Pregnancy in the context of climate change: Co-creating climate-responsive antenatal care for urban Tanzania (the CC-ANC Project)


Start date: 1 October, 2023 End date: 30 September, 2028 Project type: Research projects in countries with extended development cooperation (earlier Window 1) Project code: 23-11-KU Countries: Tanzania Thematic areas: Gender equality, Health, Lead institution: University of Copenhagen (UCPH), Denmark Partner institutions: Aga Khan University (AKU), Tanzania Project coordinator: Dan Meyrowitsch Total grant: 9,999,991 DKK

Project summary

Antenatal care (ANC), which pregnant women are recommended to obtain from trained health professionals, offers multiple opportunities to improve sexual and reproductive health and rights (SRHR). However, Sub-Saharan African (SSA) women continue to face barriers to access the full range of effective recommended SRHR services, including pregnancy care. Climate change (CC) effects in African countries are already being seen, although Africa currently contributes only 4% of the world's carbon emission. Many of the consequences of CC, including increase in frequency of extreme weather events, sea level rise, air pollution and infectious disease outbreaks, present serious obstacles for the health of vulnerable pregnant women.

With 98.5% of pregnant women in urban Tanzania having at least one ANC visit, and ANC services already decentralized to ensure short distances, the time is overdue for ensuring that pregnant women can meet their individual reproductive health goals in a safe and respectful environment. We call this new intervention project the CC-ANC Project, where CC stands for both climate change and co-creation. Acknowledging the inextricable links between pregnancy, CC and urbanization, the aim of the CC-ANC Project is to develop quality ANC care that is sensitive to CC and rapid urbanization in Dar es Salaam, Tanzania. It expands the Danida-financed safe delivery PartoMa Project with an innovative, bottom-up-created ANC intervention.

There are four stages in the CC-ANC intervention: (i) A situation assessment of the contextual circumstances of being pregnant in Dar es Salaam, focusing on CC-related challenges faced by pregnant women and healthcare providers. This will inform the (ii) co-creation of two context-specific ANC guidelines: one for pregnant women and one for healthcare providers. Thereafter, (iii) the new ANC guidelines will be implemented and tested. The evaluation of effects includes both qualitative and quantitative research methodologies, comparing with the period before the ANC facilities received new guidelines and training. Finally, (iv) lessons learned will be compiled to identify contextual factors (CC, urbanization, gender) and intervention features (co-creation process) that should be considered for intervention scale-up and sustaining positive effects, with the aim of contributing to learning for developing high quality, CC-responsive ANC in other urban contexts.

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