Inside Tanzania’s Life-Saving Birthcare Model

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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

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Tanzania Declares End of Marburg Virus Disease Outbreak

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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

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Groundbreaking Health Intervention in Tanzania Cuts Maternal And Newborn Deaths

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In: Tanzania Foreign Investment News

Monrovia — A revolutionary health intervention program in Tanzania, which focuses on improving the quality of care during birth, is significantly reducing the rates of maternal and newborn mortality in the country, according to a new study.

The Safe Birth Bundle of Care (SBBC) program involves the use of clinical and training tools for “improved labor care and newborn resuscitation”. The program, according to the authors of the study, is integrated with “new strategies for continuous quality improvement”. The intervention has “cut maternal deaths by 75% and early new born deaths by 40,” the report stated.

Tanzania’s success is being touted as a model for countries in the region to emulate. The Africa Centers for Disease Control said in February that within a seven-year period, the east African nation cut maternal deaths from 550 per 100,000 live births in 2016 to 104 per 100,000 in 2022. This, according to the African health watchdog, is attributed – among other things – to “political commitment”, which has led to various interventions in the health sector – including better equipment at hospitals and an increase in the number of health facilities.

“This study shows how by working together through innovative partnerships to leverage cost-effective solutions, we can strengthen health systems, improve birth outcomes and save lives,” Tanzanian Health Minister, Janista  Mhagama, said. She noted that in light of the “transformative impacts”  the program has had on lives and livelihoods, “we are now scaling these efforts across Tanzania”.

The report is the result of a three-year study that assessed “approximately 300,000 mother-baby pairs across 30 high-burden healthcare facilities implementing the Safer Births Bundle of Care program”. The program provides frequent on-site simulation training for health workers, in addition to clinical tools to “better monitor heart rates and perform resuscitation”, the authors said in a statement.

Despite global progress in reducing the rates of maternal and newborn mortality, Africa continues to experience disproportionately high levels of deaths related to pregnancy, childbirth, and the neonatal.  The region accounted for 69% of global maternal deaths in 2020, according to Africa CDC. The major complications, accounting for 75% of all maternal deaths, include obstetric hemorrhage, infection, and high blood pressure during pregnancy.

The SBBC study found that the newborn period accounts for almost half of the deaths of children under the age of five, “and most of those preventable deaths occur in low- and lower-middle-income countries”. The program has drawn interest from other countries, including Nigeria and Ethiopia, as they seek “cost-effective, scalable solutions” to reduce birth-related deaths.

Tanzania has made major strides in the last several years to improve health outcomes. This is attributed to an uptick in government spending in the sector. A 2024/25 revenue and expenditure report of the Ministry of Health revealed that health facilities have increased from 8,549 in 2021 to 9,693. The Ministry also cited an increase in diagnostic and disease detection equipment, as well as an increase in bed capacity.

Access to healthcare facilities in the rural parts of the country, however, still remains a challenge, as is tackling cultural practices and beliefs which tend to discourage women from seeking healthcare.

*The UN Sustainable Development of Goal of reducing maternal mortality by 20230 is less than 70 deaths per 100,000 live births.

Source: allafrica.com

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Tanzania Confirms Second Marburg Outbreak After WHO Chief Visit

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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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Investment at port to prolong cruise ship stays

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Investment at port to prolong cruise ship stays

Belfast Harbour is to invest £90m to improve the port’s facilities for cruise ships and the wind energy industry.

It is hoped the investment will mean more cruises start and finish in the city rather than just calling for a day.

It is part of a wider £300m spending plan by the harbour over the next five years.

The harbour is also seeking a change in the law which would allow it to borrow money for investment.

Almost 150 cruise ships called in Belfast last year, bringing 260,000 passengers and crew.

The harbour hopes that it can convince companies to start and finish cruises in Belfast and will upgrade its facilities for that purpose.

It will involve moving the cruise terminal to a currently undeveloped site on Airport Road West.

Belfast Harbour chief executive Joe O’Neill said: “Part of our ambition is to do what are called turnaround cruises.

“That’s where people come here, they board, they do a seven-day cruise and return.

“To cater for that segment of the market we need more substantial facilities, an airport type terminal.”

The site already has planning permission and the facility could be complete by late 2027 or early 2028.

Moving the cruise berth will also free up space to expand the harbour’s existing marshalling area for wind turbines.

Mr O’Neill said there were increased opportunities in the sector with some major offshore wind farms being planned off the Irish coast.

“We envisage about 30 different windfarm projects over the next 10 years or so in our natural trading hinterland,” he said.

“We’ve got some existing capacity but we want to enhance that.”

Investment by the harbour is currently funded from its retained earnings, rather than by borrowing money.

It wants to borrow to invest in larger projects but is currently constrained by its legal status.

It is classified as a public corporation, meaning that any debt it takes on counts as part of Stormont’s capital budget.

It wants to be reclassified as a private corporation which requires legal changes, including reducing the role of the Infrastructure Minister in appointing the harbour board.

A change to the law in Scotland has allowed similar legal reclassification of ports there.

The Department of Infrastructure has launched a consultation on the issue.

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Tanzania Declares Marburg Outbreak – Africa CDC Mobilizes Immediate Response

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Tanzania Declares Marburg Outbreak – Africa CDC Mobilizes Immediate Response

Addis Ababa, January 20, 2025</Strong> — Tanzania has declared a Marburg virus disease (MVD) outbreak after confirming one case and identifying 25 suspected cases in the Kagera Region of Northwestern Tanzania. The Marburg virus, a highly infectious and often fatal disease, is similar to Ebola and is transmitted to humans from fruit bats and monkeys. This outbreak marks the nation’s second encounter with the deadly virus, following the outbreak in Bukoba District of Kagera Region in March 2023, which resulted in nine cases and six deaths.

In response to this urgent threat, the Africa CDC is mobilizing strong support to help Tanzania contain the outbreak. A team of twelve public health experts will be deployed as part of an advance mission in the next 24 hours. The multidisciplinary team includes epidemiologists, risk communication, infection prevention and control (IPC), and laboratory experts to provide on-ground support for surveillance, IPC, diagnostics, and community engagement.

The Director-General of Africa CDC, Dr. Jean Kaseya, has engaged with Tanzania’s President Samia Suluhu Hassan and the Minister of Health to ensure coordinated efforts and secure political commitment for the response.

“Africa CDC stands firmly with Tanzania in this critical moment. To support the government’s efforts, we are committing US$ 2 million to bolster immediate response measures, including deploying public health experts, strengthening diagnostics, and enhancing case management. Building on Tanzania’s commendable response during the 2023 outbreak, we are confident that swift and decisive action, combined with our support and those of other partners, will bring this outbreak under control,” Dr. Kaseya stated.

Africa CDC has recently supported efforts to enhance the diagnostic and sequencing capacity of public health laboratories in Tanzania. PCR Test kits and genomic sequencing reagents have been dispatched, with additional supplies in the pipeline. To ensure rapid identification and confirmation of cases, the institution will also provide technical assistance to strengthen detection and genome sequencing for better characterization of the pathogen. Additionally, support will be provided to improve case management protocols and enhance the capacity to deliver safe and effective treatment.

Africa CDC is committed to working closely with the Government of Tanzania, regional partners, international organizations, and global stakeholders, including the World Health Organization, to stop the spread of the Marburg virus.

Source: allafrica.com

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Tanzania Confirms Outbreak of Marburg Virus Disease

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Dodoma — Tanzania today confirmed an outbreak of Marburg virus disease in the northwestern Kagera region after one case tested positive for the virus following investigations and laboratory analysis of suspected cases of the disease.

President of the Republic of Tanzania, Her Excellency Samia Suluhu Hassan, made the announcement during a press briefing alongside World Health Organization (WHO) Director-General, Dr Tedros Adhanom Ghebreyesus, in the country’s administrative capital Dodoma.

“Laboratory tests conducted in Kabaile Mobile Laboratory in Kagera and later confirmed in Dar es Salaam identified one patient as being infected with the Marburg virus. Fortunately, the remaining suspected patients tested negative,” the president said. “We have demonstrated in the past our ability to contain a similar outbreak and are determined to do the same this time around.”

A total of 25 suspected cases have been reported as of 20 January 2025, all of whom have tested negative and are currently under close follow-up, the president said. The cases have been reported in Biharamulo and Muleba districts in Kagera.

“We have resolved to reassure the general public in Tanzania and the international community as a whole of our collective determination to address the global health challenges, including the Marburg virus disease,” said H.E President Hassan.

WHO is supporting Tanzanian health authorities to enhance key outbreak control measures including disease surveillance, testing, treatment, infection prevention and control, case management, as well as increasing public awareness among communities to prevent further spread of the virus.

“WHO, working with its partners, is committed to supporting the government of Tanzania to bring the outbreak under control as soon as possible, and to build a healthier, safer, fairer future for all the people of Tanzania,” said Dr Tedros. “Now is a time for collaboration, and commitment, to protecting the health of all people in Tanzania, and the region, from the risks posed by this disease.”

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.

“The declaration by the president and the measures being taken by the government are crucial in addressing the threat of this disease at the local and national levels as well as preventing potential cross-border spread,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “Our priority is to support the government to rapidly scale up measures to effectively respond to this outbreak and safeguard the health of the population,”

Tanzania previously reported an outbreak of Marburg in March 2023 – the country’s first – in Kagera region, in which a total of nine cases (eight confirmed and one probable) and six deaths were reported, with a case fatality ratio of 67%.

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.

Marburg virus is transmitted to people from fruit bats and spreads among humans through direct contact with the bodily fluids of infected people, surfaces and materials. Although several promising candidate medical countermeasures are currently undergoing clinical trials, there is no licensed treatment or vaccine for effective management or prevention of Marburg virus disease. However, early access to treatment and supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms, improve survival.

Source: allafrica.com

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