Project profile — Safe Motherhood in Rukwa

• Tanzania (100.00%)

• Health, General: Health policy and administrative management (12110) (10.00%)
• Basic Health: Basic health care (12220) (20.00%)
• Reproductive health care:
Reproductive health care (13020) (25.00%)
Family planning (13030) (10.00%)
Personnel development for population and reproductive health (13081) (35.00%)

• Gender equality (significant objective)
• Environmental sustainability (cross-cutting) (significant objective)
• Participatory development and good governance (not targeted)
• Trade development (not targeted)
• Biodiversity (not targeted)
• Climate change mitigation (not targeted)
• Climate Change Adaptation (not targeted)
• Urban issues (not targeted)
• Desertification (not targeted)
• Children's issues (principal objective)
• Youth Issues (significant objective)
• Indigenous Issues (not targeted)
• Disability (not targeted)
• Nutrition (significant objective)
• ICT as a tool for development (not targeted)

This project addresses the main causes of maternal and newborn mortality and morbidity through a two-pronged approach. On the demand-side, it is increasing utilization of sexual and reproductive, health, and rights SRHR services by women, adolescent girls, newborns and their families and on the supply side, it is improving the availability of quality SRHR services. The project is also working to improve utilization of, and access to, SRHR services for women of reproductive age and adolescent girls that are both gender responsive and adolescent friendly, and that support women and adolescent girls to have greater decision making power to seek SRHR services independently through gender transformative strategies. The project works closely with regional and national level governments to ensure sustainable delivery of high quality, gender sensitive health services. Project activities include: (1) training healthcare staff on high-impact maternal and newborn health interventions such as basic emergency obstetric and newborn care (BEmONC), comprehensive emergency obstetric and newborn care (CEmONC), Helping Babies Breathe program, Kangaroo Mother Care, post-partum care and family planning; (2) equipping select facilities and hospitals with BEmONC and CEmONC equipment, Helping Babies Breathe and Kangaroo Mother Care supplies, reproductive health commodities and gender sensitive/adolescent friendly information, education and communication materials; (3) training community health workers and supporting outreach on gender equality, reproductive health services including family planning, and adolescent friendly maternal and newborn health; (4) conduct Village Health Days to provide maternal and newborn health services, including vitamin A, deworming and immunization for children under five; (5) develop new village savings and loans associations for adolescents and support existing ones for adults and community health workers to improve the financial independence of women and girls and promote the allocation of emergency funds. The project is implemented in collaboration with Jhpiego, Africare and White Ribbon Alliance for Safe Motherhood Tanzania.

The expected outcomes for this project include: (1) increased utilization of maternal and newborn health services by women and their families in targeted districts in Tanzania; and (2) improved availability of quality maternal and newborn health services in underserved districts in Tanzania.

Results achieved as of the end of the project (March 2021) include: (1) increased the percentage of women aged 14-49, with a live birth, who received antenatal care by a skilled birth provider at least four times during pregnancy from 59% to 69%; (2) increased the percentage of newborns put to the breast within one hour of birth from 49% to 55%; (3) increased the percentage of live births attended by skilled health personnel from 79% to 91%; (4) increased the percentage of mothers and newborns who received postnatal care visits within two days of childbirth from 45% to 80% for women of reproductive age and from 57% to 85% for newborns; and (5) increased the extent to which facilities use data to track maternal and newborn health services performance from a baseline average of ‘satisfactory’ to ‘high’ as reported by health facilities. Collectively, these results have increased the knowledge and utilization of maternal and newborn health services by adolescent girls, women and their families in targeted districts of Tanzania and the availability and quality of these services. Results from District Health Information Software data, which the project used to track community-level outcomes in Rukwa, indicate that maternal deaths declined from a reported total of 57 in 2016 to 45 in 2019, and perinatal deaths from 754 to 644. While results at the national level are not entirely a direct attribute to this project, these outcomes may have contributed to decreased maternal and newborn mortality and morbidity. At the outset of this project, Tanzania’s maternal mortality ratio was 556 per 100,000 live births. The neonatal mortality rate was 25 per 1000 live births (both figures from 2015-2016 Tanzania Demographic and Health Survey and Malaria Indicator Survey). Equivalent Tanzania Demographic and Health Survey data is not yet available for the most recent observation period, however as of 2019, secondary studies show the maternal mortality rate is now 292 per 100,000 live births, and the neonatal mortality rate 20 per 1000 live births.

• Proactive disclosure