Thursday, 26 May 2016

Tanzania Maternal Child


maternal & newborn health
© UNICEF Tanzania/2010/Pudlowski
Leha, 30, with her three-month old baby Shefari. She has 7 children, all were born at home. In Tanzania, only half of all deliveries take place at health facilities.
Tanzania’s progress in maternal and child health
Fast facts
  • Under-five mortality 81/1,000 live births
  • Neonatal mortality 26/1,000 live births
  • Infant mortality 51/1,000 live births
  • Maternal mortality 454/100,000 live births
  • Delivery in health facility 51%
  • Pregnant women immunized against Tetanus (TT2+) 48%
  • Children (12-23 months) fully immunized 75%
  • Children under five sleeping under an insecticide treated net 64%
  • Proportion of infants with low birth weight (<2.5kg) 7%
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.
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 immunization, Vitamin A supplementation, the use of insecticide treated bed nets and better drugs to treat malaria. Despite improvements, about 390 children under five die every day of mainly preventable and treatable conditions.
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 immunization 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.
© UNICEF Tanzania
In Tanzania, only 23 per cent of children are exclusively breastfed for the first six months of life.
Mothers and babies
Of great concern are the high death rates of newborn babies and mothers. Around 32 per cent of all under-five deaths occur in the first 28 days of life – many infants survive for only a few days.
These deaths occur in a context where about half of all births take place at home, with assistance from a relative or traditional birth attendant. Most of these births take place in unhygienic conditions. If life threatening complications develop at home the realization and decision making often comes too late to reach appropriate care at health facilities in time.  
Neonatal deaths are inextricably linked to the health of the mother during pregnancy and to the conditions of delivery and newborn care. Close to 8,000 women die every year during pregnancy and child birth as a result of conditions that could have been prevented or treated. Poor quality of care due to an insufficient number of skilled health workers and lack of basic equipment, as well as long distances from home to health care facilities are major deterrents to facility delivery. Women living in rural areas, those who come from the poorest families and those who are less educated, have the least access to skilled attendance at delivery. Women who start having children in adolescence tend to have more children and shorter spacing between pregnancies – all of which are risk factors for maternal and neonatal mortality. The neonatal mortality rate is highest among mothers under-20 years of age at 45 per 1000 live births compared with 29 per 1000 for mothers aged 20 to 29 years.
Maternal death rates are closely linked with the high fertility rates and low socio-economic status of women, especially the lack of influence that women have over their own health care or over the daily household budget. About 40 per cent of Tanzanian women do not participate in significant decisions regarding their own health care. On average, every Tanzanian woman gives birth to 5 or 6 children and 1 in 3 of them begins childbearing before the 18th birthday.
Tanzania is very far from achieving the Millennium Development Goal of reducing Maternal Mortality (MDG5). According to 2009/10 Demographic and Health Survey,  every year 454 women die from pregnancy related complications for every 100,000 live births. Causes of maternal death include obstetric haemorrhage, unsafe abortions, eclampsia, obstructed labour and infections. Low availability of emergency obstetric and new born care services, chronic shortage of skilled health providers together with a weak referral system contribute to the observed high maternal deaths.