Maternal Mortality rates (MMR) continue to be a major public health problem in Tanzania and other developing countries. Currently, MMR continues to be more than 550/100,000 live births in Tanzania. While in Japan the rate is 5/100,000, and 10/100,000 in the United States. Major causes of such high rates are due to hemorrhages, obstructed labor, sepsis, and unsafe abortions. Newborn mortality rates have been unchanged in the past 20 years. When a mother dies, the newborn baby is likely to die; other children in the household do not get adequate food, fail to get immunized, often drop out of school and become a burden to the community.
Common causes of newborn mortality rates include low birth rates, sepsis, and asphyxia. Lack of transportation, long distances to health facilities, inadequate and limited facilities all account for such dismal figures. In addition, most families in rural areas are impoverished and have no access to transport for emergencies. Timely transport to a health facility may result in a woman attempting to walk or be carried in a wheel barrel for many miles to a health facility. In some cases, the expectant mother is not allowed to make her own decision as to when she is ready to give birth; these decisions are either left to the husband or man of the house or some senior person who may or may not have full knowledge as to when the woman is ready to deliver.
The quality of care in many health facilities is inadequate. Fewer than 47% of women deliver in a health Center or hospital. Thus, many women miss essential care and much needed immunizations, nutritional supplements, health education, and sterile delivery services. Such delivery services as clean sterile birthing kits, medication to prevent or treat malaria, worm infestations, etc. Therefore it is essential in so many instances to develop outreach services to go to where the expectant mothers are in their communities for health services, and training to be aware of danger signs during pregnancies that can lead to deaths. All these require additional financial resources that will include vehicles and fuel, in addition to additional provider staff.
Two interventions that are innovative and will have a high impact are: (1) initiation of a community transport system to take expectant mothers to a health facility that is equipped to provide all maternity care; and (2) the mobile health unit that will go to remote communities to provide sterile delivery kits and make quality health care available to expectant mothers who live there. Avoiding transport delays in reaching needed services will result significantly in reduction of maternal and newborn mortality.