Evaluation of a Community-Based Maternal and Child Health Initiative of Uturo Village in Mbarali District and Prospects to Scale-Up the Initiative in Tanzania

Abstract

Background: Global Strategy for Women’s and Children’s Health demands that in 21st century more have to be done to the millions of women and children who die from preventable causes each year. It is known that community-based intervention can be a better way of emphasizing women to attend maternal neonatal and child health services for prevention of maternal and child deaths. In Tanzania, at Mbarali district Uturo community based Initiative was initiated to address the problem of maternal mortality at Uturo village. Besides, since its initiation, less is known on strategies used, its achievements, weaknesses and prospect to scale up such initiative in other places so as to address the health problems of maternal and child health. This study was an attempt to fill this gap. Main objective of the study: To evaluate a community-based maternal and child health initiative of Uturo village in Mbarali district and prospects to scale-up the initiative in Tanzania. Materials and Methods: The study employed cross sectional phenomenological design. Purposive sampling method was applied to have a better way of constructing the views of individuals that are expert in a definite area. Data collection used key informant interviews targeting people with key roles and had rich information in community based maternal and child health initiative. The number of participants was 21. Results: The study found that, strategies used in the initiative and led to successful results were social tactics, legal measures, economic measures, education measures and faith principles. Achievements of the initiative included increased awareness on the Maternal Neonatal and Child Health services, increased men involvement, increased in utilization of MNCH services and reduction of maternal and child deaths. There were weaknesses of the initiative were such as; use of financial penalties posing a burden to villagers. Insufficient infrastructure and inadequate health equipment. The study found that scalability can be possible and could base on organizational, technical and individual factors. Conclusion: The findings showed that the initiative succeeded in its implementation and outcome. Strategies used in implementation, committed health workers, committed leadership and community involvement contributed to its success. Some weaknesses shown were like use of financial penalty, and lack of secret to komandoo group which detached the trust of women to these komandoos who played an important role of collecting and keeping information on logbooks which ensured early booking and well utilization of MNCH services. Recommendation: In scaling up the initiative to other part of Tanzania, some strategies will need to be modified for more improvement of the initiative. For example legal measures will need to be modified to friendly emphasis of the community to adhere with agreed regulation for successful implementation of the initiative