Surviving childbirth through Essential Emergency and Critical Care in Kigoma Region

Anna Ezekiel, 26, is tired but happy. Two days earlier she welcomed her baby boy at Gungu Health Centre in Kigoma Municipal Council where staff have recently completed training in Essential Emergency and Critical Care (EECC).  The facility is also equipped with lifesaving tools to identify and manage critical illness. Although she had a normal delivery, Anna suffered from severe bleeding (postpartum haemorrhage) a complication which was identified early due to the new routines introduced as part of EECC. A nurse monitoring Anna’s vital signs noticed the increasing pulse rate, acted swiftly and gave her iv fluids to prevent shock, allowing time to stop the cause of bleeding and transfusing blood.

“I am very happy with the service I received. The staff have been monitoring me closely and I feel much better. I hope to be able to go home soon,” Anna says with relief.

A nurse showing UNICEF Health specialist Anase Minja the chart where Anna’s vital signs and EECC treatments were documented.

In just the past month, Anna is one of four women  to battle the life-threatening dangers of postpartum haemorrhage at Gungu Health Centre.

“We deliver up to 300 babies here every month and often manage mothers with serious complications. In the past, by the time I was called to help, these mothers were usually already in a critical state, and many needed referrals to the regional hospital, but following the introduction of EECC, this has changed,” says Dr Diana Adam, the council’s EECC coordinator and clinician in the health centre, with a proud smile on her face.

Dr Frank Sudai – Regional Clinical Services coordinator (CSCo), Dr Diana Adam – Council CSCo, Dr Noel Kimweri – Gungu HC in-charge, Dr Ulrika Baker – UNICEF Health manager, Dr Anase Minja – UNICEF Health specialist, Dr Albert Paschal – Regional EECC coordinator

EECC is transforming care for critically ill patients across Tanzania through a collaboration between UNICEF, Muhimbili University of Health and Allied Sciences, Ministry of Health and President’s Office for Regional Administration and Local Government, with funding from Global Affairs Canada via the CanGive Initiative.

EECC makes the difference between uncertainty and a peaceful start to motherhood.

“Recently, I attended to three mothers with PPH where the nurse had already taken appropriate action. Vital signs – breathing, oxygen saturation, blood pressure and pulse – had been checked and treatments began immediately, following EECC protocols. None of these mothers needed referral, and they could all leave the health centre healthy,” says Dr Diana.

EECC protocols displayed in the maternity unit.

In Gungu Health Centre, Kajuna Kulya, the nurse who is the in-charge of the maternity ward is the EECC focal person.

“The introduction of EECC in our facility has improved the teamwork, especially around emergencies, and has given nurses the confidence to act quickly to stabilise our patients, guided by practical protocols. The results are very encouraging.”

This hands-on learning is captured through robust implementation research and costing will inform a national roll-out plan.

For mothers like Anna, the impact is deeply personal. “At first, I couldn’t stand up as I was too weak, but I am now able to walk and to breastfeed my baby. Many people are now choosing Gungu because the services are good,” says Anna.

Through the CanGive initiative, so far 1,030 health workers and 207 managers have been trained across five regions in mainland Tanzania—Kigoma, Katavi, Songwe, Mtwara, and Dar es Salaam—as well as in Zanzibar, to integrate Essential Emergency and Critical Care (EECC) into routine primary health care in 79 health facilities. In addition, 141 EECC focal persons have been trained to support implementation and promote EECC practices.