Angelo S. Nyamtema

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OBJECTIVE To assess the quality of partograms used to monitor labor in Dar es Salaam hospitals, Tanzania. METHODS The study team reviewed the records of the parameters of labor, and maternal and fetal conditions in 367 partograms, and interviewed 20 midwives. RESULTS All midwives interviewed had been previously trained to use the partogram. Of all(More)
BACKGROUND The burden of maternal mortality in resource limited countries is still huge despite being at the top of the global public health agenda for over the last 20 years. We systematically reviewed the impacts of interventions on maternal health and factors for change in these countries. METHODS A systematic review was carried out using the(More)
In Tanzania maternal and perinatal mortalities and morbidities are problems of public health importance, and have been linked to the shortage of skilled staff. We quantified the available workforce and the required nursing staff for perinatal care in 16 health institutions in Dar es Salaam. WHO safe motherhood needs assessment instruments were used to(More)
BACKGROUND Effective maternal and perinatal audits are associated with improved quality of care and reduction of severe adverse outcome. Although audits at the level of care were formally introduced in Tanzania around 25 years ago, little information is available about their existence, performance, and practical barriers to their implementation. This study(More)
OBJECTIVES To assess perceptions of the quality of obstetric care of women who delivered in a rural Tanzanian referral hospital. METHODS A descriptive-exploratory qualitative study, using semistructured in-depth interviews and participatory observation. Nineteen recently delivered women and 3 health workers were interviewed. RESULTS Although most women(More)
BACKGROUND Although clinical audit is an important instrument for quality care improvement, the concept has not yet been adequately taken on board in rural settings in most resource limited countries where the problem of maternal mortality is immense. Maternal mortality and morbidity audit was established at Saint Francis Designated District Hospital(More)
BACKGROUND With 15-30% met need for comprehensive emergency obstetrical care (CEmOC) and a 3% caesarean section rate, Tanzania needs to expand the number of facilities providing these services in more remote areas. Considering severe shortage of human resources for health in the country, currently operating at 32% of the required skilled workforce, an(More)
Guidelines on prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) are inconsistently implemented in low-income countries. Strategies are needed to improve the uptake of these guidelines to prevent avoidable new HIV infections of infants. In 2010 the World Health Organisation presented its new PMTCT guidelines, offering(More)
BACKGROUND In Tanzania, maternal mortality ratio (MMR), unmet need for emergency obstetric care and health inequities across the country are in a critical state, particularly in rural areas. This study was established to determine the feasibility and impact of decentralizing comprehensive emergency obstetric and neonatal care (CEmONC) services in(More)
OBJECTIVE Poor obstetric care in low income countries has been attributed to a wide range of factors. We conducted a perinatal care needs assessment in Dar es Salaam health institutions to assess the factors underlying the present poor perinatal outcome. METHODS A cross sectional study was conducted in 2005 in all four public hospitals and all five public(More)