From the lack of life-saving medications and access to skilled birth attendants to the cost of transportation, the barriers to rural health-care facilities for antenatal care and delivery in Tanzania are numerous and well documented. For women living in Mara Region, the situation is no exception. About half of all births take place away from health facilities and post partum haemorrhaging (PPH) and infection (puerperal sepsis) account for 35 per cent and 15 per cent of the region’s total maternal deaths, respectively (TDHS-MIS). Shirati and its partners introduced the Saving Mothers project to pregnant women in 202 villages in Tarime and Bunda Districts, Mara Region. The project aimed for a 30 per cent reduction in the number of women who might otherwise die of PPH by distributing clean delivery kits containing misoprostol to prevent infection and stem heaving bleeding.
The kits were distributed by trained community health volunteers (CHVs) and district nurses to women who were between 34 and 36 weeks pregnant. The women were instructed to seek a health facility for birth, but the kits could be used for home births, delivery en route, or at the facility where supplies were lacking CHVs were given mobile phones equipped with an m-health app to register the women, send them reminders to attend antenatal clinic appointments, warn them about danger signs, and track their delivery outcomes. The app also provided information on staff workflows and stock levels.