EngenderHealth and partner organization Thamini Uhai officially transitioned leadership of vital maternal and reproductive health services in Kigoma, Tanzania, to the Tanzanian government. The nonprofit partners supported these services for more than a decade through the Maternal and Reproductive Health Program. The successful transition to government ownership a few days ago was the result of consistently building the government’s capacity to sustain program interventions.

“We are celebrating the program’s success today as activities are transitioning to the government. This success was only possible because all parties played their roles as required, from the national-level to the community-level players,” said Prudence Masako, Country Representative for EngenderHealth Tanzania, speaking at the handover. “The coordination functioned like a machine, where each party played its role.”

Masako continued, “These successes need to be celebrated by all of us and there is also a need to ensure what the program is leaving behind is going to be sustained in the coming years for more celebrations in the future and for the wellbeing of Kigoma women and girls who want to access family planning and comprehensive postabortion care services whenever they need.”

As it adopted the program, Kigoma’s Regional Administrative Secretary Office committed to an increased number of skilled health professionals in Kigoma, sustaining employment of the trained healthcare workers in facilities supported by the program, and an annual budget for health facilities that ensures adequate funds for high-quality maternal and reproductive health services.

The Maternal and Reproductive Health Program was a partnership between the Government of Tanzania, EngenderHealth, the CDC Foundation, the Global Health Advocacy Incubator, and Thamini Uhai, funded by Bloomberg Philanthropies and Foundation H&B Agerup. Over 13 years the program focused on building the capacity of 100 health facilities in Kigoma to offer life-saving maternal and reproductive healthcare. The program also supported interventions in Morogoro and Pwani regions at a smaller scale.

The program improved maternal and neonatal health and increased contraceptive prevalence by improving access to maternal and reproductive health services, particularly emergency obstetric and neonatal care (EmONC), contraception, and postabortion care. Interventions included: upgrading health facilities; supplying essential drugs and equipment for family planning and EmONC; providing training and supportive supervision in EmONC and contraceptive technology; and ensuring adequate contraceptive supplies. Thamini Uhai led the EmONC interventions, while EngenderHealth expanded access to family planning and postabortion care services.

Dr. Paul Chaote, Regional Medical Officer of Kigoma Region, said, “We have observed strengthened and improved maternal, reproductive, and child health services in Kigoma Region. Our region has improved greatly on key maternal health indicators, as compared to the past. Many pregnant women are seeking care and delivering at the improved health facilities supported by the government in partnership with development partners. We have learned a lot as a region from the Maternal and Reproductive Health Program, and this lesson can be scaled up countrywide and in other similar areas.”

Dr. Neena Prasad, Director of the Maternal and Reproductive Health Program at Bloomberg Philanthropies said, “No one should accept that it’s impossible to provide high-quality maternal and reproductive healthcare to women who live in rural communities in developing countries. In the 13 years that we have supported this program in Kigoma, the region has gone from having among the worst maternal health indicators in Tanzania to among the best. Together with the Government of Tanzania, implementing partners, and dedicated communities, we have built a model for delivering maternal healthcare that can inform similar efforts around the world. We feel proud that the program’s goals of increasing utilization of obstetric and family planning care services have been accomplished, and we have the fullest confidence that the government is committed to sustain it.”

An evaluation by the US Centers for Disease Control and Prevention measured the following impacts of the program:

• Increase in contraceptive prevalence rate from 15.6% in 2014 to 21.0% in 2018 for women in union using all modern methods.
• 43% increase in obstetric emergencies treated, from 42.8% in 2011 to 61.3% in 2018 in all facilities.
• 75% increase in facility-based deliveries, from 48% in 2011 to 85% in 2018.
• Increase in life-saving Cesarean sections provided from 2.7% in 2011 to 4.5% in 2018.
• More than 400 health providers trained on family planning services to prevent death and injury from unintended pregnancies.

Dr. Nguke Mwakatundu, Executive Director of Thamini Uhai, said, “The program’s success proved that with well-coordinated and well-implemented interventions to improve the quality of care, experience of care in the health facilities and mobilizing the communities to use the facilities, it is possible to significantly improve the maternal and reproductive health situation in rural areas in Tanzania. The program’s model is a sustainable one and hence I am hopeful the results obtained will be maintained by the government by continuing to use the model and ensure the interventions put in place continue to be implemented in the coming future.”