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Effectiveness of Community Based Safe Motherhood Promoters in Improving the Utilization of Obstetric care. The Case of Mtwara Rural District in Tanzania.

Mushi, D., Mpembeni, R. and Jahn, A. (2010) Effectiveness of Community Based Safe Motherhood Promoters in Improving the Utilization of Obstetric care. The Case of Mtwara Rural District in Tanzania. BMC pregnancy and childbirth, 10. p. 14. ISSN 1471-2393

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Abstract

In Tanzania, maternal mortality ratio remains unacceptably high at 578/100,000 live births. Despite a high coverage of antenatal care (96%), only 44% of deliveries take place within the formal health services. Still, "Ensure skilled attendant at birth" is acknowledged as one of the most effective interventions to reduce maternal deaths. Exploring the potential of community-based interventions in increasing the utilization of obstetric care, the study aimed at developing, testing and assessing a community-based safe motherhood intervention in Mtwara rural District of Tanzania. This community-based intervention was designed as a pre-post comparison study, covering 4 villages with a total population of 8300. Intervention activities were implemented by 50 trained safe motherhood promoters (SMPs). Their tasks focused on promoting early and complete antenatal care visits and delivery with a skilled attendant. Data on all 512 deliveries taking place from October 2004 to November 2006 were collected by the SMPs and cross-checked with health service records. In addition 242 respondents were interviewed with respect to knowledge on safe motherhood issues and their perception of the SMP's performance. Skilled delivery attendance was our primary outcome; secondary outcomes included antenatal care attendance and knowledge on Safe Motherhood issues. Deliveries with skilled attendant significantly increased from 34.1% to 51.4% (rho < 0.05). Early ANC booking (4 to 16 weeks) rose significantly from 18.7% at baseline to 37.7% in 2005 and 56.9% (rho < 0.001) at final assessment. After two years 44 (88%) of the SMPs were still active, 79% of pregnant women were visited. Further benefits included the enhancement of male involvement in safe motherhood issues. The study has demonstrated the effectiveness of community-based safe motherhood intervention in promoting the utilization of obstetric care and a skilled attendant at delivery. This improvement is attributed to the SMPs' home visits and the close collaboration with existing community structures as well as health services.

Item Type: Article
Keywords: Obstetric care, Safe Motherhood Promoters, Maternal Mortality Ratio, Antenatal care, Mtwara, Tanzania
Subjects: Maternal & Neonatal Health > Maternal Mortality & Morbidity
Maternal & Neonatal Health > Antenatal care
Maternal & Neonatal Health > Obstetric care
Divisions: Other
Depositing User: Mr Joseph Madata
Date Deposited: 09 Jan 2014 08:43
Last Modified: 09 Jan 2014 08:43
URI: http://ihi.eprints.org/id/eprint/2164

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