Speaking in Dar es Salaam over the weekend, Executive Director of Health Promotion Tanzania (HDT), Dr Peter Bujari said Tanzania is one of the countries, which have the highest maternal mortality in sub-Saharan Africa and that it has not declined since 2010.
Dr Bujari cited a ten-year retrospective analysis study (2006-2015) which found that there’s an increase in the number of hospital maternal deaths in public hospitals in Tanzania.
Major direct causes are reported to be eclampsia (34 percent), obstetric haemorrhage (24.6 percent) and maternal sepsis (16.7 percent). Anaemia (14.9 percent) and cardiovascular disorders (14.0 percent) were the main indirect causes.
According to the Tanzania Demographic Health Survey and Malaria Indicator Survey 2015/16, maternal death is 556 per 100,000 among women aged 15-49.
This means, at least 11, 000 pregnant women die per year due to delivery complications.
Dr Bujari said those figures show that 68 percent of deaths would have been avoided if those life-saving drugs were available in health facilities.
Dr Bujari suggested the need for the government to improve logistics of clearing life-saving drugs at the point of entry, which is a challenge that leads to stock outs, expiring at the point of entry and unnecessary storage costs.
The expert said Medical Stores Department (MSD) needs to have enough stock of life-saving drugs for the next six to nine months, “but most of the country’s zonal offices are below.”
“This is a challenge that needs swift measures to be addressed as unavailability of those drugs in health facilities puts mothers at risk of maternal hemorrhage,” he said, recommending the need for the government to review the Value Added Tax (VAT) Act of 2014 and that of public finance Act 2014 to align them with Public Procurement Act, 2016.
“We are also recommending the need for the government to issue the remove of Treasury circular number six of 2018 on the government notice (GN) for exemption of the life saving commodities,” he said.
Flattering of Reproductive and Child Health Services (RCHS) commodities budget for three consecutive years—2017/18-2019/20 and low and irregular disbursements as compared to allocations are some of the challenges fueling maternal death in the country.
“Despite increase in population between 2017/18 to 2019/20, the budget for family planning, life saving commodities and Fansidar remained the same,” he said
“So, we are recommending the need for the government to allocate realistic budget for RCHS commodities to reflect population growth and demand. This also should be in line with increasing disbursement of RCHS budget to commodities procurement,” the expert suggested.
In November last year, Vice President, Samia Suluhu Hassan launched a countrywide campaign aimed at reducing maternal and infant mortality in the country. Dubbed: Jiongeze Tuwavushe Salama, the campaign engages regional and local authorities.
The campaign aims to reduce maternal deaths from the current 556 to 292 per 100,000 women and infant mortality from the current 25 to 16 per 1,000 by 2020.
Globally, each year more than 303,000 women die and every day approximately 830 women die from preventable causes related to pregnancy and child birth. Almost all maternal deaths (99%) occur in developing countries. More than half of these deaths occur in Sub-Saharan Africa with a reported maternal mortality ratio of 239 per 100,000 live births. Another one third of maternal deaths occur in South Asia (WHO, 2016).