Safe Childbirth: Tanzania's Water and Sanitation Challenge
Welcome back to my blog!
Today, we will look into the heart of Africa, specifically focusing on Tanzania, to unravel the crucial link between water, sanitation, and childbirth. The importance of water and sanitation (WATSAN) in Africa cannot be overemphasised, and the urgent need for improvement in this area is more evident than ever. In this post, we look at how access to clean water and proper sanitation can change lives, especially when it comes to maternal health.
To understand the significance of WATSAN, let's rewind to the late 18th century when the connection between poor hand hygiene and puerperal sepsis (a severe infection during childbirth) was first acknowledged. This ground-breaking insight led to a decline in maternal mortality rates. Today, the World Health Organization (WHO) emphasises the importance of handwashing during deliveries, even in home settings. These guidelines play a key role in ensuring safe birthing practices.
| Fig.1 Distribution of facility births by facility type and zone, Tanzania DHS 2010. |
A study sheds light on Tanzania’s distribution of facility births (Benova et al., 2014). Notably, 30% of births in the country take place in dispensaries. As can be seen in Figure 1, the Central, Western and Southern Highlands regions accounted for nearly half of the total number of newborns in the clinics, with the Southern Highlands region leading the way with a remarkable 43 %.
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However, when we turn our attention to Figure 2, we see that almost all regions are faced with the shocking reality that more than half of all newborns are born in such unsafe conditions. This is a staggering statistic that reveals that in many regions, nearly half or more of all newborns are born in environments that lack adequate water and sanitation facilities.
What's even more concerning is that some zones, such as Lake, Western, and Central, which previously reported a high percentage of clinic births in the figure, are witnessing a significantly high percentage of births happening in these unsafe WATSAN environments. The Southern Highlands region stands out with a staggering 70.7% of births occurring in such conditions!
While birthing facilities are generally safer than home environments, it's essential to acknowledge that they are far from universally equipped with adequate water and sanitation, especially in the case of health centres and dispensaries (Benova et al., 2014). This deficiency in WATSAN infrastructure has the potential to pose significant risks to both mothers and newborns. Hence, ensuring a WATSAN-safe environment in dispensaries becomes paramount for the safety of mothers during labour and the care of new-borns.
In our next post, we'll look at the case of Itepula Dispensary, situated in the Songwe area within the Southern Highlands region, as depicted in Fig.2. This case study will offer a detailed story into how enhancements in WATSAN on not only elevated healthcare facilities but also enhanced hygienic conditions surrounding childbirth.
Hi Nia, thank you for your post. The statistics for Tanzania are quite striking! I wonder what your thoughts are on the positionality of these figures, particularly concerning environments classified as 'lacking' proper WASH facilities and the concept of 'proper' WASH facilities.
ReplyDeleteHi Serena, thanks for your thoughtful comment!
DeleteSolely for this data I cited, the original text of this research mentions the source of their data and their definitions of unsafe WATSAN environments for their research: "We used the most recent SPA survey conducted in 2006 to characterise the WATSAN environment of facilities. This survey included a nationally-representative sample of 611 public and non-public facilities. A questionnaire was administered and elements of the delivery room environment were observed during facility visits." The limitations of this study are also mentioned: "The lack of data about important elements of a health facility's WATSAN environment meant that these definitions are imperfect".
From my personal angle I believe that the lacking or sufficient WASH facility is difficult to determine, as the source of this data can be very subjective. But we can still find some unifying development goals in the agendas of international organisations, see: https://iris.who.int/bitstream/handle/10665/329290/A72_R7-en.pdf?isAllowed=y&sequence=1
Hello Nia,
ReplyDeleteI really like that you are taking the unique lens of childbirth to explore WASH. It kind of hinted that improvement in WASH conditions actually have significant impacts on females. Do you think that there is a lack of focus to females under current efforts to improve the WASH conditions in Africa?
Thank you Lucas, I have not highlighted gender as an issue because the diseases brought by lack of hygiene affect everyone. But it is true that women experience more issues, such as the lack of Menstrual Hygiene Management leading to girls missing school. Increasing women's participation in decision-making, education and empowerment is very important. As well as actively transforming the position of women in the cultural and social norms.
DeleteHello Nia, this is a very well-explained blog on the gender aspects of sanitation and water. My blog focuses on gender and water, and yeah, I agree what you discussed on the sanitation services women received when laboring. For my blog, I have focused more on the gender disparity on water distribution, and the impact on their menstrual and reproductive health! Welcome to check it out!
ReplyDeleteThanks Yiyi, I'll definitely have a look!
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