Tanzania: Improvement in Maternal, Child Health As Mortality Rate Drops

Kagera region has recorded impressive performance by reducing infant mortality to 15/1,000 live births compared to the national average which currently stands at 51/1,000 live births, the Kagera Regional Commissioner (RC) Salim Kijuu has disclosed.

Mr Kijuu informed the Minister for Health, Community Development, Gender, Elderly and Children, Ms Ummy Mwalimu during her recent tour of the region that the maternal mortality ration was also cut down to 115/100,000 live births compared to the national average which stood at 454/100,000 live births.

According to Mr Kijuu, Kagera region recorded impressive in vaccination of children attaining 103 per cent above the national average which stood at 90 per cent. The number of dispensaries increased from 206 during 2005 to 239 by 2010, health centres increased from 21 (2005) to 28 (2010) while the number of hospitals also increased from 13 during 2005 to 15 by 2010.

"The government is keen to ensure that more lives were saved through improved health delivery and construction of health facilities including dispensaries in rural areas where most Tanzanians lived.

The continuing decline can be attributed to Government commitments to increase use of key health interventions, such as sustained high coverage of routine under-five immunisation, Vitamin A supplementation, the use of insecticide treated bed nets and better drugs to treat malaria," Mr Kijuu said.

He further said a total of 560,484 Insecticide Treated Nets (ITN were distributed to people in effort to control Malaria, which was a leading killer disease.

The efforts include Indoor Residual Spraying (IRS), use of Insecticide Treated Nets (ITN) and to provide measles vaccinations and polio jabs to infants. However, he revealed that between 200-300 children die every year due to preventable diseases.

A Maternity Ward at the Bukoba Regional Referral Hospital was recently rehabilitated in bid to provide quality services to the patients, the Kagera Regional Medical Officer (RMO), Dr Thomas Rutachunzibwa has disclosed.

Through expansion of the two Maternity wards the bed capacity increased from 26 beds to 65. Minister Ummy Mwalimu launched the two maternity wards and pledged to donate 20 beds and mattresses. "I commend the region for their efforts.

However, more effort should be made to ensure that no woman dies due to pregnancy-related complications," she said. She noted that as the country strives to reach middle income status, the health sector has resolved to give more attention to the quality of health services in tandem with the pursuit of universal access.

The maternal mortality rate (MMR) is the annual number of female deaths per 100,000 live births from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes).

The MMR includes deaths during pregnancy, childbirth, or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, for a specified year. Millennium Development Goal (MDG) 5 calls for the reduction of maternal mortality ratio by three quarters between 1990 and 2015.

It has been a challenge to assess the extent of progress due to the lack of reliable and accurate maternal mortality data - particularly in developing-country settings where maternal mortality is high.

Complications during pregnancy and childbirth are a leading cause of death and disability among women of reproductive age in developing countries. Statistically, maternal mortality contributes to only 2.3 per cent of the total mortality.

According to recent estimates in 2013, total maternal deaths and MMR in Tanzania are 7,900 and 410 per 100,000 live births respectively. The main direct causes of maternal death are haemorrhages, infections, unsafe abortions, hypertensive disorders and obstructed labours.

The presence of these causes is exacerbated by HIV and malaria, Tanzania's number one killer. The fact that more than half of births in Tanzania occur at home also contributes to the elevated maternal mortality rate.

Of all pregnant women, only 46 percent are assisted during childbirth by a doctor, clinical officer, nurse, midwife or maternal and child health aide. Better health of a population is central to the development of a nation since a healthy population lives longer and is more productive and contributing more to a nation's economy. Effective public health system from the grassroots level are important in providing care for the sick and putting in place measures that promote preventive services of diseases.

Unsafe abortions are increasingly threatening lives of many women in the country. A recent study conducted in Sengerema District Hospital in Mwanza Region revealed that 34 women died last year as they went for treatment as soon as they underwent the bad practice.

Apart from the reported deaths, it was also revealed that between 700 and 900 women were reported to suffer from various illnesses as they attempted unsafe abortions. Legalising medical abortions or safe abortions was important due to the fact that many women in the country undergo different forms of sexual assaults that force them to experience miscarriages hence abortions.

Dr Eliezar Chibwe of the Bugando Medical Centre (MCC) said the situation was quite alarming due to the fact that performing safe abortions was not legalised in the country and is only strictly permitted on serious medical grounds.

Shortage of medical doctors was another challenge likely to worsen the situation that even if a permission for safe abortion has been granted best practices instruct for a team of three doctors to review the case.

In Tanzania one doctor attends 50,000 contrary to the World Health Organisation (WHO) which recommends for one doctor to attend 5,000. Tanzania is making considerable progress in the reduction of child mortality. Under-five mortality rates continue to drop from 112 deaths per 1,000 live births in 2005 to 81 in 2010.

The deaths of infants under one year also decreased from 68 to 51 per 1,000 live births over the same period. In the latest WHO -maternal mortality rate (MMR) Tanzania ranked 23rd among 183 countries with 460 deaths per 100,000 live births together with Malawi and Afghanistan.

Chad tops the list with 1,100 deaths followed by Somalia (1,000 deaths), Sierra Leone (890), Central African Republic ( 890), Burundi (800), Guinea Bissau (790). Tanzania is close to meeting the 2015 Millennium Development Goal of reducing child mortality (MDG 4).

However, current efforts need to be sustained and scaled up in some areas in order to maintain and build on the achievements. High population growth places additional strain on service provision at all levels.

Pockets of low performance for key interventions also have an impact. For example, fluctuations in routine measles immunisation of children under-five years has led to outbreaks and necessitated emergency measles campaigns.

Neonatal conditions like birth asphyxia and infections are the major causes of death in young children, followed by pneumonia, diarrhoea and malaria. AIDS is also a major killer, responsible for about 9 per cent of under-five deaths. Poor nutrition is a significant compounding factor in child mortality.

Source: Tanzania Daily News.