Maternity and paediatric care, Zanzibar

Maternity and paediatric care, Zanzibar

In 2020, as part of our Million Mothers pledge, we started scoping and then implementing a programme to eliminate all avoidable maternal deaths and the deaths of babies in Zanzibar. This is a five-year programme to build and equip the very best maternal and neonatal facilities on the island.

By training doctors, midwives and other health workers, the holistic programme will improve the lives of mothers giving birth with the very best care. Globally, maternal and child health outcomes have improved markedly in the last 25 years.

However, universal access to quality healthcare including maternal and new-born care – an integral part of achieving the third Sustainable Development Goal of the UN 2030 – remains a substantial challenge in many low and middle-income countries.

What is the issue? In Zanzibar, achieving universal access to quality maternal and newborn health care represents a significant hurdle towards reducing maternal and child mortality. According to the 2015/2017 Demographic Health Survey, under-five mortality in Zanzibar is elevated with 56 deaths per 1,000 live births. Rates have not been that high in the UK for over 100 years.

What is the benefit? In 2019, over 4,700 babies were delivered in the facilities we work with and on this basis, we expect over 5,000 women to benefit in the first year of this programme, a minimum of 50,000 mothers over the decade.

So, what can we do? The programme we will implement with our local delivery partner, HIPZ, will train healthcare workers in a holistic set of competencies including maternal and new-born health-specific skills, improved facility management and quality improvement. We will implement the training for 100 healthcare workers and facility development in five primary healthcare units and two district hospitals.How will we do this? Through a series of low-intensity and high-frequency in-house training, on-the-job training and supportive supervision, staff will develop a set of rounded skills that will enable them to run their facilities effectively, manage their resources efficiently and deliver high-quality clinical services. These improved facilities will in turn improve the levels of trust in the local community, increasing the mother’s trust to use hospital facilities and thereby reducing complications and the risk of death for mother or baby.

The activities outlined below will increase the number of health facilities on the islands of Zanzibar delivering high-quality services in the following stages:

  • pregnancy
  • childbirth including emergency intervention
  • essential new-born care especially for children with complications including pre-mature births

The most important part of this is the outcomes we seek to drive. This programme will increase the coverage of quality maternal and newborn health services in Zanzibar resulting in an improvement in:

  • detection of at-risk pregnancies
  • reducing the number of emergencies needing intervention
  • eliminating the number of maternal deaths and the stillbirth rate
  • early pregnancy deaths
  • the patient experience for all mothers giving birth  

By developing healthcare workers’ skills and support structures, the programme will improve the quality of service and create a positive working environment, improving medical staff satisfaction.

We will work together with leading experts in the field including Dr Tarek Meguid, a Consultant Obstetrician and Gynaecologist with over two decades experience in Burundi, Namibia and Zanzibar and a globally recognised expert in the field.  

Dr Tarek Meguid, Team Lead on Safe Births Zanzibar:

This vision starts with the ambition to actually eradicate maternal deaths and not to accept any rate of maternal deaths that is higher than that in rich countries. If this is possible anywhere in Africa, where for instance the risk of dying of complications of a caesarean section is fifty times (50!) higher than in affluent countries, then Zanzibar is the place to make this happen!

With the commitment to this, as expressed by mobilizing the needed resources and political will, by the Lady Fatemah Trust I feel honoured and excited to lead a team of equally committed colleagues from many different professional fields, in this effort and contribute to what would be the first African country to achieve a breakthrough in this area. Zanzibar could really become a shining example for others as to what can actually be achieved when putting minds, hearts and souls together for one goal. And to actually mean it when saying that mothers and their babies, born and unborn, are truly worth everything.