Is Tanzania on the Right Track to SDG 3?: Analysis of the TDHS-MIS 2022 Report

Writing from a land of natural beauty and cultural diversity, Tanzania where a healthcare revolution is quietly taking shape. The recently released Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS) 2022 has unveiled a story of remarkable progress in maternal and child health. As the report was officially launched by President Samia Suluhu Hassan, the nation celebrated a monumental achievement—a staggering 80% reduction in maternal deaths, bringing the number down from 556 deaths per 100,000 live births in 2015/2016 to a significantly improved 104 per 100,000 live births in 2021/2022. This momentous accomplishment has propelled Tanzania closer to the coveted Sustainable Development Goal (SDG) of reducing maternal mortality to 70 deaths per 100,000 live births by 2030.

But the narrative doesn't end there; the TDHS-MIS 2022 report provides a comprehensive glimpse into the intricacies of healthcare in Tanzania. From the reduction in child mortality to the challenges of teenage pregnancies, the report paints a vivid picture of the nation's healthcare landscape. Furthermore, it uncovers the experiences of mothers during childbirth, highlighting the importance of respectful care and the challenges of non dignified treatment in healthcare facilities.

From the dramatic reduction in maternal deaths to the disparities in regional teenage pregnancy rates and the profound impact of respectful care, this article unpack the essential findings of the TDHS-MIS 2022 and shed light on the transformative strides being made to enhance healthcare quality in Tanzania.

Unveiling the Remarkable Reduction in Maternal Mortality Rates

Maternal mortality is a critical indicator of a nation's healthcare system and the well-being of its mothers. The release of the Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS) 2022 brought forth some truly remarkable findings, showcasing a substantial reduction in maternal mortality rates in Tanzania by 80% over the past 5 years. The In 2016, Tanzania reported an alarming 556 maternal deaths per 100,000 live births. Fast forward to 2022, and this number had downed to an astonishing 104 maternal deaths per 100,000 live births. This represents an 80% reduction in maternal mortality over just five years. Such a rapid and substantial reduction is nothing short of remarkable and speaks volumes about the country's commitment to improving maternal healthcare.

Several factors have played a crucial role in driving this reduction in maternal mortality rates. Key among them is the government's dedication to enhancing maternal healthcare infrastructure by increasing health facilities remarkably from 10,153 in 2021 to 11651 in 2023, investment in skilled healthcare providers, decentralization of comprehensive emergency obstetric and newborn? care (EmONC) to health center level, and innovative initiatives like M-mama program has undoubtedly saved countless lives.

While the reduction in maternal mortality rates is undoubtedly a triumph, it is essential to remain vigilant and address the challenges that still lie ahead. Ensuring that this reduction is sustained and further improved will require continued investment in healthcare infrastructure, skilled personnel, and increased access to quality healthcare services, particularly in remote areas.

A Closer Look at Child Mortality

The 2022 TDHS-MIS report reveals a significant and positive trend in under-5 mortality rates in Tanzania. In 2004-05, there were 112 deaths per 1,000 live births in the 5 years preceding the survey. Fast forward to 2022, and this number has reduced to 43 deaths per 1,000 live births in the same time frame. This substantial decline signifies a substantial improvement in child health outcomes.

The decline in infant mortality is another notable achievement. In the same time frame from 2004-05 to 2022, the infant mortality rate dropped from 68 deaths per 1,000 live births to 33 deaths per 1,000 live births. This represents an encouraging reduction in infant deaths, reflecting the progress made in child healthcare in Tanzania over the years.

While there have been significant reductions in under-5 and infant mortality, the report highlights a slower decline in neonatal mortality rates. From 2004-05 to 2022, neonatal mortality only decreased from 32 to 24 deaths per 1,000 live births. Experts attribute this slow decline to the lack of Neonatal Intensive Care Units (NICUs) in healthcare facilities. However, there is optimism that this situation will improve as the government is steadily working to increase the number of NICUs in hospitals and primary healthcare facilities.

Towards SDGs by 2030?

The reduction in maternal mortality is not only a cause for celebration but also a milestone that brings Tanzania closer to the Sustainable Development Goal (SDG) target. The global community aims to reduce maternal mortality to 70 deaths per 100,000 live births by 2030, and Tanzania's achievement of 104 is a significant step towards this goal. It demonstrates the country's commitment to the well-being of its mothers and the progress made in providing access to quality healthcare.

?Tanzania's progress in reducing child mortality rates is a positive step toward achieving the Sustainable Development Goals (SDGs). The global community aims to reduce neonatal mortality to 12 deaths per 1,000 live births by 2030, and Tanzania's commitment to improving child healthcare is a testament to its dedication to this goal. While under-5 and infant mortality rates are on the decline, there is work to be done to accelerate the reduction in neonatal mortality.

Teenage Pregnancies in Tanzania: A Regional Perspective

The report highlights that teenage pregnancies in Tanzania have seen a noteworthy decline, with the percentage of teenage women aged 15-19 who have ever been pregnant decreasing from 27% in 2016 to 22% in 2022. However, these figures also reveal a more complex story, as the progress is not uniform across the nation. Some regions, notably Dar es Salaam and Ruvuma, have shown a reverse trend, indicating a need for tailored interventions.

Regional variations are striking in Tanzania when it comes to teenage pregnancies. The South West Highlands zone and Southern Highlands zone stand out with the highest levels of teenage pregnancies, reaching 31% and 29%, respectively. In contrast, Mjini Magharibi demonstrates the lowest rate at just 2%.

The report also highlights the significant influence of education and wealth on teenage pregnancy rates. Teenage pregnancy decreases as education levels increase. For instance, 53% of women aged 15-19 with no education have ever had a live birth, compared to only 9% of women with a secondary education or higher. Similarly, teenage pregnancy rates decrease as wealth quintiles rise, with 35% in the lowest quintile and 12% in the highest quintile.

Another attention drawing aspect of teenage pregnancies in Tanzania is the urban-rural divide. The percentage of teenage women aged 15-19 who have ever been pregnant is higher in rural Tanzania (25%) than in urban Tanzania (16%). Additionally, Zanzibar exhibits lower rates (4%) compared to Tanzania Mainland (23%). These urban-rural and Zanzibar-Mainland differences emphasize the need for targeted interventions tailored to specific populations.

Respectful Care and Healthcare Quality: Examining the Experiences of Mothers

Respectful care during childbirth is an essential aspect of maternal healthcare quality. When women are treated with respect and dignity, they are more likely to have positive birth experiences, feel empowered to make informed decisions about their care, and have better health outcomes for themselves and their newborns. The report assesses three aspects of respectful care: how health care providers treat women with respect, whether providers explain the reasons for examinations or procedures, and whether providers take the best possible care of them.

Among women aged 15-49 who had a live birth in a health facility in the two years preceding the survey, 90% reported that they were treated with respect at all times. This positive outcome is a testament to the dedication of healthcare providers in Tanzania to offer respectful care to mothers during childbirth. Such treatment fosters trust and ensures a positive birthing experience.

Another encouraging finding from the report is that 76% of women reported that they were always given an explanation regarding why examinations or procedures were done, while 88% reported that health care providers took the best care of them all of the time. These aspects of respectful care are critical in ensuring mothers are well-informed and receive the highest quality healthcare during childbirth.

However, the report also brings to light challenges related to nondignified treatment in healthcare facilities. Eleven percent of women reported that they shared a bed during their stay, which was more common in urban areas (19%) than in rural areas (8%) and more prevalent in Zanzibar (30%) compared to Tanzania Mainland (11%). Additionally, 3% of women slept on the floor without a mattress, and 4% were denied medical services due to a lack of money, while another 4% were prevented from leaving the health facility due to a lack of payment.

The percentage of women who felt they did not receive respectful care is higher among those who had a stillbirth compared to those with a live birth. Seven percent reported that they were not treated with respect at all, while 11% said that healthcare providers did not take the best care of them at all. These findings emphasize the need to ensure that respectful care is consistently provided, regardless of the outcome of childbirth.

Conclusion

The TDHS-MIS 2022 report offers a comprehensive overview of Tanzania's progress in maternal and child health. While there have been significant achievements, challenges remain, and further efforts are needed to meet the SDG targets. Understanding the intricacies of these health indicators is vital for shaping policies and interventions to improve the well-being of mothers and children in Tanzania. The slow decline in neonatal mortality underlines the importance of addressing challenges in neonatal healthcare.