Effectiveness of community based safe motherhood promoters in improving the utilization of obstetric care. The case of Mtwara Rural District in Tanzania

BMC Pregnancy and Childbirth

Research Article

Declare Mushi¹  Albrecht Jahn²  Rose Mpembeni³ 

[1] Department of Community Health, Tumaini University-Kilimanjaro Christian Medical Centre, P.O. Box, 2240, Moshi, Kilimanjaro, Tanzania;Institute of Public Health, Ruprecht-Karls-University, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany;School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O Box 65015, Dar es Salaam, Tanzania;

关键词: Obstetric Care;    Maternal Mortality Ratio;    Traditional Birth Attendant;    Maternal Health Service;    Community Volunteer;   

DOI  :  10.1186/1471-2393-10-14

 received in 2009-08-11, accepted in 2010-04-01,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundIn Tanzania, maternal mortality ratio remains unacceptably high at 578/100,000 live births. Despite a high coverage of antenatal care (96%), only 44% of deliveries take place within the formal health services. Still, "Ensure skilled attendant at birth" is acknowledged as one of the most effective interventions to reduce maternal deaths. Exploring the potential of community-based interventions in increasing the utilization of obstetric care, the study aimed at developing, testing and assessing a community-based safe motherhood intervention in Mtwara rural District of Tanzania.MethodThis community-based intervention was designed as a pre-post comparison study, covering 4 villages with a total population of 8300. Intervention activities were implemented by 50 trained safe motherhood promoters (SMPs). Their tasks focused on promoting early and complete antenatal care visits and delivery with a skilled attendant. Data on all 512 deliveries taking place from October 2004 to November 2006 were collected by the SMPs and cross-checked with health service records. In addition 242 respondents were interviewed with respect to knowledge on safe motherhood issues and their perception of the SMP's performance. Skilled delivery attendance was our primary outcome; secondary outcomes included antenatal care attendance and knowledge on Safe Motherhood issues.ResultsDeliveries with skilled attendant significantly increased from 34.1% to 51.4% (ρ < 0.05). Early ANC booking (4 to 16 weeks) rose significantly from 18.7% at baseline to 37.7% in 2005 and 56.9% (ρ < 0.001) at final assessment. After two years 44 (88%) of the SMPs were still active, 79% of pregnant women were visited. Further benefits included the enhancement of male involvement in safe motherhood issues.ConclusionThe study has demonstrated the effectiveness of community-based safe motherhood intervention in promoting the utilization of obstetric care and a skilled attendant at delivery. This improvement is attributed to the SMPs' home visits and the close collaboration with existing community structures as well as health services.

【 授权许可】

CC BY   
© Mushi et al; licensee BioMed Central Ltd. 2010