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Inside Tanzania’s Life-Saving Birthcare Model

Inside Tanzania’s Life-Saving Birthcare Model

Inside Tanzania’s Life-Saving Birthcare Model

Tanzania is winning the battle against maternal and newborn deaths, as the latest numbers reveal a significant decline.

“Tanzania is committed to reducing maternal and newborn mortality and ensuring safe deliveries as part of the national development plan. The Safer Births Bundle of Care is one of the key strategies supporting this effort,” said Dr. Benjamin Kamala, the Senior Research Scientist at Haydom Lutheran Hospital and Principal Investigator for the program, leading its implementation across five regions in Tanzania.

A groundbreaking study published in the New England Journal of Medicine shows that the innovative health program in Tanzania – centered on regular, on-the-job training for healthcare workers – reduced maternal deaths by 75% and early newborn deaths by 40%. The three-year study, conducted across 30 high-burden healthcare facilities in Tanzania, tracked approximately 300,000 mother-baby pairs under the Safer Births Bundle of Care (SBBC) programme. The programme focuses on improving care for mothers and babies during the day of birth, the critical time when a woman goes into labor and delivers her baby.

Maternal health is a key focus of the United Nations Sustainable Development Goals (SDGs), specifically Target 3.1, which aims to reduce the global maternal mortality ratio to fewer than 70 deaths per 100,000 live births by 2030.

Tanzania’s program combines continuous, simulation-based training for frontline healthcare workers alongside innovative clinical tools to improve labour monitoring (fetal heart rate monitoring) and newborn resuscitation.It also uses data to drive ongoing improvements, ensuring that healthcare workers have the skills, confidence, and competence to manage birth-related complications for both mothers and newborns.

“We work closely with healthcare workers, equipping them with the necessary tools to improve the quality of care, ensuring they can effectively manage both mothers and babies during and after childbirth,” Dr. Kamala said, which helps them build on over a decade of innovative research and collaboration to improve care during childbirth.

“To give you a sense of the scale of the burden of maternal and newborn mortality in Tanzania when the Safer Births Bundles of Care program was in early development in 2015/16, there were around 556 maternal deaths per 100,000 live births and 25 neonatal deaths per 1,000 live births,” he said.

The published study demonstrates the “transformative impact” of the Safer Births Bundle of Care program conducted across 30 hospitals in five high-burden regions of Tanzania, where there were about 300,000 mother-baby pairs.

Maternal deaths at the start of the program were recorded at 240 per 100,000 live births, with postpartum hemorrhage and hypertensive disorders being the leading causes of death, he said. Over the 24-month study period, this number dropped to approximately 60 per 100,000 live births, representing a 75% reduction. The number of newborn deaths – which are primarily due to breathing difficulties and complications related to prematurity – declined by 40% – from 7 deaths per 1,000 live births to 4 deaths per 1,000 live births.

“These results are remarkable,” Dr. Kamala said.

According to Dr. Kamala, the 75% reduction in maternal deaths was not expected, and a key lesson was the important role of the in-situ team simulations – including for postpartum bleeding – with reflective debriefings that trained facilitators led.

“This seems to be a major part of the success of the program,” he said. “We are delighted by these results and hope that other countries adopt and scale the Safer Births Bundle of Care program… Beyond the numbers, the Safer Births Bundle of Care program has fostered a dramatic culture shift in our healthcare system,” he said. “Healthcare workers are now more confident and better equipped to handle birth-related complications for both mothers and babies.”

Maternal death drop

Dr. Kamala attributed the 60-70% reduction in newborn deaths in Geita and Manyara to several factors.

“Firstly, Manyara was the first site for implementation, giving the region more time to adapt and experience the impact of the program. Most importantly, both regions had a high burden of stillbirths and neonatal deaths, making them ideal targets for focused intervention. As a result, newborn deaths decreased by 60-70%, showcasing a clear positive impact on newborn survival,” he said.

Dr. Kamala said another possible explanation is the differences in the culture of practices, where some health facilities reported inaccurate data due to the fear of blame and shame. However, with the project’s implementation, reporting became more accurate after mplementation. Some regions, such as Tabora, reported an increase in the number of referrals to the study hospitals from other care centers after the program was implemented. These were more likely to be late admissions, which increase the likelihood of poor health outcomes, he said.

After the implementation of the program, there was a 40% decrease in newborn deaths within the first 24 hours after birth, according to the study.

Dr. Kamala said Tanzania’s remarkable progress in reducing maternal mortality by 80% is driven by strategic investments and innovative programs focused on improving maternal and child survival rates.

“Over 2,000 new healthcare facilities have been developed, free health services are being provided to expectant mothers and children under the age of five, and emergency obstetric care – including better transport to hospitals in rural areas are helping to ensure timely, life-saving interventions.

“Most importantly, the Ministry of Health works in collaboration with healthcare workers, hospitals, and development partners to strengthen the skills of frontline healthcare workers, which has been a key factor in driving this progress.

“Political leadership, alongside strategic partnerships and financing, has been crucial in driving progress in maternal and newborn health,” he said.

The program was made possible by the support of the Global Financing Facility for Women, Children, and Adolescents, Norad, UNICEF, and Laerdal Global Health, as well as the Ministry of Health and Haydom Lutheran Hospital. Their partnership and investment enabled the scaling of the Safer Births Bundle of Care to 30 hospitals and supported the research. “The government has now scaled the program to over 150 sites, and there are plans for further expansion to three regions this year and then nationally,” he said.

Dr. Kamala outlined key policy recommendations for other governments can adopt to prioritize maternal health.

“Firstly, it focuses on cost-effective and relatively simple interventions that are essential to preventing maternal and newborn deaths. For example, stronger primary healthcare that is delivered in the community and a well-trained healthcare workforce are also critical. Additionally, working in close collaboration with national, regional, and local health authorities is key.”

He said Tanzania’s approach, where the Safer Births Bundle of Care program was successfully scaled and sustained by aligning the initiative with national guidelines for obstetrical and newborn care. In addition, the creation of mentorship programs and regular supervision has helped to sustain the results.

Looking ahead

Tanzania now plans to expand to three new regions in 2025, followed by a nationwide rollout.

The success of the program has attracted interest from other countries, with Botswana, Ethiopia, Lesotho, and Namibia expressing interest in adapting the program to their healthcare system. In Nigeria, the program has already been launched in two states, Gombe and Borno, marking a significant step in its scaling.

Source: allafrica.com

Tanzania Declares End of Marburg Virus Disease Outbreak

Tanzania Declares End of Marburg Virus Disease Outbreak

Tanzania Declares End of Marburg Virus Disease Outbreak

Tanzania today declared the end of Marburg virus disease outbreak after recording no new cases over 42 days since the death of the last confirmed case on 28 January 2025.

The outbreak, in which two confirmed and eight probable cases were recorded (all deceased), was the second the country has experienced. Both this outbreak, which was declared on 20 January 2025, and the one in 2023 occurred in the north-eastern Kagera region.

In response to the latest outbreak, Tanzania’s health authorities set up coordination and response systems, with support from World Health Organization (WHO) and partners, at the national and regional levels and reinforced control measures to swiftly detect cases, enhance clinical care, infection prevention as well as strengthen collaboration with communities to raise awareness and help curb further spread of the virus.

Growing expertise in public health emergency response in the African region has been crucial in mounting effective outbreak control measures. Drawing on experience from the response to the 2023 Marburg virus disease outbreak, WHO worked closely with Tanzanian health authorities to rapidly scale up key measures such as disease surveillance and trained more than 1000 frontline health workers in contact tracing, clinical care and public health risk communication. The Organization also delivered over five tonnes of essential medical supplies and equipment.

“The dedication of frontline health workers and the efforts of the national authorities and our partners have paid off,” said Dr Charles Sagoe-Moses, WHO Representative in Tanzania. “While the outbreak has been declared over, we remain vigilant to respond swiftly if any cases are detected and are supporting ongoing efforts to provide psychosocial care to families affected by the outbreak.”

Building on the momentum during the acute phase of the outbreak response, measures have been put in place to reinforce the capacity of local health facilities to respond to potential future outbreaks. WHO and partners are procuring additional laboratory supplies and other equipment for disease detection and surveillance and other critical services.

Marburg virus disease is highly virulent and causes haemorrhagic fever. It belongs to the same family as the virus that causes Ebola virus disease. Illness caused by Marburg virus begins abruptly. Patients present with high fever, severe headache and severe malaise. They may develop severe haemorrhagic symptoms within seven days.

In the African region, previous outbreaks and sporadic cases have been reported in Angola, the Democratic Republic of the Congo, Ghana, Kenya, Equatorial Guinea, Rwanda, South Africa and Uganda.

Source: allafrica.com

Tanzania Confirms Second Marburg Outbreak After WHO Chief Visit

Tanzania Confirms Second Marburg Outbreak After WHO Chief Visit

Dar es Salaam — Tanzania’s President Samia Suluhu Hassan has declared an outbreak of Marburg virus, confirming a single case in the northwestern region of Kagera after a meeting with WHO director-general Tedros Adhanom Ghebreyesus.

The confirmation follows days of speculation about a possible outbreak in the region, after the WHO reported a number of deaths suspected to be linked to the highly infectious disease.

While Tanzania’s Ministry of Health declared last week that all suspected cases had tested negative for Marburg, the WHO called for additional testing at international reference laboratories.

“We never know when an outbreak might occur in a neighbouring nation. So we ensure infection prevention control assessments at every point of care as routine as a morning greeting at our workplaces.”Amelia Clemence, public health researcher

Subsequent laboratory tests conducted at Kagera’s Kabaile Mobile Laboratory and confirmed in Dar es Salaam identified one positive case, while 25 other suspected cases tested negative, the president told a press conference in Dodoma, in the east of the country today (Monday).

“The epicentre has now shifted to Biharamulo district of Kagera,” she told the press conference, distinguishing this outbreak from the previous one centred in Bukoba district.

Tedros said the WHO would release US$3 million from its emergencies contingency fund to support efforts to contain the outbreak.

Health authorities stepped up surveillance and deployed emergency response teams after the WHO raised the alarm about nine suspected cases in the region, including eight deaths.

The suspected cases displayed symptoms consistent with Marburg infection, including headache, high fever, diarrhoea, and haemorrhagic complications, according to the WHO’s alert to member countries on 14 January. The organisation noted a case fatality rate of 89 per cent among the suspected cases.

“We appreciate the swift attention accorded by the WHO,” Hassan said.

She said her administration immediately investigated the WHO’s alert.

“The government took several measures, including the investigation of suspected individuals and the deployment of emergency response teams,” she added.

Cross-border transmission

The emergence of this case in a region that experienced Tanzania’s first-ever Marburg outbreak in March 2023 has raised concerns about cross-border transmission, particularly following Rwanda’s recent outbreak that infected 66 people and killed 15 before being declared over in December 2024.

The situation is particularly critical given Kagera’s position as a transport hub connecting four East African nations.

Amelia Clemence, a public health researcher working in the region, says constant vigilance is required.

“We never know when an outbreak might occur in a neighbouring nation. So we ensure infection prevention control assessments at every point of care as routine as a morning greeting at our workplaces.”

The Kagera region’s ecosystem, home to fruit bats that serve as natural reservoirs for the Marburg virus, adds another layer of complexity to disease surveillance efforts.

The virus, closely related to Ebola, spreads through contact with bodily fluids and can cause severe haemorrhagic fever.

Transparency urged

Elizabeth Sanga, shadow minister of health for Tanzania’s ACT Wazalendo opposition party, says greater transparency would help guide public health measures.

“This could have helped to guide those who are traveling to the affected region to be more vigilant and prevent the risk of further spread,” she said.

WHO regional director for Africa Matshidiso Moeti says early notification of investigation outcomes is important.

“We stand ready to support the government in its efforts to investigate and ensure that measures are in place for an effective and rapid response,” she said, noting that existing national capacities built from previous health emergencies could be quickly mobilised.

The situation coincides with leadership changes in Tanzania’s Ministry of Health, with both the chief medical officer and permanent secretary being replaced.

This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.

Source: allafrica.com

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