Tanzania: Improved Mwaya Pre-Natal Clinic Wins Residents’ Hearts
BY JAFFAR MJASIRI(Tanzania Daily News ):
The pre-natal clinic offered at the improved health centre in Mwaya Division, Ulanga District is winning hearts and minds of many residents in the neighbouring villages. Ms Mwahije Malekela who is admitted to the centre bears witness that the improved prenatal services have influenced her decision to deliver there.
"Since I was attending the clinic from the beginning of my pregnancy, I was able to learn that I will need help when its time for delivery," she said.
She said that she had learned from the centre's Assistant Medical Officer that her path to deliver was too small and she might not be able to deliver normally.
She explains that she had started feeling severe labour pain and rushed to the clinic.
Narrating her travel ordeal of a distance of 15 km to the Clinic on Friday, she said she was brought by her family members carried on a bodaboda.
"I was asked to pay 14,000/- for the transport which I did because there was a risk of delivering at home in hands of a traditional birth attendant," she said.
Another woman, Ladia Hassan who spoke to this paper has also benefited from the World Lung Foundation on the Comprehensive Emergency Obstetric care.
She said she was attended by an AMO who had undergone training on the care in Tanzania Training Centre for International Health (TTCIH) which is the architect of the AMO training in Tanzania. The Centre is based in Ifakara, Morogoro.
She further said that she was experiencing serious pain when she arrived in the Mwaya Health Centre. "The baby which is my first born had delayed to come out which made me feel a severe pain," she said.
But the AMO of the Health Centre at Mwaya, Dr Adjustus Haule said that this year there was an increase in the number of patients who delivered at the centre."Currently the number of deliveries has increased to 60," he said.
He also said that many people now opt to deliver at the clinic because maternal health facility has come near them.
Another principle which has lead to the success story, is the task-shifting of Comprehensive Emergency Obstetric care to assistant medical officers and nurse-midwives, he said.
Started in 2008, the project has been able to upgrade ten health centres to perform surgeries in Kigoma, Morogoro and Coast regions.
It also continues to support five hospitals. Under the project more than 100 assistant medical officers have been trained on surgery and nurse-midwives/clinical officers for anaesthesia. The project, however, comes to an end in 2015.
The 'AMO further said the project provides a model where mothers' lives are saved by decentralised life-saving comprehensive obstetric care.
"Operation theatres such as the one here are installed in rural health centres and continuous education is provided to non-physician clinicians (NPCs), so that they can carry out caesarean sections and other designated tasks normally performed by surgeons," he said.
He said that in some regions it is difficult to reach rural areas, adding that in order to reach the health workers such as him and provide continuous clinical support in such areas, the project has improvised a telemedicine approach supported by Airtel - a mobile communication company operating in Tanzania.
He said that the project conducts teleconference or meeting every week which is conducted through phone, drawing participants from various health centres and hospitals in the country to discuss on what has transpired during the week.
He explained that it is an opportunity to highlight problems and discuss the magnitude of the problems facing health centres in the country and make possible intervention. "One of the WLF specialists working with the project normally moderates the discussions," he said, adding that everyone gives suggestions and exchange views on the way to handle the medical cases arising from the discussion. "The objective of the project is to achieve uniform care countrywide.
If a medical practitioner has handled a clinical case wrongly, once the corrections are made during teleconference, someone else will not repeat the mistake," he said.
He said that the mobile phones have been instrumental in saving the lives of patients. "Recently there was a woman with raptured uterus who arrived at 3am and we could not trace anything in the uterus," he said.
But through the mobile interaction with the expert at dawn he advised the AMO and his assistant to carry out a surgery. Through the expert advice the AMO open the stomach of the patient and found the baby. "Though the baby was dead we could save the mother's life," he said.
He also said that it was a blessing to have in place a laboratory, which was installed by the WLF, which has added a burden to them.
"Nowadays all the patients do not want to be treated without taking a blood test, but unfortunately there was no skilled personnel to run the lab.
"Nearly all the patients who had in the past to go to Mahenge to take blood tests now come to our centre which has the capacity to check various communicable and non-communicable diseases.