Maternal Death Surveillance and Response: Factors Affecting its Implementation in Mtwara Region, Tanzania

Abstract

Abstarct Background: Tanzania like many other developing countries continues to experience alarming levels of maternal deaths despite a number of years of implementing Maternal Death Surveillance and Response (MDSR) strategies. This study examined the factors influencing MDSR implementation in Mtwara region, Tanzania. Methods: This is a mixed methods with quantitative and qualitative data collection approaches. Semi-structured interviews were conducted to 84 health workers and in-depth interviews to 15 facility and district committee members. Logistic regression analysis for the quantitative data was done using STATA version 14, and p-value<0.05 were considered statistically significant. Qualitative data was analyzed using a thematic analysis. Result: Overall proportion to maternal deaths reviewed as per National MDSR guidelines were 50.5%, and the percentage of implemented MDSR recommendations was only 34.6%. The factors influencing attendance in the review meeting includes knowledge of MDSR recommendations (p=0.03) and perception of increases workload (p=0.03). The pressure from RHMT on MDSR performance and involvement of different stakeholders were reported to facilitate implementation of MDSR recommendations. However, the factors which reported to hinder its implementation includes; inactive MDSR Committees as a results of inadequate capacity building in terms of poor support to implement MDSR recommendations, heavy workload and lack of motivation. Conclusion: The overall implementation of MDSR in Mtwara region is low. This is due to inadequate capacity building and support of implementation process. The Government and RHMT need to strength training programs on MDSR to district and facility committees, ensure timely financial support and regular supportive supervision.