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October 10, 2014

Government of Kigoma Launches Campaign to Persuade Women to Deliver in Health Facilities

Note: World Lung Foundation united with The Union North America. From January 2016, the combined organization is known as “Vital Strategies.”

The Government of Kigoma and World Lung Foundation (WLF) today launched Thamini Uhai (Value Life), a radio, outdoor, mobile phone and community outreach campaign aimed at increasing the number of women delivering their babies in health facilities. Delivering at a health facility is the best way of ensuring the health of mothers and babies. This is true not only for women with high-risk pregnancies but for all women, because unanticipated complications can occur at any stage during the delivery process. Only 1 in 3 women in Kigoma deliver their baby in a health facility and this low utilization of health facilities is an underlying reason why Kigoma is estimated to have an even higher rate of maternal death than the country’s maternal mortality ratio of 410 per 100,000 live births.

The Thamini Uhai campaign is designed to address the socio-cultural and attitudinal factors that lead to low health facility utilization. These include misconceptions about the safety of delivering at home, lack of planning to address the long distances and transportation issues that many women face in reaching health facilities, and, in some instances, concerns about poor capacity and care at health facilities. The campaign is intended to reduce deaths due to complications during childbirth by:

– Increasing the likelihood that women will form an intention to deliver at a health facility;
– Increasing the likelihood that women will make a birth plan with their partners and families, including planning for costs, transport and supplies; and
– Increasing the likelihood that women will seek skilled care immediately in response to pregnancy danger signs.

The campaign was pre-tested among its target audience of women and men in the Kigoma region to confirm the effectiveness of the campaign’s messages. The campaign highlights three main messages using five radio spots: one message is focused on the need for birth planning; another on the importance of delivering in a health facility; and the third on the warning signs of complications during pregnancy. Pre-testing found that the most effective radio ads increased risk perception, generated conversation, and modeled positive male behavior, among other variables. The Thamini Uhai campaign also includes wall paintings, posters, mobile phone outreach and an extensive effort to engage community leaders as message ambassadors.

mHealth Messaging Service Promoted to Turn Intention into Action

As women progress through pregnancy and into motherhood, they are expected to attend regular medical appointments to ensure both mother and baby are well. Reminders can help them to attend those appointments, so WLF partnered with the Ministry of Health and Social Welfare and CDC Foundation to incorporate the mHealth messaging service into the campaign. The service, offered by the mHealth Tanzania Public Private Partnership, reaches out to pregnant women and new mothers via mobile phones. It delivers important information and appointment reminders in Swahili, free of charge, to pregnant women and mothers of babies up to 16 weeks of age, their supporters (husband, friends and family) and other interested parties. The content is tailored depending upon the information provided by the mother, who can specify her current week or month of pregnancy (or the age of her newborn baby) during the enrolment process. This enables women to receive specific text messages at the time the information is most relevant to them. The Thamini Uhai ads running on TBC and Radio Kwizera will encourage women to register for this free service by texting the word ‘MTOTO’ (child) to the short-code 15001.

Dr. Leonard Subi, Regional Medical Officer, Ministry of Health and Social Welfare, said, “Knowledge is power, and our duty is not just to make sure that our health facilities are prepared to help mothers deliver their babies safely but that these women and their families are educated to know that coming to a health facility to deliver is the best way to save mothers’ and babies’ lives, especially if there are complications. We appreciate the partnership of World Lung Foundation and all the donors who have helped to make this campaign a reality. Together with continuous strengthening of our health systems, and the collaboration of the many local partners and organizations working to reduce maternal deaths in Kigoma, this campaign is sure to have a positive impact.”

“We are very pleased to have worked closely with the Kigoma regional authority and our partners to launch the Thamini Uhai campaign. One of the best ways to save a mother from needlessly dying in childbirth is to make sure she plans for the birth, and this plan includes planning to deliver in a health facility such as those in the Kigoma region that have been upgraded by WLF and that are staffed with experienced health workers,” said Dr. Nguke, Director of the WLF Maternal Health Project Tanzania. “We know that many women in Kigoma attend ante-natal care appointments but that far fewer go to health facilities to give birth and it is our hope that this campaign, combined with community mobilization efforts on the ground, will help close this gap.”

WLF’s Maternal Health Program

The Thamini Uhai campaign is part of WLF’s Maternal Health Program, which seeks to address several major challenges impeding efforts to reduce maternal mortality in Tanzania. These challenges are exacerbated in the rural region of Kigoma, where there is a higher incidence of staff shortages (Assistant Medical Officers, skilled nurses), inadequate resources, and women coming late to the facilities that are available. Kigoma has been a major focus of WLF’s Maternal Health Program’s efforts for the past five years and a priority for support from Bloomberg Philanthropies.

WLF has supported the upgrade and building of 15 health facilities in the Kigoma, Morogoro and Pwani regions and has trained 106 Non-Physician Clinicians, nurse-midwives and clinical officers in Comprehensive Emergency Obstetric and Newborn Care (CEmONC) and anesthesia across Tanzania. Working across five districts in Kigoma, WLF has helped to upgrade nine facilities, including six health centers, to become CEmONC service delivery facilities. These facilities include health centers in Ujiji, Nguruka, Kakonko, Mabamba, Nyenge, Buhingu and three hospitals: Maweni, Kibondo and Kasulu.

Campaign Donors

The campaign is made possible by support from The Swedish International Development Cooperation Foundation (SIDA), with programmatic support for the Maternal Health Project in Tanzania from Bloomberg Philanthropies and the H & B Agerup Foundation, the project’s principal donors.

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