White Ribbon Alliance

women in health centre (1024x937)

Be Accountable So Mama Can Live

August 19, 2013

Twenty-four women die in pregnancy and childbirth every day in Tanzania. These are close to nine thousand lives that can be saved in the country every year. White Ribbon Alliance Tanzania is mobilizing citizens to ensure that national leaders and district councillors prioritize life-saving services for mothers.

A woman suffering from obstructed labour, heavy bleeding or high blood pressure may have only two hours to live. However, in a region such as Rukwa, it takes five hours by boat from Wampembe to the nearest clinic that offers Comprehensive Emergency (CEmONC) services. The alternative to this journey is a 118 km (over 70 miles) walk to the clinic.

Many women faced with the long distance from home to the health facility have no choice but to endanger their lives and those of their babies by giving birth at home, with no help except from unskilled fellow women. According to Tanzania’s Demographic Health Survey, only three out of ten women in Rukwa give birth at health facilities.

Moreover, lack of hospital equipment and proper infrastructure, such as electricity, are some of the barriers in providing Comprehensive Emergency Care. A health worker in Wampembe explains, “What can we do when a woman is dying? There is no operating theatre, no laboratory or blood bank, no running water, no 24 hour communication, the radio call is not on during weekends, and there is no mobile phone network”.

Efforts to alert communities to the danger signs of pregnancy are useful, but they amount to nothing unless health facilities can provide life-saving services. Without functional operating rooms, lack of midwives and doctors, shortages in the supply of blood, antibiotics, and other drugs, women will continue to die.

In response to the UN Millennium Development Goal 5 to improve maternal health, the Tanzanian Government set out a plan to reduce maternal mortality, including the provision of more emergency obstetric care. Considerable progress has been made, but more needs to be done, and currently the Government is falling short on its commitment to ensure that 50 percent of health centres in the country have comprehensive emergency obstetric care. Wajibika Mama Aishi (Be Accountable so Mama Can Live) is White Ribbon Alliance Tanzania’s three-year campaign to remind the Government to uphold its commitment.

The Alliance in Tanzania has already started to work with district, regional and national stakeholders to ensure that funds are specifically budgeted for CEmONC and that the services are implemented in health centres to at least the promised level. This means that a health facility should be able to provide a set of lifesaving procedures that include:

  1. Manual removal of retained placenta;
  2. Parenteral administration of antibiotics by injection;
  3. Parenteral administration of drugs (oxytocin) that make the womb contract and so prevent haemorrhage;
  4. Administration of magnesium sulphate to prevent fits from high blood pressure;
  5. Assisted vaginal delivery;
  6. Removal by vacuum of retained products of conception;
  7. Resuscitation of the newborn;
  8. Caesarean section;
  9. Safe blood transfusion.


In the initial stage of the Campaign, White Ribbon Alliance Tanzania conducted assessment visits to ten health clinics. During one of the stops, the team learned that maternal deaths in a regional hospital dropped by 60 percent when one of the health centres started performing caesarean sections and providing safe blood transfusion.  Because of this change, women with complications in this area were no longer referred to a distant regional hospital. This is proof that there are effective solutions to saving lives across the country, and that the Government has to uphold its previous commitments in order to save those thousands of lives.