Neonatal, child and maternal health
Together with other UN partners, UNICEF has raised the profile of maternal, newborn and child health and made it a priority in the health sector. UNICEF works with the Ministry of Health and Social Welfare to improve the quality of maternal, newborn and child health services in health facilities and to decentralize aspects of mother and child healthcare to community level.
The specific focus of UNICEF support includes the provision of essential equipment and supplies to health facilities and skill-development of health workers to improve the quality of focused antenatal care, emergency obstetric care, neonatal care including new born resuscitation, prevention of mother to child transmission of HIV, adolescent friendly reproductive health services, and integrated management of childhood illnesses (IMCI) - in line with national guidelines and standards.
Although the number of children under-five sleeping under an insecticide treated net has increased, malaria is still a major cause of death among children in the country, particularly in rural areas. UNICEF supports the National Malaria Control Programme through distribution of long-lasting insecticide treated bed nets and improved access to treatment with better malaria medication for children and pregnant women.
UNICEF also supports the Government to ensure a strong and functional nation-wide cold chain storage capacity for vaccines and adequate vaccine and cold chain management capacity. Every year, UNICEF assistance helps to protect over 1.8 million children 0-11 months from vaccine preventable diseases. To reduce inequities, UNICEF focuses on hard to reach areas to increase and sustain immunization coverage by supporting low performing districts to operationalize the Reaching Every Child (REC) strategy. UNICEF has been supporting government efforts in implementation of integrated measles campaigns, polio eradication efforts, neonatal tetanus elimination and control of vaccine preventable diseases.
Following successful GAVI application, Tanzania will introduce new vaccines (Pneumococcal and Rotavirus) for the under-five age group, in 2013. UNICEF is providing technical and financial support in the development of training guidelines for health workers, advocacy and social mobilisation materials on new vaccine introduction through different communication channels, including health service providers, community health workers, radio programmes and mobile video shows etc.
Infants and mothers
Of great concern are the high death rates of newborn babies and mothers. Around 32 percent of all under-five deaths occur in the first 28 days of life – many infants survive for only a few days.
These deaths occur in a context where about half of all births take place at home, with assistance from a relative or traditional birth attendant. Most of these births take place in unhygienic conditions.
If life threatening complications develop at home the realization and decision making often comes too late to reach appropriate care at health facilities in time.
Neonatal deaths are inextricably linked to the health of the mother during pregnancy and to the conditions of delivery and newborn care. Close to 8,000 women die every year during pregnancy and child birth as a result of conditions that could have been prevented or treated.
Poor quality of care due to an insufficient number of skilled health workers and lack of basic equipment, as well as long distances from home to health care facilities are major deterrents to facility delivery. Women living in rural areas, those who come from the poorest families and those who are less educated, have the least access to skilled attendance at delivery.
Women who start having children in adolescence tend to have more children and shorter spacing between pregnancies – all of which are risk factors for maternal and neonatal mortality. The neonatal mortality rate is highest among mothers under-20 years of age at 45 per 1000 live births compared with 29 per 1000 for mothers aged 20 to 29 years.
Maternal death rates are closely linked with the high fertility rates and low socio-economic status of women, especially the lack of influence that women have over their own health care or over the daily household budget.
About 40 percent of Tanzanian women do not participate in significant decisions regarding their own health care. On average, every Tanzanian woman gives birth to 5 or 6 children and 1 in 3 of them begins childbearing before the 18th birthday.
Tanzania is very far from achieving the Millennium Development Goal of reducing Maternal Mortality (MDG5). According to 2009/10 Demographic and Health Survey, every year 454 women die from pregnancy related complications for every 100,000 live births.
Causes of maternal death include obstetric haemorrhage, unsafe abortions, eclampsia, obstructed labour and infections. Low availability of emergency obstetric and new born care services, chronic shortage of skilled health providers together with a weak referral system contribute to the observed high maternal deaths.