ZANZIBAR: SINCE 2016, maternal mortality ratio (MMR) and infant mortality rate has been decreasing globally, particularly in two regions of central and south Asia and Australia and New Zealand.
With only six years to SDG 2030, researchers say that the goal of reaching a global maternal mortality ratio (MMR) of 70 maternal deaths per 100 000 livebirths remains elusive, as in many developing countries more than two hundred maternal deaths per 100 000 livebirths is still reported.
Zanzibar has been recording an overall decrease, but the current estimated rate of 260 per 100,000 deaths; the Neonatal mortality at 29 per 1000 live births; infant mortality at 54 per 1000 live births and mortality in children under 5 years old at 73 per 1000 live births, is unacceptable.
The majority of maternal deaths in Zanzibar occur during childbirth and the immediate postpartum period and the major direct causes of maternal mortality include haemorrhage, pregnancy-induced hypertension, obstructed labour, high blood pressure during pregnancy, malnutrition, infection and unsafe abortion.
Studies have indicated that although antenatal care (ANC) coverage is high in Zanzibar, with more than 90 per cent of pregnant women making at least one visit during pregnancy, many women do not attend the recommended four ANC visits and the use of maternal health services is low, where about 50 per cent of all babies are delivered at home by unskilled attendants.
Health researchers have pointed out that major challenges that obstruct reducing maternal, newborn and child mortality had been limited access to quality health services, a weak referral system and poor health-seeking behaviour among women.
Against that backdrop, Zanzibar with support from different development partners has embarked on multiple interventions: training workforce, employ more health workers, build new or improve health facilities and digitising services, including ‘wired mothers’ among others.
USAID is one of the committed development partners supporting Zanzibar end maternal and child mortality by introducing five-year (Jan 2022– Jan 2027) activity/project dubbed ‘Afya Yangu, Mama na Mtoto (My Health, Mother and Child)’.
The project which is also implemented in some areas of Tanzania mainland, supports the government of the United Republic of Tanzania and the Revolutionary Government of Zanzibar to increase use of, demand for and access to quality integrated RMNCAH services, particularly among women of reproductive age, youth and children.
The activity is implemented in 11 regions of Tanzania mainland and Zanzibar and the integrated reproductive, maternal, newborn, child and adolescent health (RMCAH), primary health care focused project uses a client-centred and results-driven approach to programme implementation.
The project amplifies best practices and accelerates progress with the use of innovations to achieve the following intermediate results: improved access to quality, client-centred RMNCAH services at health facilities and community and strengthened linkages between health facilities and communities.
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USAID Afya Yangu, Mama na Mtoto overall vision is to have Tanzanian youth and women engaged, empowered and well-informed when making decisions relating to their reproductive health needs, ultimately contributing to the country’s long-term prosperity and improving the health outcomes of Tanzanians.
In line with locally led development strategies, USAID Afya Yangu, Mama na Mtoto engaged 21 civil society organisations through grants under contracts, to plan, coordinate and supervise the implementation of community-level interventions to promote the adoption of positive health-seeking and self-care behaviours across priority areas.
Key Achievements recorded in almost two years (October 2022 – September 2023) on Maternal, Newborn Health include around 6,000 health care providers across 1,915 health facilities in project-supported regions, including Zanzibar, have been capacitated on high impact maternal/newborn health skills targeted to address root causes of maternal and newborn deaths to improve both the quality and outcomes of RMNCAH services.
About 355,000 pregnant women were supported to attend their first antenatal care visit before 12 weeks of gestation (contributing to 42 per cent of the national annual antenatal care coverage) to ensure care during pregnancy for improved maternal and newborn.
According to Mr Dominic Fortunatus, Communications Officer, USAID Afya Yangu, Mama na Mtoto, about 870,210 women (in regions covered by the project) gave birth in health facilities receiving U.S. government technical assistance (contributing 50 per cent of the national annual facility delivery coverage).
He added that the expected results and impact by September 30, this year, in project-supported regions, an estimated 2,800 maternal and newborn health facilities will receive technical assistance to improve access and quality of RMNCAH, Family Planning (FP) and nutrition services.
“An estimated 400,000 pregnant women will access improved quality antenatal care and childbirth services for better pregnancy and newborn outcomes and more than one-million pregnant women will deliver in a project-supported health facility (contributing 50 per cent of the national annual facility delivery coverage),” he explained.
Health officers in Zanzibar, such as Dr Kamilya Ali Omar- Programme Manager, Integrated Reproductive and Child Health Programme (IRCHP) commend the impact of the USAID Afya yangu Mama na Mtoto project.
She said that the more than USD 79 million project is making a difference “And we hope that its objectives that include reduction of maternal and infant mortality in Zanzibar will be achieved. Commitment and behaviour change among health workers after training, is important.”
She said that with improved facilities in Zanzibar under the eighth phase government of President Hussein Ali Mwinyi, there should be no more deaths of women and infant linked to delivery and that by applying knowledge received during USAID Afya yangu capacity building, it is possible for Zanzibar to get closer to the SDG target.