Enabling best possible childbirth care in Tanzania – The PartoMa Project

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.