Sustainability of Maternal and Newborn Health Programs: What Can We Learn from Tanzania?

Florina Serbanescu, Centers for Disease Control and Prevention (CDC)
Ahmad Makwuani, Tanzanian Ministry of Health
Abdulaziz Msuya, CDC Foundation, Field
Sunday Dominico, Tanzania Ministry of Health
Carrie Shapiro-Mendoza, Centers for Disease Control and Prevention

Reducing maternal and newborn mortality is a global priority. During 2013–2018, a donor-supported Program to Reduce Maternal Deaths was successfully implemented in Kigoma, Tanzania, a region with high maternal and newborn mortality. The program increased access to emergency obstetric and reproductive health care, resulting in 43% maternal and 29% neonatal mortality declines. Because health benefits may diminish or disappear after donor funding ends, assessing ongoing trends in maternal, newborn and reproductive health services and outcomes is critical to understand program sustainability. To better understand program sustainability, we compared the status of maternal and newborn health services and outcomes in 2018 with the status 4 years after the program ended (2022). We used multiple data collection methods. They included health facility assessments, pregnancy outcomes monitoring, and Rapid Ascertainment Process of Institutional Death methodology to extract, verify, and triangulate data on maternal deaths from all available sources (e.g., patient records, birth registers, nurses’ notebooks, morgue) in 202 maternities. The sustainability evaluation found that maternal and newborn health services and outcomes continued to improve after the program ended, demonstrating that a well-designed and implemented transition of key program strategies and activities to local leadership helped maintain and expand the program gains.

Keywords: Health and Morbidity, Longitudinal studies , Family Planning and Contraception, Sexual and Reproductive Health and Rights

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