ASDIT Project

ACCESSING SAFE DELIVERIES IN TANZANIA

Background information

Accessing Safe Deliveries in Tanzania (ASDIT) is the project implemented by Tanzanian Training Centre for International Health (TTCIH) based in Ifakara and Dalhousie University of Canada. This project is funded by the Canadian government through its Innovating for Maternal and Child Health for Africa (IMCHA) program. The overarching goal of this project is to reduce maternal and neonatal morbidity and mortality in Tanzania by means of enhancing safe deliveries through supporting comprehensive emergency obstetric and neonatal care services at the health centre (HC) level. With maternal mortality ratio (MMR) at 554 per 100,000 live births, neonatal mortality rate at 19 per 1,000 livebirths in 2015 and only 10% – 13% of health facilities providing the full set of basic emergency obstetric and neonatal care (BEmONC) or comprehensive emergency obstetric and neonatal care (CEmONC) signal functions, Tanzania needs to expand the number of facilities providing these services in more remote areas.[1, 2] This project introduced/ strengthened CEmONC services in five health centres located in underserved rural areas in Morogoro region in 2016 – 2019 using associate clinicians.

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Research Questions

To what extent does CEmONC implementation in health centres alter unmet need for emergency obstetrical and newborn services, and change maternal and newborn morbidity & mortality rates in the study health centres?
How does post-training mentorship, continuous supportive supervision, and continuing education impact on CEmONC delivery in health centres?

Research Areas

We Deliver Innovative Solutions

CEmONC Training

Training of staff from five health centres in CEmONC and anaesthesia were carried out in various periods

The first group of 20 care providers that included teams of associate clinicians and nurse-midwives

Were conducted from April – October 2016. Assistant medical officers (AMO) were trained in CEmONC

Clinical officers and nurse/ midwives were trained in anaesthesia.

Other training programs were held during implementation of the project.

Post Training Activities

These activities were conducted on quarterly basis and included:

Clinical audits for C-sections

Maternal and deaths and morbidities

Fresh stillbirth admitted with audible fetal heart beats

Early neonatal deaths.

eLearning for HealtH Care Workers

Six eLearning modules were developed and uploaded on stand-alone computers in all supported health centres to reinforce CEmONC skills and knowledge

Computers that did not require continuous internet access since this is not available to most of the health centres. In 2019 the modules were uploaded on the care providers’ mobile phones through mobile Moodle app

The project established mobile based-teleconsultation services in all these facilities. All health centres were equipped with the mobile phones (handsets) enabled with Closed User Group (CUG) service

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