Enabling best possible childbirth care in Tanzania – The PartoMa Project

Info

Start date: 1 April, 2019 End date: 31 March, 2024 Project type: Research collaboration projects in Danida priority countries (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.

Outputs

First-year report:

1) All five hospitals have given their formal acceptance to participate in the research project.
2) Ethical research clearance and research permit have been issued by National Institute for Medical Research, Tanzania and COSTECH, Tanzania.
2) PhD student 1 (Brenda D’Mello) has been enrolled at University of Copenhagen and has finalised development of data collection tools. PhD student 2 (Rashid Khamis) from State University of Zanzibar is presently engaged in developing a study protocol.
3) The first scientific paper, which provides a historical review of the maternal and perinatal health internventions in the five study study sites, has now been submitted to BMJ Global Health. First author is PhD student Brenda D’Mello.
4) A commentary with the title ’Impact of COVID-19 on maternal and child health’ was published by PhD student Brenda D’Mello and other PartoMa Project researchers in The Lancet on 3rd August 2020.

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