Observational studyBMC pregnancy and childbirth2018
Reintroducing vacuum extraction in primary health care facilities: a case study from Tanzania.
Observational study in BMC pregnancy and childbirth, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Interventions to reintroduce or increase assisted vaginal births: a systematic review of the literature.BMJ open · 2023Pooled it
- Maternal and perinatal outcomes after vacuum-assisted vaginal delivery versus second-stage caesarean delivery in a generalist-run rural district hospital: A retrospective cohort study.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2026Article
- Feasibility of the OdonAssist device for assisted vaginal birth in a low-resource setting: ASSIST Ethiopia study protocol.BMJ open · 2026Article
- Understanding the underuse: Barriers to vacuum-assisted birth among clinicians in Tanzania: An exploratory qualitative study.PloS one · 2026Article
- Evidence-informed framework for gender transformative continuing education interventions for midwives and midwifery associations.BMJ global health · 2023Article
- A Comprehensive Approach to Improving Emergency Obstetric and Newborn Care in Kigoma, Tanzania.Global health, science and practice · 2022Article
- Factors related to the practice of vacuum-assisted birth: findings from provider interviews in Kigoma, Tanzania.BMC pregnancy and childbirth · 2021Article
- Cesarean delivery in low- and middle-income countries: A review of quality of care metrics and targets for improvement.Seminars in fetal & neonatal medicine · 2021Review
- Perinatal outcomes of babies delivered by second-stage Caesarean section versus vacuum extraction in a resource-poor setting, Nigeria - a retrospective analysis.BMC pregnancy and childbirth · 2020Article
- Women's recommendations: vacuum extraction or caesarean section for prolonged second stage of labour, a prospective cohort study in Uganda.Tropical medicine & international health : TM & IH · 2019Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn rural Tanzania access to emergency obstetric and newborn care is threatened by poor roads and understaffed facilities among other challenges. Districts in Kigoma, Pwani and Morogoro regions were targeted by a local non-governmental organization to assist local government to build capacity and improve access to clinical management of severe obstetric and newborn complications. The program upgraded ten primary health care centres to provide comprehensive emergency obstetric and newborn care. This paper describes the process of reintroducing vacuum extraction into ten health centres and five hospitals, highlighting patterns in uptake, mode of delivery and lessons learned.
methodsThis observational study uses facility-based trend data collected between 2011 and 2016.Descriptive outcomes include institutional caesarean delivery rates, vacuum extraction rates, and the ratio of caesareans to vacuum-assisted deliveries.
resultsInstitutional caesarean delivery rates remained stable at about 10-11% and the vacuum extraction rate rose from virtually no procedures in 2011 to about 2% in 2016. The increase was more visible in upgraded health centres than in hospitals. In 2016 vacuum extraction rates in newly upgraded health centres ranged from 0.5 to 7.8%. Between 2011 and 2016, the ratio of caesareans to vacuum extractions in hospitals changed from 304 caesareans to 1 vacuum extraction to 10:1, while in health centres the ratio changed from 22: 1 to 3: 1.
conclusionsReintroduction of vacuum extraction into clinical practice in primary health care facilities with task-shifting is feasible. Reintroduction of this procedure was more successful when part of an integrated upgrading of health centres to provide comprehensive emergency obstetric care than when reintroduced into busy hospital environments. Turnover of trained staff in hospitals contributed to the uneven uptake of vacuum extraction. Lessons learned are applicable to further national scale up and to other countries.
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