Major increase in births at Haydom hospital in Tanzania

The hospital attributes the increase in deliveries partly to free transport costs for delivering mothers. Previously women in labour had to pay for transport, including ambulance, but in order to attract more delivering mothers Haydom Hospital decided that these services should be free of charge. The hospital services to mothers and children are already exempted from payment. This policy shift to free ambulance services seems to have had a clear impact by augmenting both the number of women using the ambulance services, and the overall number of deliveries.

High Maternal and Child Mortality

Skilled care at delivery is internationally recognized as crucial for reducing maternal deaths, and Tanzania has adopted a policy of increasing the number of births attended by skilled health workers. Today less than 50 percent of all births in Tanzania occur at health facilities. Annually, more than 8000 women die in the country due to pregnancy related causes.

Tanzania has had success in reducing child mortality under 5 years, but there has been little progress in reducing the mortality rate of newborns, the current estimates for newborn, infants and under five mortality rates are; 32, 68 and 112 per 1 000 live births.

Visit from the Embassy

A delegation from the Norwegian Embassy visited Haydom Lutheran Hospital from 20- 22 January in connection with the Annual Meeting between the Embassy and Haydom Hospital. The meeting focused on progress made in 2008, and especially on the hospital's achievements related to improving reproductive and child health care services.

For a number of years the Norwegian Embassy has cooperated with Haydom Lutheran Hospital, which is situated in Mbulu district in Manyara region. The hospital is run by the Evangelical Lutheran Church of Tanzania, Mbulu Diocese, and has a capacity of 400 beds, serving 5 districts in 4 regions. The hospital's immediate catchment area is approximately 300.000 people and the greater reference area is of more than 2.1 million people. The hospital serves 27 reproductive and child health mobile clinics, providing services to more than 28.000 mothers and 83.000 children annually.

Decrease in Patient Deaths

In 2007 the cooperation between the Embassy and the hospital was expanded as Haydom became a partner under the Norway Tanzania Partnership Initiative on Millennium Development Goals 4 and 5 (NTPI), which aims at reducing maternal and child mortality. The Embassy has provided additional funds of NOK 14,8 million to Haydom for a five year period for scaling up the hospital's ongoing work on maternal, newborn and child health care.

Haydom Hospital has intensified and improved its work at the hospital and its connected health centres, as well as in the outreach work. The focus on improving hospital care has shown effect, and there has been a substantial increase in the number of women and children attending the Reproductive and Child Health Care services, and in the number of children treated in the hospital's 70 bed Paediatric Ward. Equally important, the hospital has witnessed a decrease in deaths of hospitalized patients.

Research

As a part of the hospital's MDG 4&5 programme researchers are enabled to follow the programme and document results and constraints in order to improve the clinical quality, which produces valuable data that the NTPI as a whole can benefit from. Haydom has a long tradition of scientific work and has for many years hosted numerous research projects. With NTPI-funds from the Embassy, Haydom Hospital has recruited a research coordinator to attract and facilitate research activities related to MDG 4&5.

In April 2008 the hospital facilitated a research conference on nutrition and child behaviour in Haydom with the collaboration of researchers from the University of Illinois and the University of Bergen. The hospital will further participate in a large world wide state of art study on malnutrition. This project is funded by the Gates Foundation, and involves collaboration between institutions from nine different countries. Also several of the ongoing research projects at Haydom have as their objectives to gain insights that could potentially lead to improved maternal, newborn and child health. Among others there is an ongoing medical anthropology research project focusing on why and how women make decisions of giving birth in health institutions, and a research project focusing on prevention of mother to child transmission of HIV and mothers' views on the recommended nursing practices.

Reproduced with permission from the Norwegian Embassy in Tanzania.