May 2024 was the warmest May on record. And every month before that, starting in June 2023, was the world’s hottest such month on record, according to data from the Copernicus Climate Change Service.
This warming climate has generated devastating impacts on communities across the world, but especially in Africa, where droughts and floods are lasting longer and cyclones are becoming more destructive.
We are seeing this now in Eastern Africa, where heavy rains and flash floods continue to cause damage and displacement. And who can forget the devastation caused by Cyclone Freddy, which in 2023 affected six countries in Africa and was the longest-lasting tropical cyclone ever recorded. It became the third-deadliest tropical cyclone recorded in the Southern Hemisphere.
Communities that face extreme weather and climate events exhibit tremendous resourcefulness, local innovation and resilience to deal with these events with the locally available knowledge and resources, as best as they can.
However, in the face of such extreme weather events, if their efforts are complemented by effective early warning and early action systems, the loss of lives and livelihoods can be reduced greatly.
Effective early warning and early action systems, that are multi-hazard and trigger early actions by governments and communities, have been shown to help countries reduce disaster deaths by six-fold, and can help them reduce economic damage by 30 percent with warnings as little as 24 hours before a hazardous event.
Despite these benefits, huge gaps remain around the world in early warning coverage. In Africa, only 45 percent of countries have reported the existence of systems.
That is why the Government of Tanzania, the Government of Italy, through the Italian Agency for Development Cooperation (AICS), and the United Nations Office for Disaster Risk Reduction (UNDRR) have partnered to establish Tanzania’s first national situation room for early warning and early action – the Emergency Operation and Communication Centre (EOCC), which was inaugurated in Dodoma on June 14, 2024.
This centre will combine real-time data on current and emerging disaster risks with data on past disasters to issue timely forecasts and bulletins. These forecasts and bulletins will aim to trigger protective early actions to save lives, protect livelihoods and safeguard economic sectors.
What makes this centre unique is that it is also the first national situation room to join a growing content-wide network of sub-regional situation rooms under the African Union’s Africa Multi-Hazard Early Warning and Early Action System Programme. As a result, Tanzania will be able to access data from across Africa to guard against cross-border hazards, increase its early warning lead time to meet the needs of its vulnerable communities, and enhance the coordination and effectiveness of early and anticipatory action, while at the same time contributing its data for the benefit of the region.
On a broader level, Italy has been a steadfast partner in supporting Africa to build its disaster resilience. The continental situation room in Addis Ababa and the regional ones in Niamey, Nairobi, Abuja have been created thanks to the support of Italy. This is the fruit of a partnership with Africa which will grow even more with the “Mattei Plan,” which was launched by the Italian Government and aims to intensify and expand cooperation with the continent.
The inauguration of the national centre in Tanzania and the expansion of the African Union network are two great steps towards creating universal early warning coverage, as called for by the United Nations Secretary-General’s Early Warnings for All initiative, which he launched in 2022 to protect every person on the planet with an early warning system by the year 2027.
Italy, Tanzania, the African Union and UNDRR are all proud to play their part in achieving this goal, but we can’t do this alone.
The scale of the challenges that countries face is large and covers every aspect of the early warning chain, from understanding risks to enabling the most vulnerable members of society to act on the early warnings. That is why we need all countries and partners, including the private sector, to support this global effort.
We cannot rest until every country and every community in Africa is protected by a multi-hazard early warning system that leaves no one behind.
Written by Dr Jim James Yonazi, Permanent Secretary, Prime Minister’s Office for Policy, Parliament and Coordination, United Republic of Tanzania; Mr Marco Riccardo Rusconi, Director of the Italian Agency for Development Cooperation (AICS); Mr Kamal Kishore, the Special Representative of the UN Secretary-General for Disaster Risk Reduction and Head of the UN Office for Disaster Risk Reduction (UNDRR)
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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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