Photo credit: Benjamin Eagle
At Kupona Foundation, we believe that disability prevention is just as important as the ‘cure’ available through corrective surgery and rehabilitation. That is why our maternal and newborn healthcare and disability programs work hand-in-hand to improve the quality of comprehensive care available to Tanzanian families. In this ‘cross over’ report, we share how our maternal and newborn healthcare teams are improving outcomes for people with disabilities in Dar es Salaam.
In February 2012, Dr. Yoni Barnhard, a Kupona Board member and American OBGYN, visited Amana Hospital in Dar es Salaam, Tanzania. He found himself in an overcrowded, under-staffed, under-equipped labor and delivery ward, and later shared his experiences in a series of GlobalGiving reports.
“Amana. Second largest district hospital in Dar es Salaam. 29,000 deliveries each year. Do the math. Teeming with births. Just 6 birthing beds. Not actually birthing beds. Metal tables with a hole at one end. Fresh blood dripping through. A bucket underneath. No full-time OBGYN. No full-time anesthesiologist. No air conditioning. 92 degrees outside. Hotter inside. This is where we start.”
Four years later, we’ve come a long way. Improvements1 across the board at Amana Hospital mean that staff have the skills, confidence and time to provide high quality care.
But what does maternal health have to do with disabilities?
Quality maternal healthcare is one of the cornerstones of disability prevention. Trained healthcare workers providing high quality maternal healthcare in clean, well-resourced facilities are better equipped to recognize and mitigate the risk of a woman developing a disability like obstetric fistula during childbirth. Teams also have the time and training to identify congenital impairments such as cleft lip or clubfoot in newborns, and refer them for treatment as soon as possible after birth.
A healthy child born to a healthy mother is less likely to be caught in the cycle of poverty, and more likely to pursue education and employment later in life.
Relieving the Pressure
Dar es Salaam’s healthcare system was designed to support a city of 750,000 people; hospitals and clinics now serve a population of over 4.4 million. Severe overcrowding hampers healthcare workers’ ability to give every patient the attention and quality of care they deserve. When Dr. Barnhard first visited Amana, the hospital conducted 2,000 deliveries a month. He counted three nurses helping 41 women in labor.
Capacity building and training at smaller pre-referral healthcare facilities across the region means that families now place their trust in more facilities, decongesting wards at district and regional hospitals and relieving the pressure on healthcare teams. Today, Amana Hospital conducts 1,000 deliveries a month, giving staff more time to focus on each patient.
Lasting Change You Empowered
Thanks to the tireless efforts of CCBRT’s Maternal and Newborn Healthcare team, in close partnership with the Government of Tanzania, Amana is unrecognizable. Kupona’s dedicated donors joined a committed network of supporters and partners including Vodafone Foundation, Global Affairs Canada (GAC – formerly DFATD), and CBM Australia. Today, expectant mothers are entering a very different hospital with the confidence that their attending delivery teams will be able to identify and treat complications before a serious injury or disability develops.
The team at CCBRT’s Disability Hospital in Dar es Salaam, a referral center for people with disabilities in the region, has also observed positive trends. A marked decline in the number of women presenting with obstetric fistula after delivering at a Dar es Salaam healthcare facility, and an increase in the number of children with impairments such as clubfoot and cleft lip being referred for treatment as newborns reinforces the link to improved maternal and newborn healthcare. More importantly, it means fewer women and children are suffering needlessly for months or years with preventable or correctable impairments.
There is still room for improvement, particularly in early labor wards which are still crowded. However, CCBRT is ready to meet remaining challenges, spurred on by the success you’ve supported. Four years later, the future for Tanzanian families looks much brighter.
- Following a recent assessment, Amana achieved 78% of quality standards for Basic Emergency Obstetric Care, measured by Standards-Based Management and Recognition (SBMR) assessments, developed by Jhpiego, an affiliate of Johns Hopkins University compared to Amana’s baseline score of 9% in 2010.
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