In Tanzania, like in the rest of Sub-Saharan Africa, there are high maternal mortality rates. In response to the fifth Millennium Development Goal, the government has put in place strategies to extend the coverage of health facilities to increase the number of deliveries in health facilities. As a result, in the district of Iringa, in 2012 there were 73 facilities, including 66 dispensaries, six health centers and one hospital. The high healthcare coverage has meant that in recent years births in health facilities surpassed 80%. Can these numbers be considered a success in terms of mortality reduction?
The study, published in December 2014 in Plos One analyzes data from several studies and surveys conducted among women who gave birth in hospitals and other health facilities in the district of Iringa, finding socio-economic differences in access to different levels of healthcare coverage. It has been observed that women of high socio-economic levels tend to give birth in hospitals and poorer women are more likely to go to the closest dispensaries. However, these dispensaries often provide low-skilled services. The high number of dispensaries does not correspond to an adequate number of skilled health personnel. The result is that women of lower socio-economic levels receive less skilled care and are therefore more susceptible to death.
This study’s results highlight the problems of increasing first-line healthcare facilities; this is not an adequate response to high maternal mortality rate if not combined with a commitment to improve the quality of services as well. To solve this conflict between coverage and quality, it is recommended to reduce the number of dispensaries in the area to improve their quality and foster a more equitable health service.
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