Joining Hands to Improve the Health of Mothers and Children

When I was in Tanzania in February, I met a woman named Kundi. She lived among the Southern Highlands, in a small village bordering Zambia and Malawi. Kundi was holding her two-week old mtoto (Kiswahili for child) while waiting at the Ivuna dispensary, a rural clinic set amidst rolling hills, lush forests and flowing rivers. With the help of translators, Kundi shared a bit about her life: 12 pregnancies, nine living children, and only four were born inside a health facility. Her newborn mtoto was one of them.

Ivuna dispensary has only four staff members to serve nearly 26,000 people. The facility offers basic reproductive and child health services to Tanzanian mothers. It’s one of the few clinics in this rural area with no paved roads, limited electricity and no public transit. Community members often have to walk or hitch rides on crowded transport trucks. The closest ambulance is 120 km away and often needs repairs due to poor road conditions.

The staff at Ivuna are on call 24 hours a day in order to serve the growing population and often face challenges with electricity shortages, access to clean water and the supply of essential medicines. When I visited Ivuna one late afternoon, the staff was busy attending to over 60 pregnant women and children in the middle of a hail and rain storm.

In Canada, health risks during pregnancy and child birth are low. In Tanzania, 454 out of 100,000 pregnant women don’t survive childbirth. For every 1,000 babies born, 54 do not survive to see their fifth birthday. Mothers often do not have access to a health facility with doctors, nurses or midwifes who can deliver the baby safely. Screening for complications during pregnancy is rarely performed.

Partnerships improve maternal, newborn and child health

With support from Canada’s Department of Foreign Affairs, Trade and Development (DFATD), Aga Khan Foundation Canada (AKFC), through its implementing partner Aga Khan Health Services Tanzania (AKHS-T), is working in partnership with the Government of Tanzania to improve maternal, newborn and child health in fifteen districts across five regions of Tanzania. The Joining Hands: Improving Maternal, Newborn and Child Health (JHI) project partners 31 health facilities, such as Ivuna dispensary, with AKHS-T medical centres across the country. Through this program, health workers have access to training and facilities can receive much-needed repairs and new equipment, such as a portable ultrasound machine to help mothers monitor the growth and development of their babies. Outreach teams bring essential medicines, like iron supplements and drugs to treat malaria. The JHI program also works directly within communities to promote healthy practices for mothers and children, such as exclusive breastfeeding and birth spacing; and to improve prenatal care, post natal care, and to increase number of births that happen at a health centre.

Doctors and nurses from the AKHS-T medical centres visit the Ivuna dispensary regularly to offer supervision, medical education, and to assist the small staff with patient care. Thanks to the JHI program, mothers like Kundi can deliver their babies safely with the care of a skilled birth attendant, the necessary equipment and proper medicine.


About the Author

Neelam Merchant is a program officer at Aga Khan Foundation Canada (AKFC). AKFC is a non-profit international development agency, working in Asia and Africa to find sustainable solutions to the complex problems causing global poverty. Established in 1980, AKFC is a registered Canadian charity and an agency of the worldwide Aga Khan Development Network.

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March 21, 2014


Neelam Merchant