By Pooja Senthamaraiselvan – Art in Tanzania internship
Tanzania is making great strides in reducing child mortality, but has demonstrated slower progress in reducing neonatal deaths. There has been a declining trend in NMR over the past decade but it indicates a very gradual improvement. In order to meet the Millennium Development Goal (MDG) 4 for child survival, the number of newborn deaths in Tanzania must be greatly reduced. At the current rate of progress, Millennium Development Goal 4 could be met, if more attention is given to newborn survival .
Most neonatal deaths are due to preventable and treatable causes. Up to two-thirds of newborn lives could be saved if essential care reached mothers and babies . Hence, there are opportunities to lower mortality rates even further with interventions at both the health facility level and the community level in Tanzania to ensure better healthcare provision to these parties.
This will mainly require implementing improvements in resources for maternal and neonatal care in terms of quality, availability, accessibility, and affordability as well as creating more awareness about birth plans for labour and delivery among the people in Tanzania, particularly pregnant women.
Actions at the health facility level to save newborn lives
- Improve infrastructure and supplies – ensuring every district hospital has a neonatal unit, practices Kangaroo Mother Care (KMC) and all health facilities have functional equipment and essential drugs such as gentamicin for treating neonatal sepsis
- Recruit and retain quality staff – filling vacant posts and addressing turnover among existing staff; ensuring competence in key skills such as neonatal resuscitation
- Improve guidelines and service delivery – establishing or improving procedures for routine postnatal care and management of preterm and sick newborns
- Integrate services – linking emergency obstetric services with newborn care and improving transport and referral mechanisms
- Use data locally for quality improvement – recording and auditing neonatal deaths and stillbirths 
Actions at the family and community level to save newborn lives
- Identify a means to reach every mother and baby in the early postnatal period (within the first two days after birth)
- Invest in primary health care at the village level by ensuring appropriate supervision, remuneration and working conditions for village health workers
- Strengthen community – Integrated Management of Childhood Illness (IMCI) to effectively reinforce healthy behaviours, recognition of danger signs and timely care seeking, to identify harmful traditional practices and awareness of key newborn health packages, such as routine postnatal care, KMC and IMCI
- Engage communities in birth preparedness, including planning to give birth at a health facility and emergency transport
- Reduce the economic burden of a facility birth on women and their families 
These actions depend on leadership at all levels. Tanzania’s decentralised health system ensures that public health interventions are linked to those who need them but more effort is needed to integrate newborn health packages into district level budgets and planning. Newborn lives can be saved by implementing appropriate policies, improving staffing levels and supervision in health facilities and providing an enabling environment for community-level care.
There is an immediate opportunity for Tanzania to implement the recommendations within the Road Map/One Plan to improve newborn health from the highest level in both public and private health facilities and to infl uence the care newborns receive at home.
Tanzania’s future depends on the ability of these newborns to survive and thrive. This situation analysis sheds light on the current state of care and the opportunities to save lives. While better data, policy change and revised guidelines will make a difference, it takes people to act to save newborn lives. Will you use this information to become a champion of the country’s most vulnerable and precious citizens?