Evaluation of the project introducing and strengthening ultrasound diagnostic for maternal and newborn care services in Tanzania

Title Introduzione e sviluppo della diagnostica ecografica nella regione di Iringa e Zanzibar

Location District of Iringa and Island of Unguja, Tanzania

Duration 11 months

Lead partner CUAMM Medici con l’Africa

Funding Fondo Beneficenza Intesa Sanpaolo

 

Context

According to UNICEF, coverage of basic obstetric and newborn care in Tanzania remains low, with only 20% of dispensaries and 39% of health centres offering childbirth services that also guarantee any referral system to be activated in case of complications. Coverage of assisted childbirth in the country stands at 85% in the mainland and 89% in Zanzibar.

In the District of Iringa, where the Tosamaganga hospital is located, coverage of assisted childbirth is limited to 67% while coverage of the 4 antenatal visits is 72.5% and in Zanzibar it is 74.5%. In contrast, the perinatal mortality rate is particularly high in Zanzibar, compared to the rest of the country (45 deaths per 1000 live births versus 37 deaths per 1000).

On the island of Unguja, Basic Emergency Obstetric and Newborn Care facilities that provide basic services lack qualified staff and basic equipment to provide essential services. This leads to overcrowding in the second and third level hospitals, with very little access in the primary facilities.

The World Health Organisation (WHO) recommends expanding access to the practice of ultrasound for health personnel in resource-limited systems as a strategy to improve the quality of care and accessibility of services, by making this technology available and promoting the training of local personnel.

The project initiated by CUAMM in the districts of Iringa and on the island of Unguja (the main island of the Zanzibar archipelago) aims to address the following needs:

  • Lack of use of basic obstetric and thoraco-abdominal ultrasound diagnostics to prevent and treat obstetric emergencies and chronic diseases at the hospital level and in health units
  • Lack of knowledge of health personnel on the adoption of ultrasound diagnostic tools
  • Limited access to peripheral health services on the island of Unguja due to reduced quality of services
  • Lack of basic equipment, drugs and consumables to provide quality care
  • Limited sharing of good practices and exchanges

 

Generale Objectives

The Inclusive Development Unit was involved to conduct the monitoring and evaluation of the project, which aims to strengthen the use of ultrasound diagnostics at the regional referral hospital in Tosamaganga and in four health units in Unguja.

 

Our contribution

The Inclusive Development Unit will conduct the final evaluation of the project, adopting a qualitative-quantitative mixed-methods approach and using the OECD-DAC (2019) criteria for evaluating development projects. In particular, the evaluation will follow a two-pronged approach:

  • on the one hand, it is intended to examine how the use of ultrasound diagnostics can improve the quality of care for women’s childbirth and treatment of chronic illnesses in the immediate term;
  • on the other hand, it is intended to investigate how training for local health personnel strengthens the provision of care in the long term.

In the evaluation, the two contexts of Zanzibar and Iringa district will be examined separately, considering both peripheral health centres and the district hospital in Tosamaganga.

The evaluation was based on the analysis of the various documents produced within the project activities (monitoring matrix, documentation of training activities and internal activity reports) and on the collection and analysis of district data processed by the DHIS2 system. In addition, interviews and focus groups will be conducted to report the perspective of the project staff and beneficiaries involved in the various project activities. This whole process will lead to an evaluation report highlighting good practices and recommendations.

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