Enabling best possible childbirth care in Tanzania – The PartoMa Project


Start date: 1 April, 2019 End date: 31 March, 2025 Project type: Research projects in countries with extended development cooperation (earlier Window 1) Project code: 18-08-KU Countries: Tanzania Thematic areas: Health, Lead institution: University of Copenhagen (UCPH), Denmark Partner institutions: State University of Zanzibar (SUZA), Tanzania Aga Khan University (AKU), Tanzania Comprehensive Community Based Rehabilitation Tanzania (CCBRT), Tanzania Free University Amsterdam (VU), The Netherlands Hvidovre Hospital (HvH), Denmark Project website: go to website (the site might be inactive) Project coordinator: Dan Meyrowitsch Total grant: 11,999,203 DKK

Project summary

Unsafe care at birth is a human rights violation negatively impacting gender equality. Globally, 300,000 women and 5 million babies die annually around birth. With proper care, most would survive. Therefore, clinical guidelines production has expanded for low-resource settings. The guidance is, however, often incompatible with realities. This leaves birth attendants de facto without guidance and with disrespectful work conditions, while care at birth remains unchanged. In collaboration with birth attendants at Zanzibar’s main hospital, the PartoMa study developed a booklet of context-tailored clinical guidance for safe care at birth and quarterly seminars to strengthen its use. A limited pre-post study suggested associated reductions in stillbirths and improved immediate state of health of newborns. The proposed action-based implementation research aims to examine whether the promising pilot intervention of context-tailored guidance and training can be upscaled.

Overall main objectives

In five mega maternity units to:
1. Assess quality of care;
2. To develop and test effects of an upscaled, context-modified PartoMa intervention of clinical guidelines and repeated training for intrapartum care.

Main outputs
1. Results of baseline quality of care assessment;
2. A context-tailored, cost-effective clinical guidance and training intervention;
3. Effects of intervention;
4. Results of baseline mixed-methods assessment of nursing and medical students before and after transitioning to in-service clinical realities in maternal health care.

Main outcomes
1. Simple context-adaptable strategies for safe and respectful care at birth in busy low-resource maternity units, resulting in cost-effective improvement of birth attendants’ knowledge, skills and care delivery and survival at birth;
2. A modified training module for nursing and medical students;
3. Research capacity strengthened at three collaborating institutions in Tanzania.


Midterm report:
Since 2014, the PartoMa project (publichealth.ku.dk/partoma) has co-created and implemented simple and locally achievable clinical practice guidelines and associated training for childbirth care in Tanzania. It was initially a pilot-study in Zanzibar (2014-2018), and it is now implemented as a large scale-up project in Dar es Salaam’s five most busy maternity units. The PartoMa project thereby aims to assist birth attendants in busy low-resource maternity units in delivering best possible safe and respectful care during childbirth.
In October-December 2021, the co-creation of the clinical guidelines and associated training was completed. In May 2022, the intervention was implemented at three of the five hospitals, and the intervention will be implemented at the final two sites in August 2022. Although, the final evaluation will be completed in 2023, the intervention appears highly popular among the health providers and the request for additional clinical guidelines is beyond expectations. Alongside the implementation, the team members are currently analyzing and preparing scientific papers related to the situational analysis and co-creation process.
Six PhD candidates, of which four are supported by DFC, are progressing as planned. They are supported by a strong team of research assistants, master students and highly engaged senior researchers. We have currently collected data for more than 25 scientific publications, which are in different stages of analysis and writing.

Go back to all projects