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Open Access Research article

Staff experiences of providing maternity services in rural southern Tanzania – a focus on equipment, drug and supply issues

Suzanne Penfold1*, Donat Shamba2, Claudia Hanson13, Jennie Jaribu2, Fatuma Manzi2, Tanya Marchant1, Marcel Tanner4, Kate Ramsey2, David Schellenberg1 and Joanna Armstrong Schellenberg1

Author Affiliations

1 Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK

2 Ifakara Health Institute, Dar es Salaam, Tanzania

3 Division of Global Health, Karolinska Institutet, Stockholm, Sweden

4 Swiss Tropical and Public Health Institute, Basel, Switzerland and University of Basel, Basel, Switzerland

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BMC Health Services Research 2013, 13:61  doi:10.1186/1472-6963-13-61

Published: 14 February 2013

Abstract

Background

The poor maintenance of equipment and inadequate supplies of drugs and other items contribute to the low quality of maternity services often found in rural settings in low- and middle-income countries, and raise the risk of adverse patient outcomes through delaying care provision. We aim to describe staff experiences of providing maternal and neonatal care in rural health facilities in Southern Tanzania, focusing on issues related to equipment, drugs and supplies.

Methods

Focus group discussions and in-depth interviews were conducted with different staff cadres from all facility levels in order to explore experiences and views of providing maternity care in the context of poorly maintained equipment, and insufficient drugs and other supplies. A facility survey quantified the availability of relevant items.

Results

The facility survey, which found many missing or broken items and frequent stock outs, corroborated staff reports of providing care in the context of missing or broken care items. Staff reported increased workloads, reduced morale, difficulties in providing optimal maternity care, and carrying out procedures with potential health risks to themselves as a result.

Conclusions

Inadequately stocked and equipped facilities compromise the health system’s ability to reduce maternal and neonatal mortality and morbidity by affecting staff personally and professionally, which hinders the provision of timely and appropriate interventions. Improving stock control and maintaining equipment could benefit mothers and babies, not only through removing restrictions to the availability of care, but also through improving staff working conditions.

Keywords:
Maternal health services; Neonate; Qualitative research; Equipment and supplies; Healthcare systems; Health manpower; Africa south of the Sahara