Providing postpartum care with limited resources: Experiences of nurse-midwives and obstetricians in urban Tanzania

Publication date: Available online 9 August 2018

Source: Women and Birth

Author(s): Danielle Macdonald, Megan Aston, Gail Tomblin Murphy, Keisha Jefferies, Lilian T. Mselle, Sheri Price, Shawna O'Hearn, Maureen White, Columba Mbekenga, Thecla W. Kohi

Abstract

Background

Tanzania has high maternal and neonatal mortality rates. Comprehensive guidelines for postpartum care have been developed by the government as a means to improve health outcomes during the perinatal period. Despite the creation of these guidelines and the government's commitment to universal perinatal care for women and neonates, there is concern that the delivery of postpartum services may not be meeting the needs of mothers and neonates.

Aim

The purpose of this feminist poststructuralist study was to explore nurse-midwives' and obstetricians' experiences of providing postpartum care in Tanzania.

Methods

This qualitative study used feminist poststructuralism to explore the personal, social, and institutional discourses of postpartum care. We individually interviewed ten nurse-midwives and three obstetricians in Dar es Salaam, Tanzania. Feminist poststructuralist discourse analysis was used to analyze the transcribed interviews after their translation from Kiswahili to English.

Findings

Four main themes were identified. In this paper, we present the main theme of availability of resources, and its four corresponding subthemes; (1) space, (2) equipment, (3) staffing, and (4) government responsibility.

Discussion

The findings from our study illustrate the need for health workforce planning to be addressed in a comprehensive manner that accounts for context, required resources and systemic challenges. These findings are consistent with findings from other studies.

Conclusion

Understanding the resource challenges that nurse-midwives and obstetricians are facing in one low-and-middle-income-country will assist researchers, decision makers, and politicians as they address issues of mortality, morbidity, and disrespectful maternity care.

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