The cornerstone of Thamini Uhai's Maternal Health Program is task shifting, training, supervising and supporting non-physician clinicians to provide care to thousands of women and newborns in project-supported facilities. We also provide continuous investment in health facility infrastructure. After initial training, we help these  assistant medical officers, nurse midwives and clinical officers to maintain and improve their new level of competency through continuous mentoring, medical education, skills workshops, clinical audits, and information and communication technology.
  • PROFESSIONAL DEVELOPMENT
  • MENTORING AND SUPPORTIVE SUPERVISION
  • INCREASING ACCESS TO CEMONC SERVICEES
  • INFORMATION AND TECHNOLOGY (ICT) INNOVATIONS
  • MATERIAL SUPPORT
  • COMMUNICATION
  • MONITORING AND EVALUTION
INCREASING ACCESS TO CEMONC SERVICES

Thamini Uhai has launched a pilot referral project in Nguruka Health Center’s catchment area in Uvinza district to improve access to emergency obstetric and neonatal care and skilled birth attendance. The goal is to reduce the delay in reaching appropriate care, which is the second of the three delays leading to maternal mortality.

This innovative project aims to improve referral practice by working closely with health facilities and communities, using locally designed solutions to ensure referral preparedness, transportation and communication.

MENTORING AND SUPPORTIVE SUPERVISION

Mentoring is a central pillar of the program. Senior specialists have created an environment of close interaction, where team-based learning centers on actual clinical scenarios in the facilities.

On their regular visits, regional program officers who are consultant obstetrician/gynecologists spend one to three days in each Thamini Uhai supported facility to conduct team-based practical training, which includes guiding and closely supervising AMOs and nurse midwives.

This team-based approach to case management focuses on case studies, including emergency situations that provide critical learning opportunities.

PROFESSIONAL DEVELOPMENT

The program has provided competency-based training in CEmONC for AMOs and obstetric anesthesia training for nurse-midwives and clinical officers. The curriculum covers both theory and practical skills. In 2015 the program started to build capacities of several dispensaries on skilled birth attendance and BEmONC.

Continuing medical education (CME) entails highly focused and practical skills-building workshops conducted by specialist obstetricians, pediatricians and anesthesiologists. The workshops are about three days long and cover such subjects as neonatal resuscitation and vacuum extraction.

INFORMATION AND COMMUNICATION TECHNOLOGY (ICT) INNOVATIONS

Thamini Uhai recognizes the potential of ICT in addressing some of the challenges in providing accessible, cost-effective and high-quality health care. Since 2012, the program has developed and implemented a number of ICT innovations to help improve the quality of care in Thamini Uhai supported facilities, including weekly teleconferences, emergency call support, and e-learning.

Weekly teleconferences are used as virtual classrooms for discussing challenging obstetric cases encountered during the previous week. Health-care providers in Thamini Uhai supported facilities, Thamini Uhai consultant obstetrician/ gynecologists, and senior anesthesiologists are routinely connected through toll-free mobile phones via a closed user group. These teleconferences are documented and disseminated to the relevant stakeholders for action- oriented feedback.

In an emergency situation when further guidance or advice is needed, health-care providers working in Thamini Uhai supported facilities can call senior obstetricians using toll-free mobile phones. This service is available 24 hours a day, every day. Occasionally, senior practitioners may travel to assist the facility in need.

Thamini Uhai is also assisting with the implementation of Tanzania’s National e-Health Strategy (2013–2018), advocating e-health solutions and enabling health-care providers to access continuing professional development through e-learning and digital resources.

The e-learning platform developed for health-care providers improves clinical decision-making skills needed to manage life-threatening obstetric emergencies. This virtual classroom enables health-care providers to access clinical instructions in lecture format through educational videos and interactive online training.

MATERIAL SUPPORT

Thamini Uhai  has built and renovated operating theaters and delivery and postpartum wards, and has provided key equipment for EmONC.

Staff housing has been built at several program sites to help retain health workers in rural settings, where highly skilled health-care providers are scarce.

The program also procures supplies and commodities for partner sites, particularly in cases of severe stockouts.

COMMUNICATION

Thamini Uhai’s communication initiative, Thamini Uhai (Value Life), designed to help women and families make life- saving choices about childbirth, child spacing and limiting family size, continued in Kigoma in 2015 after a successful launch in 2014 with a campaign focused on encouraging facility delivery.

The second phase of Thamini Uhai focused on family planning with a campaign called Jitofautishe (Differentiate Yourself), which promoted the long-term health and economic benefits of using modern contraception.

Thamini Uhai  has also advocated in the media for training and deploying skilled human resources, ensuring continuous and adequate supplies in health facilities, and securing sufficient budgets for maternal health services, among other priorities.

MONITORING AND EVALUATION

The program conducts data collection and clinical auditing in order to assess the level of services provided, monitor service provision, and identify clinical issues requiring attention. Routine service statistics are collected every month. Additional data is collected and analyzed quarterly to enable qualitative assessments in areas such as “near-misses,” cesarean section, EmONC signal functions, and maternal and neonatal deaths. Thamini Uhai uses these findings to monitor the progress of clinical care and to plan supervision visits and Continuous Medical Education ( CME ).