Tanzania opens frontiers for MSF’s safe delivery mission

LIWALE: “I WANT to continue giving birth to more children even though I have a grandchild at the moment. Having a health centre very close to my home gives me the courage to continue giving a safe birth,” says Vumili Mohammed, aged 36, after her 20-year-old daughter, Sharuu Iddi, recently gave birth to a baby boy.

Vumili, a mother of three, lives at Kuchochorokana village, Likongowele Ward, Liwale District, Lindi Region, and she sees the major improvement in the provision of reproductive health services as relief to young mothers in the Southern regions of Tanzania.

In its tour of the Lindi region, the Daily News found that teen marriages in the Southern regions of Tanzania is a very customary practice to the extent that most of the mothers attending clinics are young.

“Medical staff and nurses are very helpful and humane. For expecting mothers, you just go there with clothes, a basin and a bucket, what comes then is good service and they look after you very well,” she explains.

She commends the Tanzanian government’s commitment to providing quality health care, saying that it has significantly reduced many maternal deaths.

“I thank our government for collaborating with Doctors Without Borders (Médecins Sans Frontières) to help young mothers deliver safely,” she said.

The three-year contract of Doctors Without Borders (MSF) to support the government’s efforts in improving health services is about to end.

In 2023, MSF, in collaboration with the Tanzanian government, began implementing a project to improve maternal and child health by providing services to mothers and children in three dispensaries, two health centres, and the Liwale District Hospital.

This step has had a great opportunity to change the direction of services and increase the number of women giving birth in health centres while reducing maternal deaths.

In 2020 to 2022, before the start of the project, women giving birth in health centres were 9,324, but after the improvement began in 2023 to 2025, the number has reached 12,059.

Regarding maternal deaths, the figures for 2020 to 2022 were 119, and after the project started, it has decreased to 16.

During interviews with villagers, they said that the improvement of services, the provision of education in villages through community-level health workers and others has been building awareness to a great extent.

Despite being her first pregnancy, Sharuu says she has been well educated on maternal health as they were taught the importance of going to the clinic, how to breastfeed, hygiene, sleeping habits, the required diet, and other things.

“We were educated by community health workers, nurses and there was also a television that we watch, they even follow you at home. When we go to the hospital, we sit with the workers who explain the procedures before and after giving birth.

Adding she says she did not know how to breastfeed a child, so after receiving education, she breastfed her child for six months.

She says MSF sends specialists into the community to follow up with patients and women who have given birth at home every few days to check on their condition.

Community-level health worker at Liwale hospital, Said Hassan is supported by MSF to go into the community and provide education.

“They have formed a mother club and they also attend meetings and villages. I get invitations to social activities, and I also go door to door to provide education.

“There is a big challenge of pregnancy and marriage at a young age for the pastoralist community; girls as young as 14 are getting pregnant and married, which leads to problems during childbirth,” she emphasises.

And a nurse from MSF, Majaliwa Joel, says they have built their capacity to provide care, especially for emergency services, and they are now doing well.

“We go to villages to build their capacity on which patients they should serve and which ones they should not serve.

The Nurse Midwife Officer at Kimambi dispensary, Roman Maganya, says that in 2023, MSF went and in 2024 they started providing services, they increased the number of staff from three to six.

“They have helped us with on-the-job training, they transport mothers by car, which is 72 kilometres from their home to the District Hospital, they also provide education and teenage pregnancies have decreased.

MSF Project Manager, Azhar Shah says they provide services in six health centres which are Kibutuka, Kimambi, Barikiwa, Mlembwe, Mpengere, Lilombe and Liwale District Hospital.

“We have chosen Liwale District after seeing that there are many mothers and pregnant women with different problems. We provide maternity care and services for children under five years of age, outpatients at Liwale Hospital.

He notes that they provide care for newborns, train community-level health workers, and provide training in the use of medical equipment.

“Our workers go to the community, meet with village chairmen, sensitise the community about dangerous situations, premature birth,” he explains.

He also identifies challenges as being inaccessible areas and the distance from villages.

He says sometimes they are forced to cross borders to provide services, such as going to Lindi Regional Hospital if there are epidemics such as cholera.

After the three-year contract ends, he says they will add another one and continue to be there for another three years in that service area.

“After three years, the situation will be better, we will improve more services such as medicine, transportation, and emergency cases up to the regional level,” he insists.

Liwale District Chief Medical Officer, Dr Hadija Kitiku, says MSF has been supporting six of the 46 facilities in Liwale District Council by bringing in 16 staff and 16 community health workers.

She says there is still an insufficient number of staff in the District, which is now 30 per cent, and a shortage of equipment.

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“Antenatal services are provided free of charge to mothers and children under five, perhaps outside and not available inside the facility.

Acting Director of Liwale District Council, Hamisi Namaleche, says MSF support has facilitated services as citizens are being treated in their areas.

“MSF has supported us in infrastructure, it pays a percentage of the staff who are employed by the government, it has increased the morale to work efficiently, on Children’s Day, they provided them with necessities such as school supplies, and girls get feminine hygiene products.