This document outlines an introduction to antenatal care training in Tanzania. It discusses the country's current maternal and child health situation, including high mortality rates. It also introduces the new recommended antenatal care guidelines, which include more frequent visits compared to previous models. The training aims to explain these new guidelines and important health indicators to help improve outcomes and meet national targets of reducing mortality rates for mothers, newborns, and children under five by 2020.

1. United Republic of Tanzania
THE UNITED REPUBLIC OF TANZANIA
MINISTRY OF HEALTH, COMMUNITY DEVELOPMENT,
GENDER, ELDERLY AND CHILDREN
1

2. United Republic of Tanzania
INTRODUCTION TO ANTENATAL CARE
TRAINING
2

3. United Republic of Tanzania
By the end of this session, participants will be
able to:
 Explain the aim, goal and objectives of ANC
training
 Explain the Current Maternal and Child Health
situation in Tanzania
 Explain the rationale of the new ANC Guidelines
 Explain Important RMNCH Indicators
3

4. United Republic of Tanzania
 Routine antenatal care – Before 2003
 Focused antenatal care – 2003 to 2017
◦ Individualized care
◦ Client friendly antenatal care
◦ Culturally appropriate care
◦ Good communication in care provision
◦ Goal oriented care
 Recommended antenatal care 2017 – in line
with new ANC WHO recommendations
8

5. United Republic of Tanzania
 The FANC model does not offer women adequate
contact with health-care practitioners and is no
longer recommended.
 Is probably associated with more perinatal deaths
than models that comprise at least eight ANC
visits.
 More ANC visits is probably associated with
greater maternal satisfaction (+Ve pregnancy
experience)
9

6. United Republic of Tanzania
Recommended antenatal contacts
Trimester Week of contacts
First trimester Up to 12 weeks
Second trimester 20 weeks
26 weeks
Third trimester 30 weeks
34 weeks
36 weeks
38 weeks
40 weeks
Return for delivery at 41 weeks if
not given birth
First visit: < 12
weeks
Second visit: 24-
28weeks
Third visit: 28-32
weeks
Fourth visit: 32-36 &
> weeks
BOTH ARE GOAL
ORIENTED 10

7. United Republic of Tanzania
 MMR has remained high for the past 20 years
578 per 100,000 live births in 2004/2005, 434 in
2010 and 556 in 2015/16.
 Neonatal mortality unchanged since 2010: 26 per
1,000 live birth in 2010 vs 25 (2015/16 TDHS)
 These and other findings has alarmed all
stakeholders in the Health sector and raised a call
for a broader commitment to address this public
health challenge.
11

8. United Republic of Tanzania
 98% women age 15-49 receive ANC from a
skilled provider
 1/4 women have first ANC visit in the first
trimester
 51% of women make 4+ ANC visits.
 8/10 take Iron tablets or syrup during
pregnancy
 88% receive TT
(2015/16 TDHS)
12

9. United Republic of Tanzania
 35% of pregnant women take 2+ doses of IPTp,
while only 8% take 3+ doses.
 ITN use by children and pregnant women 70%
 Blood pressure measurement 71%
 Urine sample assessment 60%
 Blood sample assessment 87%
 Facility delivery 63%, 36% of births occur at
home.
(2015/16 TDHS)
13

10. United Republic of Tanzania
14

11. United Republic of Tanzania
 Infant mortality has decreased from 92
deaths per 1,000 live births in 1991-92 to
43 deaths per 1,000 live births in 2015-16.
 During the same period, under-5 mortality
has declined from 141 to 67 deaths per
1,000 live births. (2015/16 TDHS)
15

12. United Republic of Tanzania
16

13. United Republic of Tanzania
17

14. United Republic of Tanzania
1. Reduce maternal mortality from 556 to 292 per
100,000 live births by 2020.
2. Reduce neonatal mortality rate from 21 to 16 per
1,000 live births by 2020.
3. Reduce infant mortality rate from 45 to 25 per
1,000 live births in 2020
4. Reduce under-five mortality from 54 to 40 per
1,000 live births by 2020.
18

15. United Republic of Tanzania
 Increase eight or more antenatal care visits from
43% to 70%.
 Increase coverage of health facility delivery from
50% to 80%.
 Increase postnatal care within first 48 hours from
31% to 80%.
 Increase male involvement on HIV testing during
ANC interventions from 44 % to 60 %
19

16. United Republic of Tanzania
 To reduce stillbirth rate from 16 to 8 per 1000 live
births.
 Increase initiation of breastfeeding within 1 hour
after delivery from 49% to 80%.
 Reduce HIV Mother-to-Child Transmission rate
from 8.6% to < 5%.
 Increase the level of data completeness reporting
from 94 % in 2015 to 98 %
20

17. United Republic of Tanzania
1. Nutritional Intervention
2. Maternal and foetal assessment
3. Preventive measures
4. Intervention for common physiologic symptoms
5. Antenatal care contacts
6. Management of common obstetric complications
7. ANC for women with special needs
8. Counseling
9. Infection prevention control
10. Quality Improvement and M&E
21

18. United Republic of Tanzania
 Lecture discussion
 Group work
 Simulations
 Brain storming
 Role play
 Buzzing
 Demonstrations
 Case studies
22

19. United Republic of Tanzania
Training materials
 Participants manual
 Trainer’s guide
 Training slides
 ANC Quality
Improvement tool
 Questionnaire
References
 One plan II
 IPC
 TDHS
 Malaria treatment
guidelines
 HIV Guidelines
23

20. United Republic of Tanzania
Asanteni sana
24