Our Initiatives


The Issue: Maternal mortality is unacceptably high. According to the World Health Organization, approximately 830 women die from preventable causes related to pregnancy and childbirth everyday.  66% of those maternal deaths occur in sub-Saharan Africa. In other words, a woman dies from complications related to pregnancy and childbirth every two minutes.  

Tanzania has one of the highest maternal and newborn death rates in the world, with 556 deaths per 100,000 live births. Roughly 63% of births occur in health facilities. About 36% of births occur at home.  Access to skilled maternal health at birth in remote rural settings is particularly challenging. There is a marked disparity in skilled birth attendant coverage between urban (83%) and rural areas (51%).  While 98% of pregnant women aged 15-49 receive antenatal care at least once from a skilled provider, only 51% of women receive the minimally required 4 antenatal care visits.  Only 34% of women receive postnatal check-ups within two days of their delivery, and 63% of women do not receive a postnatal check up at all within the first 41 days of delivery.  

Midwives can play an instrumental role in ensuring that women and their babies receive a continuum of skilled care during pregnancy, childbirth and the important days immediately after birth.  According to the UNFPA, qualified midwives could avert 83% of maternal and newborn deaths. The Lancet reports that countries that have taken policy action and increased the number of midwives have resulted in significant improvement to maternal and newborn survival rates.

Solution: In partnership with the Ministry of Health, Members of Parliament and His Excellency Jakaya Kikwete, The Access Challenge is trying to raise the profile of the important role that midwives can play improving access to trained care and thereby in reducing maternal mortality in Tanzania.   
The goals of this work are to:  
  1. Increase the understanding of the importance of midwives amongst Tanzanian citizens and high-level decision makers.
  2. Create a stand-alone midwifery profession.
  3. Improve the Tanzanian midwifery curriculum.
  4. Increase the availability of trained maternal care in all communities in Tanzania.