and for Tanzania it is now at 238/100,000 with lower limit of 174/100,000 and upper limit of 381/100,000, indicating that the deaths have been declining steadily but slowly over the years.

However, it's until a new Tanzania Demographic and Health Survey is released that the latest data on maternal deaths in Tanzania can be revealed.

Dr Chetan Ramaiya, the Vice-President of the Association of Gynaecologists and Obstetricians of Tanzania (AGOTA) said there is an obvious need for improvement in the practice.

"There has been a lot of improvement in the use of digital technology and other methods and the government has invested a lot and engaged maternal health professionals in controlling maternal mortality," he said.

"It is important that, as a country, we improve our treatment guidelines to accommodate the new life-saving medications and interventions which have shown effectiveness in reducing maternal deaths," he said.

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