Partnering with districts councils to increase the number and improve retention of nurse-midwives in Tanzania: lessons learned by Amref Health Africa Ngilangwa David P 1, Dhalla Magdalena 1, Msegu Elia 1, Sambili Benatus 1, Chaya Pius 1, Noronha Rita 1 1 Amref Health Africa, Dar es Salaam, Tanzania 1 st Amref Health Africa International Conference Safari Park Hotel, Nairobi, Kenya th November, 2014

Outline Issue Descriptions Lessons learnt Conclusion and recommendations Acknowledgments

Issue o Tanzania among the ten countries with high maternal deaths o Critical shortage of skilled nurse-midwives attributed by attrition o Only 51% of all births are attended by skilled health personnel o Amref Health Africa believes that no woman should die while giving life o Stand Up for African Mothers(SU4AM) aim to train 1,000 nurses-midwives to certificate and diploma levels by 2015.

Description o Amref Health Africa is supporting the GoT to train pre-service midwives in 8 district councils o Provides scholarships to qualified permanent residents of the targeted districts to pursue midwifery training. o The district councils are obliged to advertise, select and approve qualified potential students for training o Employ students for 3 years upon successful completion of their studies

Description… o Amref Health Africa, students and district councils sign a legal contract to bind them fulfill their roles o 80 students are pursuing their midwifery training in different schools in Tanzania

Description … Distribution of supported students by district DistrictNumber of Student Kilindi30 Busega4 Itilimia4 Maswa4 Meatu2 Bariadi4 Mtwara rural30 Mtwara Municipal2

Lessons learnt o SU4AM campaign has been well-accepted by the district authorities and community o Training midwives from their own communities ensure retention o There is great demand of the training (applicants are as many as compared with slots available) o Among students male and female ratio was slightly equal against the previous notion that midwifery is for females.

Lessons learnt… o Most students are from low income families thus, can not afford the training expenses o Regular supervision visits in schools helps in identifying challenges and ways of solving them

Challenges o Criteria set by MoHSW are still very high especially for applicants in rural area o Lack of enough funds to meet all beneficiaries' needs

Next steps o Project should be scaled up to other regions with great shortage of Human Resources for Health(HRH)and continue to monitor performance of graduates. o Awareness raising and fundraising for SU4AM campaign from International up to the grass root level

Acknowledgement o All donors (Bank M, Barclays Banks, Amref Health Africa-Netherlands and others) o District Council Authorities o Ministry of Health and Social Welfare