%0 Journal Article
%T Effectiveness of community based safe motherhood promoters in improving the utilization of obstetric care. The case of Mtwara Rural District in Tanzania
%A Declare Mushi
%A Rose Mpembeni
%A Albrecht Jahn
%J BMC Pregnancy and Childbirth
%D 2010
%I BioMed Central
%R 10.1186/1471-2393-10-14
%X This community-based intervention was designed as a pre-post comparison study, covering 4 villages with a total population of 8300. Intervention activities were implemented by 50 trained safe motherhood promoters (SMPs). Their tasks focused on promoting early and complete antenatal care visits and delivery with a skilled attendant. Data on all 512 deliveries taking place from October 2004 to November 2006 were collected by the SMPs and cross-checked with health service records. In addition 242 respondents were interviewed with respect to knowledge on safe motherhood issues and their perception of the SMP's performance. Skilled delivery attendance was our primary outcome; secondary outcomes included antenatal care attendance and knowledge on Safe Motherhood issues.Deliveries with skilled attendant significantly increased from 34.1% to 51.4% (¦Ñ < 0.05). Early ANC booking (4 to 16 weeks) rose significantly from 18.7% at baseline to 37.7% in 2005 and 56.9% (¦Ñ < 0.001) at final assessment. After two years 44 (88%) of the SMPs were still active, 79% of pregnant women were visited. Further benefits included the enhancement of male involvement in safe motherhood issues.The study has demonstrated the effectiveness of community-based safe motherhood intervention in promoting the utilization of obstetric care and a skilled attendant at delivery. This improvement is attributed to the SMPs' home visits and the close collaboration with existing community structures as well as health services.According to the recent review of the Millennium Development Goals (MDG), little progress has been made with respect to MDG 5 on improving maternal health [1]. Skilled delivery care is considered a crucial function within the health care system for saving the lives of mothers and newborns and represents an important indicator for monitoring MDG 5 [2,3]. In Tanzania, pregnancy-related mortality remains unacceptably high with estimated maternal mortality ratio of 578/100,000 and a neonatal mort
%U http://www.biomedcentral.com/1471-2393/10/14