Women in the Simiyu Region of Tanzania face many challenges that prevent them from accessing a health facility to deliver their babies, or receive medical advice during their pregnancy. Adolescent girls in Simiyu also face many challenges that prevent them from accessing a health clinic that is private in order to learn about their changing reproductive system and how to access contraception. These challenges lead to high rates of maternal and newborn death in their rural region of Tanzania.
In March 2020, women and adolescent girls were hit with an unexpected and additional barrier to care: the COVID-19 pandemic. Like much of Tanzania, travel restrictions were put in place as well as a limit to public gatherings. This meant that it was difficult for women and adolescent girls to meet in public forums to learn about their health or to attend a busy family planning outreach day.
The Uzazi Uzima (Kiswahili for “Safe Deliveries”) project works closely with the Ministry of Health (MOHCDGEC) and local government officials in Simiyu to strengthen the health care system. When the pandemic reached Tanzania, the project had to shift its activities to prepare the communities to respond to COVID-19. This story highlights how the project has integrated COVID-19 responses into its existing programming. In the last several months, the project has adapted to continue providing essential maternal and newborn care services while integrating prevention methods for COVID-19. Through strong partnerships and creativity, the project has assisted the government in continuing to provide essential health care.
Family Planning Outreach Services
One of the components of the project is providing outreach services to communities to receive family planning services. Marie Stopes Tanzania (MST) staff spend a week at a health facility and meet with adolescents and adults to educate them on sexual and reproductive health. Often, the project will use people in the community and announcements via a PA system to spread the word about the dates of these outreach events at each health care facility.
In order to assist the government in its response to the pandemic, the project used its PA system to inform community members on how to prevent COVID-19. This, combined with messaging about reproductive health, ensured that the community could be educated in a safe way that respected the social distancing requirements at the start of the pandemic.
When it was safe for family planning outreach to resume in person, health workers began to educate community members on COVID-19 while also talking to them about sexual and reproductive health. This integrated approach ensures that a patient is receiving comprehensive information to prevent the spread of the virus and improve their overall health. This approach also ensures that many members of the community are knowledgeable about COVID-19 so that they can avoid myths and misinformation and share accurate facts with their friends and family.
Water and Sanitation Infrastructure and Equipment
One of the key ways to prevent the spread of COVID-19 is regular handwashing with soap and clean water. In some of the health facilities in Simiyu, there is no access to clean running water. To respond to this, the project has been working with the government to drill bore holes and install water pumps to supply running water, build raiser tanks to increase height and availability of water from reservoir tanks and install solar panels. When COVID-19 became a threat, health facilities needed expanded access to water and sanitation infrastructure to prevent any spread of the disease. The Uzazi Uzima project responded to this by procuring 300 buckets with water taps for health facilities to support with frequent handwashing. This enables the health workers to operate in a sanitary environment while preventing the spread of COVID-19.
Another project activity is regular segments on Sibuka Community Radio station where health workers are invited to educate listeners about various health issues. On the shows, health workers discuss topics such as common myths that prevent women going to a health facility to deliver their baby. Listeners can text the radio station to ask questions directly to the health experts.
In order to quickly respond to the need for the community to be educated on COVID-19, the Uzazi Uzima project increased the radio segments and devoted air time to spreading messages and answering questions about the disease. These radio segments have been crucial to the rapid spread of accurate information in the community, especially in remote areas of the region.
Youth Peer Education
The closure of schools to slow the spread of COVID-19 early on in the pandemic resulted in a risk of youth not having access to sexual and reproductive health education. During this time, the only way to connect with youth was by driving through the community and providing information via a PA system.
As part of the project, 145 youth clubs have been established in Simiyu in order to create safe spaces for youth to learn about sexual and reproductive health. Once schools opened back up in Tanzania, the project used the opportunity to teach students about COVID-19. The peers who were trained to facilitate the youth clubs carried out education campaigns where they taught 118 of their fellow students about proper handwashing, coughing, and social distancing protocols. They also answered questions about reproductive health. Finding entry points into the community has been a key resource for educating individuals on COVID-19 and reproductive health.
While the project design has shifted, the COVID-19 pandemic has been an opportunity to develop innovative ways of reaching a community to improve overall health, such as using a PA system in cars and trucks to spread messages. Health education and outreach at the community level is one of the emerging best practices in improving access to essential maternal and newborn care. The project has been able to use its existing community structures and champions, such as community health workers, to help them create their own responses to the pandemic. This community connection has also enabled a continuity of care so essential services to improve the health of moms and babies can continue throughout the pandemic.
The Uzazi Uzima project in Simiyu Region, Tanzania is a partnership among Amref Health Africa, Marie Stopes and the Government of the United Republic of Tanzania, with Deloitte as a service partner. Uzazi Uzima (Kiswahili for “Safe Deliveries”) is focused on reducing maternal mortality and morbidity rates in six district councils in the region. With support from the Government of Canada through Global Affairs Canada and from James Percy Foundation, this four-year project aims to reach about 345,000 women and adolescent girls and 330,000 men and adolescent boys directly.
The partners are working together with communities and local authorities in Simiyu Region to: improve the knowledge and skills of health workers to provide quality maternal and newborn care, and sexual and reproductive health services; increase access to maternal care and family planning for women and adolescent girls and boys; refurbish health facilities and dispensaries, including building infrastructure for clean water and sanitation; increase the number of women and adolescent girls who are using skilled maternal and reproductive health services, through community outreach and advocacy; strengthen community and government engagement in creating lasting improvements in health throughout the project area.