Make Motherhood Safe for Tanzanian Women

“Once you know something, it’s hard to un-know it, and you will be compelled to act.” This is a quote from IBM’s Ginni Rometty at the 2014 CGI Annual Meeting. It means a lot to me because, in large part, that’s why I do this. I spent five months at Comprehensive Community Based Rehabilitation in Tanzania (‘CCBRT’) in 2012, and learned about the organization and what they were doing. I was compelled to act by joining Kupona Foundation. Likewise, CCBRT’s 20-year history working in the community in Tanzania led to the recognition that many of the conditions treated at its Disability Hospital (obstetric fistula, cleft lip/palate, clubfoot, pediatric cataract…) could be prevented or identified early and easily corrected. There was a gap. And we were compelled to act. What does Ms. Rometty's quote mean to you?

This is a longer report than we often share. If you have three minutes, watch this YouTube video, which provides a great overview of the maternal and newborn healthcare program that YOU are helping make possible. 

If you have time, I encourage you to read on to learn more about the work that you’re supporting, and to check out photos of the latest construction and our capacity building team at work!

On October 24^th, CCBRT will be celebrating its 20^th Anniversary with an event at the construction site of the Maternity and Newborn Hospital - and we want you to join us for the celebration! Follow our live tweets of the event on Twitter (@KuponaFdn) and check out Kupona Foundation’s Facebook page for photos and updates of the day’s activities. We look forward to celebrating our accomplishments and sharing plans for the future with the supporters who are behind our successes. 

We cannot thank you enough for what you’ve done to help make accessible quality maternal and newborn healthcare in Tanzania a reality. Your donations to Kupona are directly improving the quality of maternal and newborn healthcare available in Dar es Salaam. Contributions will enable us to complete construction on the Maternity and Newborn Hospital on schedule and bring quality medical services to more mothers and newborns in high-risk health situations. With your help, Kupona Foundation and CCBRT look forward to serving the women and children of Tanzania for the next 20 years and beyond!

With gratitude,

Abbey

A look at maternal and newborn healthcare in Dar es Salaam: the past, present and future.

October 12^th, 2014 will mark CCBRT’s twentieth year of service to some of Tanzania’s most vulnerable populations, including pregnant mothers and newborns. Maternal and newborn healthcare in Tanzania has come a long way in the last 20 years. With your help and through our implementing partner, CCBRT, we will strive to ensure that every expectant mother and baby in Dar es Salaam has access to high quality and affordable healthcare in the years to come.

The Past: Twenty years ago, maternal and newborn healthcare providers and facilities in Tanzania did not receive the necessary attention or support to enable them to adequately serve their surrounding populations. The three regional hospitals in Dar es Salaam[1] that now perform most of the deliveries in the city, Temeke, Amana and Mwanyanamala, were not built until 2004. Caesarean sections were only performed at hospitals, rather than at lower level health centers, which meant that women in labor had to travel a longer distance to access emergency services. Furthermore, residents of Dar es Salaam did not trust that lower level health facilities could provide quality healthcare services, which caused significant overcrowding at the municipal maternity and regional hospitals. Tanzania’s national hospital, Muhimbili, had the only maternity unit that operated 24 hours a day; maternity units at other facilities were only open during the mornings.

The Present: With the understanding that many health facilities were overcrowded while some were underutilized, and that many of these facilities could significantly improve their quality of care with some basic investments in human and physical resources, CCBRT established its Maternity and Newborn Healthcare Program in 2010. Since 2010, CCBRT staff have been contributing to capacity building efforts in public health facilities throughout Dar es Salaam, which includes advocating for and investing in respectful and inclusive maternal care as well as training doctors, nurses, anesthetic officers and supporting staff in the most up-to-date maternal and newborn healthcare practices. The capacity building program is also conducting on-the-job training and mentorship for its trainees in Basic Emergency Obstetric and Newborn Care to support their continuous education. CCBRT’s investments in infrastructure and human resources are significantly raising the standards of care in medical situations that were considered hopeless when the program first began.

Just a few months ago, CCBRT added 6 more health facilities in Dar es Salaam to our Maternity and Newborn Healthcare Capacity Building Program, bringing the total number of health facilities supported by CCBRT to 22. These health facilities were selected as partner healthcare centers because they had the staffing potential and adequate existing infrastructure to succeed in enticing patients to use them. Additionally, all of these health centers serve densely populated areas of Dar es Salaam. When CCBRT conducted assessments of these 6 healthcare facilities in April, we found that the facilities were operating well below their delivery capacity. Now, healthcare providers in these facilities are being trained to improve their skills and management systems, and are simultaneously being equipped with the physical resources necessary to close the medical equipment and infrastructure gaps. To combat the distrust of these lower level health facilities in the neighborhoods in which they are located, CCBRT is conducting local sensitization and awareness campaigns that highlight the support that is being given to its partner health centers and to encourage mothers to deliver their babies at these facilities.  

The Future: When it opens in 2016, the CCBRT Maternity and Newborn Hospital will be accessible to patients 24 hours a day and will serve all of the Dar es Salaam region, which is home to over 8 million people. The hospital is projected to perform 15,000 high-risk deliveries a year and will serve women who are experiencing delivery complications such as eclampsia, hemorrhaging and severe anemia; women with disabilities; young women under the age of 18; women with a history of obstetric fistula (who must have a C-section to ensure safety for mother and baby); and newborns with birth asphyxia and low birth weight. These patients will be referred from lower level health centers and hospitals that to do not have the capacity or expertise to care for them, and will receive treatment at CCBRT from the most qualified clinicians in the region. We are in the process of seeking out the best obstetric/gynecologists, anesthesiologists, neonatologists, qualified nurses, midwives and pediatricians – training new healthcare providers within Tanzania (not taking them away from the existing healthcare facilities!), and from abroad for specialists that are not available within the country or region. Through your contributions, you are helping to make this high caliber life-saving care for mothers and babies in Dar es Salaam available for all.

Because of your support, the Maternity and Newborn Hospital will be entering “Phase 5” of construction in the new few weeks. This means construction will soon commence on the outside walls and roofing elements. Plans will be confirmed for the final parts of the building that still need to be constructed, as well as the interior finishing.

Kupona and CCBRT: Confused about how Kupona Foundation fits in? New York-based Kupona was established in 2009 to help connect donations, resources and technical expertise to CCBRT, and to raise awareness about CCBRT’s work. If you have questions or suggestions, send us an email! info@kuponafoundation.org

Congratulations if you made it through the entire report! Many thanks for your ongoing support.

[1] The region of Dar es Salaam has a population of 4.36 million per 2012 national census data.