ArticleBulletin of the World Health Organization2015
Identifying implementation bottlenecks for maternal and newborn health interventions in rural districts of the United Republic of Tanzania.
Article in Bulletin of the World Health Organization, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 2 of them syntheses that pooled it.
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Who cites it
49 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A rapid systematic review and evidence synthesis of effective coverage measures and cascades for childbirth, newborn and child health in low- and middle-income countries.Journal of global health · 2022Pooled it
- Pooled it
- Child health and the implementation of Community and District-management Empowerment for Scale-up (CODES) in Uganda: a randomised controlled trial.BMJ global health · 2021Trial
- Did a quality improvement intervention improve quality of maternal health care? Implementation evaluation from a cluster-randomized controlled study.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2020Trial
- Trial
- Barriers and bottlenecks to implementation of WHO recommendations for prevention, detection, and treatment of postpartum hemorrhage: a mixed-methods triangulation study.Implementation science communications · 2026Article
- Discharge time from healthcare facilities after birth in Tanzania : a secondary analysis of demographic and health surveys from 2015 to 16 and 2022.BMC health services research · 2026Article
- Article
- Implementing telemedicine for medical abortion within the public health system: a qualitative study on implementation bottlenecks and solutions in South Africa.BMC public health · 2025Article
- Implementation effectiveness of 'Problem solving for better health' training in Lesotho using mixed methods and the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework.BMC medical education · 2025Article
- Bottleneck Analysis of Maternal, Newborn and Child Health Services in Underserved Areas of Kwale County, Kenya.Health services insights · 2025Article
- Bottlenecks Analysis in the Intervention of Improving Maternal Health in Rural Areas of Tanzania: A Convergent Mixed-Method Approach.International journal of health policy and management · 2025Article
- Effective coverage of maternal and neonatal healthcare services in low-and middle-income countries: a scoping review.BMC health services research · 2024Article
- Effect of neonatal nurse mentorship in improving neonatal care competencies among neonatal nurses in Rwandan hospitals.Public health challenges · 2023Article
- Do public health expenditures affect maternal and child health in Madagascar?Health economics review · 2023Article
- Exploring a framework for demandable services from antenatal to postnatal care: a deep-dive dialogue with mothers, health workers and psychologists.BMC pregnancy and childbirth · 2023Article
- Facilitators and barriers to point-of-care testing for sexually transmitted infections in low- and middle-income countries: a scoping review.BMC infectious diseases · 2022Article
- Operationalizing Implementation Science in Nutrition: The Implementation Science Initiative in Kenya and Uganda.Current developments in nutrition · 2022Article
- No increase in use of hospitals for childbirth in Tanzania over 25 years: Accumulation of inequity among poor, rural, high parity women.PLOS global public health · 2022Article
- Operationalising effective coverage measurement of facility based childbirth in Gombe State; a comparison of data sources.PLOS global public health · 2022Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectiveTo estimate effective coverage of maternal and newborn health interventions and to identify bottlenecks in their implementation in rural districts of the United Republic of Tanzania.
methodsCross-sectional data from households and health facilities in Tandahimba and Newala districts were used in the analysis. We adapted Tanahashi's model to estimate intervention coverage in conditional stages and to identify implementation bottlenecks in access, health facility readiness and clinical practice. The interventions studied were syphilis and pre-eclampsia screening, partograph use, active management of the third stage of labour and postpartum care.
findingsEffective coverage was low in both districts, ranging from only 3% for postpartum care in Tandahimba to 49% for active management of the third stage of labour in Newala. In Tandahimba, health facility readiness was the largest bottleneck for most interventions, whereas in Newala, it was access. Clinical practice was another large bottleneck for syphilis screening in both districts.
conclusionThe poor effective coverage of maternal and newborn health interventions in rural districts of the United Republic of Tanzania reinforces the need to prioritize health service quality. Access to high-quality local data by decision-makers would assist planning and prioritization. The approach of estimating effective coverage and identifying bottlenecks described here could facilitate progress towards universal health coverage for any area of care and in any context.
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