Averting Maternal Death and Disability in an Urban Network of Care in Dar es Salaam, Tanzania: A Descriptive Case Study
The non-governmental organization Comprehensive Community Based Rehabilitation in Tanzania (CCBRT) developed a multi-facility maternal and neonatal Network of Care (NOC) among 22 government hospitals and catchment facilities operating across Dar es Salaam. While facility delivery rates were above 90...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2020-09-01
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| Series: | Health Systems & Reform |
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| Online Access: | http://dx.doi.org/10.1080/23288604.2020.1834303 |
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| author | Brenda Sequeira D’Mello Paschal Bwile Andy E. Carmone Katherine Kalaris Grace Magembe Mangalu Masweko Esther Mtumbuka Timothy Mushi Zaida Sellah Bedan Gichanga |
| author_facet | Brenda Sequeira D’Mello Paschal Bwile Andy E. Carmone Katherine Kalaris Grace Magembe Mangalu Masweko Esther Mtumbuka Timothy Mushi Zaida Sellah Bedan Gichanga |
| author_sort | Brenda Sequeira D’Mello |
| collection | DOAJ |
| description | The non-governmental organization Comprehensive Community Based Rehabilitation in Tanzania (CCBRT) developed a multi-facility maternal and neonatal Network of Care (NOC) among 22 government hospitals and catchment facilities operating across Dar es Salaam. While facility delivery rates were above 90% in the Dar es Salaam region, the quality of services was substandard, leading to an excess of preventable maternal and neonatal morbidity and mortality. In partnership with the Dar es Salaam regional health authorities CCBRT developed a plan to improve the quality of service delivery at childbirth by through a system strengthening approach, capacitating lower-level facilities to provide routine care during pregnancy and uncomplicated deliveries, as well as improving care at secondary level referral hospitals and developing an inter-connected strengthened referral system. The Regional–CCBRT partnership implemented interventions across the continuum of care that included clinical training in basic and comprehensive emergency obstetric care, investments in infrastructure, and a rigorous maternal and perinatal death audit and follow-up program. Routine data generated were reflected upon at quarterly quality improvement meetings to follow up on problems identified. The government has initiated the replication of the model. This descriptive case study uses the four domains of the Networks of Care framework to document the wide-ranging efforts made to build and maintain the CCBRT Network of Care in order to solve for specific challenges in maternal and neonatal health service delivery in the urban context of the Dar es Salaam region. |
| first_indexed | 2024-12-14T17:42:53Z |
| format | Article |
| id | doaj.art-f438eb0a9fc244fd913aeda6e33c1037 |
| institution | Directory Open Access Journal |
| issn | 2328-8604 2328-8620 |
| language | English |
| last_indexed | 2024-12-14T17:42:53Z |
| publishDate | 2020-09-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Health Systems & Reform |
| spelling | doaj.art-f438eb0a9fc244fd913aeda6e33c10372022-12-21T22:52:48ZengTaylor & Francis GroupHealth Systems & Reform2328-86042328-86202020-09-016210.1080/23288604.2020.18343031834303Averting Maternal Death and Disability in an Urban Network of Care in Dar es Salaam, Tanzania: A Descriptive Case StudyBrenda Sequeira D’Mello0Paschal Bwile1Andy E. Carmone2Katherine Kalaris3Grace Magembe4Mangalu Masweko5Esther Mtumbuka6Timothy Mushi7Zaida Sellah8Bedan Gichanga9Comprehensive Community Based Rehabilitation in Tanzania (CCBRT)Clinton Health Access InitiativeClinton Health Access InitiativeClinton Health Access InitiativeTanzania - Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC)Comprehensive Community Based Rehabilitation in Tanzania (CCBRT)Clinton Health Access InitiativeComprehensive Community Based Rehabilitation in Tanzania (CCBRT)Tanzania - Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC)Comprehensive Community Based Rehabilitation in Tanzania (CCBRT)The non-governmental organization Comprehensive Community Based Rehabilitation in Tanzania (CCBRT) developed a multi-facility maternal and neonatal Network of Care (NOC) among 22 government hospitals and catchment facilities operating across Dar es Salaam. While facility delivery rates were above 90% in the Dar es Salaam region, the quality of services was substandard, leading to an excess of preventable maternal and neonatal morbidity and mortality. In partnership with the Dar es Salaam regional health authorities CCBRT developed a plan to improve the quality of service delivery at childbirth by through a system strengthening approach, capacitating lower-level facilities to provide routine care during pregnancy and uncomplicated deliveries, as well as improving care at secondary level referral hospitals and developing an inter-connected strengthened referral system. The Regional–CCBRT partnership implemented interventions across the continuum of care that included clinical training in basic and comprehensive emergency obstetric care, investments in infrastructure, and a rigorous maternal and perinatal death audit and follow-up program. Routine data generated were reflected upon at quarterly quality improvement meetings to follow up on problems identified. The government has initiated the replication of the model. This descriptive case study uses the four domains of the Networks of Care framework to document the wide-ranging efforts made to build and maintain the CCBRT Network of Care in order to solve for specific challenges in maternal and neonatal health service delivery in the urban context of the Dar es Salaam region.http://dx.doi.org/10.1080/23288604.2020.1834303health systems strengtheningmaternal and neonatal healthnetworks of carestandards-based performanceperformance management |
| spellingShingle | Brenda Sequeira D’Mello Paschal Bwile Andy E. Carmone Katherine Kalaris Grace Magembe Mangalu Masweko Esther Mtumbuka Timothy Mushi Zaida Sellah Bedan Gichanga Averting Maternal Death and Disability in an Urban Network of Care in Dar es Salaam, Tanzania: A Descriptive Case Study Health Systems & Reform health systems strengthening maternal and neonatal health networks of care standards-based performance performance management |
| title | Averting Maternal Death and Disability in an Urban Network of Care in Dar es Salaam, Tanzania: A Descriptive Case Study |
| title_full | Averting Maternal Death and Disability in an Urban Network of Care in Dar es Salaam, Tanzania: A Descriptive Case Study |
| title_fullStr | Averting Maternal Death and Disability in an Urban Network of Care in Dar es Salaam, Tanzania: A Descriptive Case Study |
| title_full_unstemmed | Averting Maternal Death and Disability in an Urban Network of Care in Dar es Salaam, Tanzania: A Descriptive Case Study |
| title_short | Averting Maternal Death and Disability in an Urban Network of Care in Dar es Salaam, Tanzania: A Descriptive Case Study |
| title_sort | averting maternal death and disability in an urban network of care in dar es salaam tanzania a descriptive case study |
| topic | health systems strengthening maternal and neonatal health networks of care standards-based performance performance management |
| url | http://dx.doi.org/10.1080/23288604.2020.1834303 |
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