How newly deployed nurse-midwives are saving lives in Musoma, Tanzania.

Musoma, Tanzania: When Otilia Mhagama and three other nurse-midwife colleagues arrived at Nyasho Health Centre in Musoma for their first deployment, they were reflecting on the possibilities their potential tasks could hold. Little did they know their arrival would have a huge impact for Dr. Hillary Mohamed, the Medical Officer in-charge, who manages the understaffed health center. Overall, the health center has a total of 13 nurses with an average 11 deliveries per day. The team typically operates with less than four nurses on a daily roster who are in charge of caring for patients in the Labor & Delivery and Post-Natal wards.

Otilia and her colleagues are among 93 nurse-midwives allocated to the Health Centre through the USAID Afya Endelevu (“Sustainable Health”) activity. The activity, implemented by the Benjamin Mkapa Foundation, supports the Government of Tanzania to address human resources for health gaps across the country. The activity also strengthens the quality of delivery for maternal, reproductive, and child health care services in places like Mara and Geita regions. 

Located in the heart of Musoma Municipality, the  Nyasho Health Centre, which also serves as the Musoma Municipal Council Facility,  attracts a high-volume of children and pregnant women who are often waiting an average of 3 hours due to a shortage of nurses and other healthcare staff. For Dr. Hillary Mohamed, the support of these four newly deployed nurse-midwives, includingOtilia, is a life-changing experience.

“The support came at the right time. Due to a shortage of nurse-midwives, we were working under tension especially when there was a caesarean-section emergency.  But today, we thank God, these staff have improved daily roster and patient care which have also improved client flow and reduced unnecessary referrals,” said Dr. Hillary Mohamed.

Today, with the presence of nurse-midwives like Otilia and her colleagues, they have improved the efficiency of services, including vital procedures such as cesarean-sections. The number of cesarean sections for the months of October to December 2020 were at 31 clients and increased to 56 clients for the months of January to March 2021. In that same time period, the total amount of child deliveries increased from 612 clients to 766 clients, and antenatal care attendance increased from from 271 clients to 315 clients. 

“We used to refer clients to the regional referral hospital because we didn’t have adequate manpower to conduct thorough clinical assessment of pregnant women including care and support during labor and delivery,” added Dr. Hillary.

Client trust and confidence in healthcare workers at Nyasho Health Centre has also improved because of the changes they have seen in the quality of service delivery and the decreased amount of time that patients spend in the waiting room. Due to these changes, healthcare workers feel appreciated for the work they do for their clients. This rewarding experience is a service  many nurse-midwives hope they can continue to provide, as well as improve quality of care and expand extensive outreach to women and children for maternal, reproductive, and child health care services. Afya Endelevu identified the needs at the Nyasho Health Centre by looking into the deficiencies in service delivery needs by using service delivery data, client volume, and the workload.  

Through the support of the USAID, the Afya Endelevu Activity led by Benjamin Mkapa, and in close collaboration with the Tanzania Ministry of Health, Community Development, Gender, Elderly and Children (MOHCDGEC), President's Office Regional Administration and Local Government (PORALG), and Legislative and Government Authorities (LGAs) has made significant progress in its goal of strengthening the delivery of quality reproductive, maternal and child health (RMCH), TB, and HIV services in high-disease burden areas. Through sustainable investments of human health resources in Tanzania, these areas, often with shortages of healthcare staff, have managed to allocate 988 healthcare workers in 16 regions.