The official opening ceremony of the MEST training Morogoro occurred on Nov16, 2015 at Kibo Peak Palace Hotel.
It was attended by Mr. Donald W.Pambe (The Acting District Executive Director of Morogoro) and Dr. Abraham Mahizo (The District Medical Officer of Morogoro district council).
Martha Rimoy ( the project coordinator) explained some details about the project. The project was described as a mutual effort between Canadian Association of Midwives (CAM) and Tanzanian Midwives of Association (TAMA) in collaboration with International Confederation of Midwives.
The aim of project is to strengthen the capacity of practicing, and re-engaged rural midwives across the country through Emergency Skills training workshops, co-delivered on location, by Tanzanian-Canadian midwife pairs. It also focuses on linking the right competencies with rural areas, by identifying community health workers in target communities, and bringing them together with re-engaged retired midwives within those same settings, for mentorship, and skills sharing support – strengthening the continuum of care. Various tools have been created to enhance midwifery knowledge transfer and advocacy; and essential resources have been provided to support increased access to quality midwifery care.
In July 2013, CAM was awarded funding by the Sanofi Espoir Foundation for the Improved Service Delivery for Safe Motherhood Project: Strengthening & supporting midwifery in Tanzania (ISDSM).This three-year project is addressing the need for improved maternal health service delivery in 6 targeted districts across 6 zones of Tanzania; specifically recognizing geographically disadvantaged areas that face limited access to emergency obstetric care; and shortages of adequately skilled maternity health care providers.
Five districts across Tanzania, including: Mtwara (Mtwara Rural District), Mbeya (Mbeya Rural District), Shinyanga (Ushetu District), Mara (Musoma Rural District), and Tanga (Korogwe District) have completed the program in the last two years. The sixth district ,Morogoro (Morogoro Rural District) is the last one to take part in this project.
The training consists of 4 days workshops that focuses on emergency skills training and improved communication between the care providers. In each district 50 midwives have been trained and we are planning to do the same in Morogoro to bring the number of trained midwives to 300.
In each training a local midwife from the district was chosen to attend and contribute to the training of participants. In general they were District Reproductive Maternal and Child Coordinator except in Korogwe and Mtwara where District Nursing Officers took this role. The local instructors were working as part of the training team and they were responsible to follow up with participants, provide additional information, support and continue to mobilize funds from different organizations to further continue the similar training.
After Martha conducted her statements about the project, Basak Ardalani (Canadian Instructor) emphasized on the importance of this project and how the official could provide support for continuum of this training in other parts of the districts and for more midwives. She emphasized that this program is aligned with MDG 5 – Improve maternal health goals. She stressed on the importance of trained birth attendance such as midwives as the main contributor to reduce maternal, newborn morbidity and mortality around the globe. She highlighted the importance of this training as the knowledge, skills, and attitude gained by the participants could be transferred to other colleagues and encourages them to attend similar workshops or training.She was hoping that CAM/TAMA could continue with this program for years to come to build capacity for Tanzanian Midwives to operate themselves and provide similar workshops. She was happy to contribute to this good cause and learn from Tanzanian Colleagues’ experiences.
Martha requested the officials to watch “Why Mrs. X died” video from WHO with the rest of participants to share the similarity of Tanzanian problems with many other parts of the world and try to find solutions and be proactive to prevent such disasters.
After watching the video, the District Medical Officer of Morogoro district council, Dr. Mahizo welcomed the participants and instructors. He mentioned that this project is aligned with the district strategic planning to reduce maternal and newborn morbidity and mortality.
The district executive director of Morogoro, Mr.Pambe also acknowledged the TAMA and CAM for providing the training and supporting the district on their strategic planning. He stated that the rate of maternal/ morbidity rate is high in this region due to large geographical area and infrastructure. For instance in the period between Jan –Sep 2015 , 7 from 5847 women died due to preventable obstetrical complications such as Post Partum Hemorrhage, Eclapmsia, uterus rupture and sepsis.
At this point he paused with some tears in his eyes and shared a personal story of a coworker’s wife who lost her and her baby’s life due to preventable obstetrical complications this year.
This woman had Prolonged Ruptured of Membrane, was referred to the closest health centre for further management, her case was more complicated with antenatal bleeding while being transported. By the time she reached the Health centre, it was recognized that she needs further help and possibly a Caesarian Section. Unfortunately the Health Center was not equipped with the resources to perform the Caesarian Section . As a result she had to be transferred to Morogoro Regional Hospital. She lost her life on the way to the hospital. This catastrophic experience could have been avoided with a timely, professional management. A young mother could have been saved to mother her other children . A family was shattered due to delay in accessing appropriate care.
When he was telling us the story, he was very emotional and upset as it has affected him tremendously.
Then he shared the strategic planning for the 2015 which included 1) educating the district population on the benefit of long term contraceptive and make it accessible and available, 2)to strengthen the referral system by improving communication and transportation,3) to educate community about the importance of attending antenatal clinics before 12 weeks of pregnancy, 4)to increase the employment of midwives including retired midwives who are willing to work, 5)to ensure the availability of working equipment and medication in each facility,6)to upgrade health centre to enable them to provide emergency obstetrical care such as CS, and finally 7) to collaborate with different partners to enhance the capacity of midwives to provide emergency services.
At his closing statement, he encouraged participants to be attentive, and hope that they could improve their skills, attitude and knowledge and transfer that back to their communities.
At another occasion, on November 23rd, TAMA had the pleasure of Dr. Koleth Winani’s attendance to our training. He is the National Safe Motherhood Coordinator for the Ministry of Health and Social Welfare for about ten years and participated in many initiatives to enhance maternal health in Tanzania. He attended the training on communication session, provided a very positive feedback on the method of facilitation and the content of training. He highly appreciated the effort and participation of CAM in this project as it contributes greatly to safety of motherhood in Tanzania and wished to expand the program to all regions and districts in Tanzania. In his talk, he addressed the participants and indicated that population is more aware of their rights and responsibility of health care providers and hold them accountable for the services they provide. He emphasized that all health care providers should be committed in providing high quality of care and effective and respectful communication with clients and their families. He strongly advised keeping accurate documentation as an evidence of the care which was provided to the clients. He mentioned that he would attend more sessions to observe and provide direction and feedback.