Mama na Mtoto: Barriers and enablers to gender, equity and scale-up in Tanzania (IMCHA)
In Tanzania, a project popularly known as “MamaToto” (mother-baby) is building local capacity to improve maternal, newborn, and child health (MNCH). It is testing a comprehensive MNCH package that builds on district-led implementation, evidence, and best practices from similar efforts in Uganda. It aims to reduce maternal and child mortality by increasing deliveries by skilled birth attendants, increasing antenatal and postnatal care attendance, developing an implementation model for MNCH districts, and establishing strategies for future scale-up in Tanzania, targeting the most vulnerable populations.
However, as this project demonstrates, barriers to scaling up population-based MNCH life-saving interventions must be removed to reduce maternal and child deaths and morbidity — including engaging men and community stakeholders. In the Misungwi district of Tanzania, where the project is being implemented, only 13% of pregnant women attended antenatal care in the first trimester and only 47% had four or more of the minimum recommended visits. Contraceptive prevalence rate is 17% and unmet need for family planning is 27%.
This project, a partnership between two Tanzanian institutions, the Catholic University of Health and Allied Sciences and the Mbarara University of Science and Technology, will enhance local capacity for qualitative research design, delivery, analysis, synthesis, and knowledge translation (moving from theory to practice). It aims to increase understanding of opportunities to foster male/adolescent/vulnerable population involvement, hence increasing access to antenatal care, delivery, and post-natal care. More generally, it will increase understanding of what factors encourage and discourage the scale-up beyond project-funded districts, based on similar experiences with MamaToto in Uganda. Finally, it provides opportunities for East African researchers working in a South-South partnership.
Qualitative methodology using focus groups and key informant interviews will be used to gather information on potential barriers and enablers to address current implementation gaps. Stakeholders and end users will be engaged throughout the research cycle using an integrated approach to translating this knowledge into action. Early input of research priorities will be sought through meetings with district health teams and district and national policymakers in the Ministry of Health.
This project is funded by the Innovating for Maternal and Child Health in Africa program. It is a seven-year $36 million initiative funded by Global Affairs Canada, IDRC, and the Canadian Institutes of Health Research.