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The Nilinde Nikulinde Project: Investing in maternal and newborn health care services

As pregnant women and their newborns are at the highest risk of death and morbidity during labour, childbirth and the first week after birth, investing in improved access to and quality of care, especially emergency obstetric and newborn care (EmONC), is essential.

Since 2013, UNFPA has been complementing government efforts to reduce maternal mortality in the Simiyu Region of Tanzania.  As part of the two-year 'Nilinde Nikulinde Project' (“I protect you; and you protect me”), funded by the Korea International Cooperation Agency (KOICA), 38 maternity wards and seven operating theatres have been renovated in six districts of Simiyu Region, equipped and staffed to provide EmONC services.

Improving maternal health outcomes

Although the project is still on-going, data from the District Health Information System 2 already show the impact of project activities.  Since July 2017 there has been a significant increase in deliveries at health facilities and a decline in women giving birth at home in the catchment areas of renovated health facilities.

  July 2017 – Sep 2017 July 2018 – Sep 2018
Deliveries at UNFPA-supported EmONC facilities 3,759 4,622
Deliveries at home 113 23

Yulita gave birth to her baby daughter following the renovations at Nassa Health Centre.  She experienced complications with her previous home-based deliveries, losing four children during childbirth. Prior to renovations under the Nilinde Nikulinde project the infrastructure at Nassa Health Centre was poor and it was not well equipped; today this has changed.

Nassa Health Centre now has a maternity ward and an operating theatre. The maternity ward is equipped with a high-quality ultrasound/sonography machine as well as a foetal doppler, and there is a labour room and an operating theatre for  caesarean sections. There is also a neonatal intensive care unit to improve the survival chances of children born prematurely.

With the renovated facilities at Nassa Health Centre Yulita did not have to risk her own or her child’s life giving birth at home.

Investing in infrastructure and equipment

The improvement in the infrastructure of renovated health facilities is remarkable.  Small, cramped delivery rooms have been transformed in to fully functioning maternity wards, equipped to provide EmONC services.  
At Simiyu Regional Hospital, there is now a modern maternity complex and a fully functioning operating theatre.  Dr Mlekwa, obstetrician-gynaecologist at Simiyu Regional Hospital, says: “We were forced to conduct deliveries and perform caesarean sections under challenging conditions. We also had very basic equipment. UNFPA has revolutionized the way we can provide care to mothers and their newborns and this will significantly reduce the number of maternal and newborn deaths.”

Constructing a satellite blood bank for transfusions

Urgent access to a safe supply of blood for transfusions is critical to save the lives of women experiencing complications before, during and after childbirth. A new blood bank has been constructed in Simiyu Region and will be opening soon. Nyambaro Shemu, Regional Blood Transfusion Services Coordinator, Simiyu, said: “We have been losing a significant number of mothers as there is no reliable blood transfusion service. We access blood from the zonal blood bank in Mwanza; it takes at least eight hours for it to arrive here in Bariadi. Thanks to UNFPA’s support in constructing a new satellite blood bank, we can now access blood for transfusions immediately.”

Coordinating maternal and child healthcare services at the district level

Six coordination cars have been supplied under the project; one for each of the district health management teams in Simiyu Region who oversee and monitor health programmes and activities at the district level. The team can now provide supportive supervision; mentorship, problem-solving, and capacity building to all health facilities in their districts, however remote they are. This will build the capacity of staff at the district level to provide quality maternal and newborn healthcare services.

Supporting referrals for the hard-to-reach

Three ambulance have been provided to three high-burden health facilities in outlying areas of the region to support timely referrals to district hospitals for mothers experiencing pregnancy-related complications.

These combined interventions mean that women in rural areas of Tanzania can now access the high-quality, and life-saving maternal health care that they so desperately need and deserve, and that is their basic human right.

1. UNFPA Maternal Health Thematic Fund Annual Report 2015.