1. EFFORTS TO PREVENT MATERNAL AND NEWBORN MORBIDITY AND MORTALITY IN KISARAWE DR. M.O. KISANGA KISARAWE INTRODUCTION Kisarawe District is among the seven District of Coast Region. It boulders Dar Es Slam City to the East while to the North it boulders with Kibaha District and Rufiji in the South. The total population is 102,783. Children under 5 year is 13,156 children under one year 2,878, women of bearing age mothers 21,584 it consists of 4 Division, 15 Wards and 74 Villages.

2. SITUATION ANALKYSIS The District has one Hospital 3 Health Centers and 17 Dispensaries. Among those facilities 17 Health facilities provides Reproductive and child health service 3 which is antenatal Care, Delivery and Post Partum care services. How ever health Deliveries of community level is mostly facilitated by community based actors (CORPS) such as traditional birth attendants, etc. About 69.5% of pregnant mothers in Kisarawe District deliver their baby’s under the supervision of clinician Nurses with Midwifery skills in ensuring survival of both mother and baby, pregnancy and child birth complications are the leading cause of death for women of bearing age.

3. PROBLEMS STTEMENT 1.30.5% of home deliveries conducted t home by TRDITIONAL BIRTH attendants; 2. Low attendance of pregnant mothers to reproductive child health clinic before 20 weeks of gestation, pregnant mothers miss opportunity of getting early provision of care e.g. intermittent presumptive treatment, vaccination Iron tabs and mabendazol etc. 3.Lack of knowledge on family planning which results in high risk pregnancies e.g.: –Too early pregnancy before 20 years of age contributes to criminal abortion; –Too soon pregnancy before 2 years after the last pregnancy, this affects the health of mother and contributes to infant death due to early weaning and luck of exclusive breast feeding;

4. Too many-more than 4 pregnancies which increases post partum Hemorrhaged Too late – getting pregnancy after 35 years of age leading to complicated delivery. 4.Poor referral system due to Luck of Transport (Ambulance) and communication from the District level to other health facilities

5. 5.Lack of birth preparedness from the family members e.g. funds for transport ect. 6.Shortage of Trained personnel especially at ruler area sometimes deliveries are conducted by entrained health workers leading to delay in decision making

6. CAUSES OF MATERNAL DEATH. (a)Direct causes (b)Indirect causes Major contributing factors to high maternal mortality. CAUSES OF PERINATAL MORTALITY

7. STRATEGIES. Employment of skilled service providers Training of health workers on focused Antenatal care Strengthening community pregnancy monitoring system at village level and follow up of pregnant mothers. Regular supportive supervision at the health facilities.

8. To purchase an ambulance of improve referral system To procure and supply of essential obstetrical emergency care To up grade Health centers for Emergency obstetrical care On job training on how to fill maternal and perinatal death review forms and to take action of the problem Identified.

9. EFFORTS DONE TO PREVENT MATERNAL AND PERINATAL MORTALITY Employed 6o skilled staffs 39 Nurses and 21 clinical officers 35 service providers trained on Focused Antenatal care. Process of Purchasing an ambulance done Maternal and perinatal death review forms are discussed and action taken on the problems Identifies when the death occur

10. Community pregnancy monitoring forms distribute at village level Process of procurement of essential obstetrical Emergency care is proceeding. Thank you for listening.