Service availability and readiness to provide maternal and newborn healthcare services in Kilimanjaro region, Tanzania: a cross sectional study

BMJ Open. 2024 Dec 9;14(12):e086275. doi: 10.1136/bmjopen-2024-086275.

Abstract

Objective: To assess service availability and readiness of health facilities to provide maternal and newborn care in the Kilimanjaro region, northern Tanzania: a study conducted between August to October 2022.

Design: The study used a cross-sectional design by adopting WHO Service Availability and Readiness Assessment tool to assess basic maternal, newborn and child health services delivery in the health facilities of the Kilimanjaro region.

Setting: The study was conducted in seven districts of Kilimanjaro region at health facilities with a labour ward and where delivery and maternal services for women and neonatal care were offered.

Participants: The study included all district hospitals, two selected health centres and two dispensaries within every district with high utilisation of delivery services as well as the regional hospital of Kilimanjaro region making a total of 37 health facilities that were assessed.

Primary outcome: Basic emergency obstetric and newborn care (BEmONC) service availability, BEmONC service readiness, comprehensive emergency obstetric and newborn care (CEmONC) service availability and CEmONC service readiness.

Results: A total of 37 facilities were enrolled that included 14 dispensaries, 14 health centres, 8 district hospitals and 1 regional hospital. The study highlights that majority of the signal functions are available in all levels of health facilities with overall readiness scores in BEmONC and CEmONC being 83% and 98.87%, respectively. However, the study reports that 40.5% of health facilities do not conduct death reviews. Similarly, on-job trainings regarding maternal and newborn healthcare was low, with only 29.8% of all healthcare workers in the region received training for the past 2 years.

Conclusion: Despite progress, challenges persist in delivering tailored maternal and newborn healthcare services in Kilimanjaro region. The study revealed strong readiness in essential care functions, but shortcomings in maternal and neonatal death reviews and training, emphasise the need for improved practices to further enhance maternal and newborn health outcomes.

Keywords: Cross-Sectional Studies; Maternal medicine; PAEDIATRICS; REPRODUCTIVE MEDICINE.

MeSH terms

  • Cross-Sectional Studies
  • Female
  • Health Facilities / statistics & numerical data
  • Health Services Accessibility* / organization & administration
  • Humans
  • Infant, Newborn
  • Maternal Health Services* / organization & administration
  • Maternal Health Services* / standards
  • Maternal Health Services* / statistics & numerical data
  • Maternal-Child Health Services / organization & administration
  • Maternal-Child Health Services / standards
  • Pregnancy
  • Tanzania