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Needs Assessment of Reproductive Maternal Newborn and Child Health in Lake and Western Zones of Tanzania

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Needs Assessment of Reproductive Maternal Newborn and Child Health in Lake and Western Zones of Tanzania The United Republic of Tanzania Ministry of Health and Social Welfare Needs Assessment of Reproductive Maternal Newborn and Child Health in Lake and Western Zones of Tanzania Technical Report July 2015 Disclaimer This need assessment was conducted by a team of contributors from National Institute for Medical Research (NIMR). Funding of the survey was organized by the MOHSW and implemented by the United Nations through UNFPA. The opinions given herein are those of the authors and are not necessarily reflective of the funding agents or the government of Tanzania. List of contributors SN Name Affiliation 1. Dr Julius J.Massaga NIMR 2. Dr Edward S.Maswanya NIMR 3. Dr. Gasto Frumence MUHAS 4. Dr.Ahmadi Makuwani MoH&SW/EAC 5. Ms. Stella Kilima NIMR 6. Ms. Grades Stanley NIMR 7. Prof. Projectine S.Muganyizi MUHAS MsRegional Grades supervisors Stanley 1. Dr. Judith Msovela Shinyanga 2. Dr. Magreth Kagashe Geita 3. Dr. Ali Said Mwanza 4. Ms. Diana Kasembe Tabora 5. Ms, Alfreda Kabakama Kagera 6. Ms, Winfrida C.Newa Simiyu 7. Ms Vicky Magoti Mara 8. Ms. Eugenia Kidyalla Kigoma 9. All data collectors Appendix ii | P a g e Ministry of Health and Social Welfare Tanzania EmONC Assessment report, 2015 TABLE OF CONTENT LIST OF ABBREVIATIONS ....................................................................................................................................... VIII EXECUTIVE SUMMARY ................................................................................................................................................. X 1. BACKGROUND .......................................................................................................................................................... 1 1.1 EMERGENCY OBSTETRIC AND NEWBORN CARE (EMONC) IN TANZANIA ............................................................... 2 2 METHODOLOGY AND LIMITATIONS ................................................................................................................ 5 2.1 SAMPLE SIZE AND DESIGN ................................................................................................................................................. 5 2.1 QUESTIONNAIRE ................................................................................................................................................................. 8 2.2 TRAINING OF FIELD STAFF ................................................................................................................................................ 8 2.3 DATA COLLECTION AND QUALITY CONTROL .................................................................................................................. 9 2.4 DATA ANALYSIS AND PRESENTATION ............................................................................................................................. 9 2.5 LIMITATIONS OF THE SURVEY ....................................................................................................................................... 11 1. FINDINGS ................................................................................................................................................................ 13 3.1 AVAILABILITY OF EMONC SERVICES ........................................................................................................................... 13 3.2 EMONC SERVICE UTILIZATION ..................................................................................................................................... 21 3.3 QUALITY OF LABOUR MONITORING USING PARTOGRAPHY ....................................................................................... 28 3.4 REFERRAL SYSTEM AND INFRASTRUCTURE ................................................................................................................ 31 Distance to refferal Health facility .......................................................................................................................................... 33 3.5 NEWBORN CARE .............................................................................................................................................................. 35 4 CONCLUSION AND RECOMMENDATIONS .................................................................................................... 45 LIST OF TABLES Table 1: Calculation of sample weights for Kagera region ............................................................................ 10 Table 2: Distribution of potential EmONC health facilities by type and region in Lake and Western Zones ........................................................................................................................................................................... 13 Table 3: Percentage of fully functional health facilities in the Lake and Western Zones ........................... 15 Table 4: Distribution of fully functional EmONC facilities per population in the Lake and Western zones ........................................................................................................................................................................... 16 Table 5: Percentage of all potentially EmONC health facilities that provided specific EmONC signal functions in last three months ........................................................................................................................ 18 Table 6: Percentage of EmONC health facilities that provided specific EmONC signal functions adjusted for absence of indicated cases and limiting policy issues. ............................................................................ 18 Table 7: Percentage of Health Facilities giving reasons for failure to provide BEmONC functions .......... 21 iii | P a g e Ministry of Health and Social Welfare Tanzania EmONC Assessment report, 2015 Table 8: Crude Birth Rates and proportion of births in EmONC health facilities in the Lake and Western zones ................................................................................................................................................................. 22 Table 9: Annual Caesarean Section Rate for deliveries that occurred in the Lake and Western zones of Tanzania, 2014 ................................................................................................................................................. 23 Table 10: Direct causes of Mortality- All cases, deaths and Case Fatality Rate in Lake and Western Zone, 2014 .................................................................................................................................................................. 26 Table 11: Percentage of Health Facilities using specific types of partograph ............................................. 31 Table 20: The distribution of Average Time Distance to nearest referral point for EmONC health facility in Lake and Western Zones ............................................................................................................................. 34 Table 21: Proportion (%) of Health Facilities with sanitation and sterilization services .......................... 35 Table 23: Percentage of Health Facilities with utilities for newborn and adult resuscitation in .............. 36 Table 22: Percentage of HFs with elements of essential newborn care and baby friendliness services .. 37 Table 24: Percentage of Health Facilities with utilities for newborn care in Neonatal room .................... 38 Table 25: Percentage of Health Facilities with case management protocols in place ................................ 39 Table 26: Percentage of Health Facilities that consistently provided Antenatal tests and services in last three months .................................................................................................................................................... 40 Table 27: Percentage of all Health Facilities that provided Family planning Methods in last three months .............................................................................................................................................................. 42 LIST OF FIGURES Figure 1: Total number of health facilities that provide delivery services in Lake and Western zones ...... xi Figure 2: Percentage of all deliveries that took place in health facilities (weighted data). .......................... xii Figure 3: Percentage of health facilities that provided full sets of EmONC functions in last three months ........................................................................................................................................................................... xiii Figure 4: Proportion of deliveries in full and non-fully functional health facilities .......................................... xiv Figure 5: Percentage of direct obstetric complications treated in health facilities (weighted data) ......... xiv Figure 6: Annual Cesarean section rates (%) in Lake and Western Zone during 2014................................ xv Figure 7: Percentage of health facilities that provided EmONC functions in last three months ................. xvi iv | P a g e Ministry of Health and Social Welfare Tanzania EmONC Assessment report, 2015 Figure 8: Percentage met need for fully functional EmONC facilities by region ......................................... xvii Figure 9: Overall Case Fatality Rate (%) for the major direct obstetric complications in 2014 ............... xviii Figure 10: Causes of maternal deaths in the Lake and Western zones ........................................................
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