Caesarean section for stillborn babies, Benin, Malawi, Uganda and United Republic of Tanzania.

Objective: To understand why caesarean sections are performed for stillborn babies by investigating caesarean section rates and indications in sub-Saharan African countries and to examine whether fetal vital status at admission is associated with caesarean section.

Methods: The study involved registry data on 105 872 babies weighing 1000 g or more born to women aged 13 to 50 years at 16 hospitals in Benin, Malawi, Uganda and United Republic of Tanzania between 1 July 2021 and 30 June 2023. We assessed caesarean section rates and indications, and used multivariable logistic regression analyses to estimate associations between fetal heartbeat at admission and caesarean section, by birth outcome.

Mandatory second opinion to reduce caesarean section rate among low-risk pregnant women at a private tertiary hospital, a pre and post intervention study: an analysis using WHO Robson classification.

Background: Caesarean section rate has increased globally even among low-risk obstetric deliveries. Therefore, more mothers and babies are subjected to potential complications associated with caesarean section. Hence, World Health Organization introduced measures to reduce unnecessary caesarean section, including worldwide accepted means of classifying all deliveries by the Robson's classification system and recommended safe non-medical interventions, such as mandatory second opinion prior caesarean section.

"It's the Time they Take to Give Feedback; it has Become a Problem" Exploring Barriers and Facilitators for Research Supervision in Postgraduate Medical Education in Tanzania. A Qualitative Study.

Background: Research supervision is a multifaceted task that combines academic knowledge with managing interpersonal relationships. Postgraduate trainees often receive inadequate supervision due to their supervisors' demanding schedules and limited supervision competencies. Most supervisors, especially in low-resource settings, lack formal training in supervision and thus rely on personal experiences to fulfil this role.

Delayed diagnosis of concurrent intrauterine and intraperitoneal intrauterine devices following assumed expulsion: A case report.

Introduction: Intrauterine devices (IUDs) are effective long-term contraceptives. Although rare, IUD migration can lead to severe complications if undiagnosed. Migration may present with pain, or remain asymptomatic, and unvisualized devices are often presumed expelled without confirmation.

Frequency, predictors and outcomes of intradialytic complications in patients on maintenance haemodialysis in Dar es Salaam: Prospective longitudinal study.

Introduction: Hemodialysis is a crucial renal replacement therapy option for end stage renal disease (ESRD) patients. Currently, there is a rise of patients who require hemodialysis with concurrent rise in intradialytic complications which can potentiate several outcomes some of which are life threatening. This study assessed the frequency, predictors, and outcomes of intradialytic complications amongst ESRD patients on maintenance hemodialysis.

Mixed vulnerabilities: the biological risk of high parity is aggravated by emergency referral in Benin, Malawi, Tanzania and Uganda.

Identification of interacting vulnerabilities is essential to reduce maternal and perinatal mortality in sub-Saharan Africa (SSA). High parity (≥ 5 previous births) is an underemphasized biological vulnerability linked to poverty and affecting a sizeable proportion of SSA births. Despite increased risk, high parity women rarely use hospitals for childbirth.

Experiences and perceptions of a perinatal eRegistry in two hospitals in Mtwara region, Tanzania.

Introduction: Digital data systems have the potential to improve data quality and provide individual-level information to understand gaps in the quality of care. This study explored experiences and perceptions of a perinatal eRegistry in two hospitals in Mtwara region, Tanzania. Drawing from realist evaluation and systems thinking, we go beyond a descriptive account of stakeholders' experiences and provide insight into key structural drivers and underlying social paradigms.

Congenital ureterovaginal fistula and a duplicated left ectopic ureter: A rare case in Tanzania.

This case report presents the clinical journey of a 28-year-old nulliparous woman from Dar es Salaam, Tanzania, who sought medical attention due to lifelong urinary leakage since birth, profoundly impacting her emotional well-being and sexual encounters. Clinical examination revealed urinary leakage from the vagina, with unremarkable abdominal and genital findings. Laboratory investigations were normal.

Health professionals' experiences and views on obstetric ultrasound in Tanzania: A cross-sectional study.

Background: Obstetric ultrasound is considered important for determining gestational age, identifying single or multiple pregnancies, locating the placenta and fetal anomalies and monitoring fetal growth and pregnancy-related complications in order to improve patient management.

Objectives: To explore health professionals' perspectives on different aspects of obstetric ultrasound in Tanzania regarding self-reported skills in performing ultrasound examinations and what could improve access to and utilization of obstetric ultrasound in the clinical setting.

Design: Cross-sectional study.

Medical management of ectopic pregnancy: Case series at a private tertiary hospital, Tanzania.

Ectopic pregnancy is a pregnancy in which the developing blastocyst implants outside the endometrial cavity. An estimated 1.3%-2.

Stillbirth mortality by Robson ten-group classification system: A cross-sectional registry of 80 663 births from 16 hospital in sub-Saharan Africa.

Objective: To assess stillbirth mortality by Robson ten-group classification and the usefulness of this approach for understanding trends.

Design: Cross-sectional study.

Setting: Prospectively collected perinatal e-registry data from 16 hospitals in Benin, Malawi, Tanzania and Uganda.

Birth asphyxia and its association with grand multiparity and referral among hospital births: A prospective cross-sectional study in Benin, Malawi, Tanzania and Uganda.

Introduction: Birth asphyxia is a leading cause of neonatal mortality in sub-Saharan Africa. The relationship to grand multiparity (GM), a controversial pregnancy risk factor, remains largely unexplored, especially in the context of large multinational studies. We investigated birth asphyxia and its association with GM and referral in Benin, Malawi, Tanzania and Uganda.

Advancing primary care: Establishing family medicine specialty in Tanzania.

Family medicine has existed as a training pathway through a private university in Tanzania since 2004. As global calls have increased to embrace primary health care as a pathway to ensuring universal health coverage, so has Tanzania recently turned to explore family medicine as a specialty to improve access to comprehensive, high-quality healthcare for her entire population. This article outlines ongoing efforts to define competencies and skills of a family medicine physician in Tanzania, engage government support and open the first public university training programme for family medicine postgraduate education.

A rare case report of tuberculosis endometritis in a private hospital Dar es salaam, Tanzania.

Tuberculosis endometritis is a pathological diagnosis and has been always over shadowed by pelvic tuberculosis. It is usually asymptomatic, but patients could complain of menstrual irregularity and per vaginal discharge. We report a case of a 37-year-old female who presented with per vaginal discharge for 2 years.

Perceptions of surgeons on surgical antibiotic prophylaxis use at an urban tertiary hospital in Tanzania.

Background: Surgical Site Infections are a major cause of morbidity and mortality among operated patients. In spite of the accessibility of universal and national guidelines for surgical prophylaxis, recent studies surveying the present routine of prophylaxis have demonstrated overutilization of a wide range antibacterial medication for a single patient. Few studies have shown qualitatively factors influencing this and perceptions of surgeons on surgical antibiotic prophylaxis use.

Effectiveness of a Novel Continuous Doppler (Moyo) Versus Intermittent Doppler in Intrapartum Detection of Abnormal Foetal Heart Rate: A Randomised Controlled Study in Tanzania.

: Intrapartum foetal heart rate (FHR) monitoring is crucial for identification of hypoxic foetuses and subsequent interventions. We compared continuous monitoring using a novel nine-crystal FHR monitor (Moyo) versus intermittent single crystal Doppler (Doppler) for the detection of abnormal FHR. : An unmasked randomised controlled study was conducted in a tertiary hospital in Tanzania (ClinicalTrials.

Implementation of a novel continuous fetal Doppler (Moyo) improves quality of intrapartum fetal heart rate monitoring in a resource-limited tertiary hospital in Tanzania: An observational study.

Background: Intrapartum Fetal Heart Rate (FHR) monitoring is crucial for the early detection of abnormal FHR, facilitating timely obstetric interventions and thus the potential reduction of adverse perinatal outcomes. We explored midwifery practices of intrapartum FHR monitoring pre and post implementation of a novel continuous automatic Doppler device (the Moyo).

Methodology: A pre/post observational study among low-risk pregnancies at a tertiary hospital was conducted from March to December 2016.

Challenges in day-to-day midwifery practice; a qualitative study from a regional referral hospital in Dar es Salaam, Tanzania.

Background: Maternal and infant mortality rates in Tanzania have decreased over the past decades, but remain high. One of the challenges the country faces, is the lack of skilled health care workers. High fertility rates make midwives and their patients particularly susceptible to stress as a result of understaffing.

"I Was Relieved to Know That My Baby Was Safe": Women's Attitudes and Perceptions on Using a New Electronic Fetal Heart Rate Monitor during Labor in Tanzania.

To increase labor monitoring and prevent neonatal morbidity and mortality, a new wireless, strap-on electronic fetal heart rate monitor called Moyo was introduced in Tanzania in 2016. As part of the ongoing evaluation of the introduction of the monitor, the aim of this study was to explore the attitudes and perceptions of women who had worn the monitor continuously during their most recent delivery and perceptions about how it affected care. This knowledge is important to identify barriers towards adaptation in order to introduce new technology more effectively.

Evaluation of a training program for health care workers to improve the quality of care for rape survivors: a quasi-experimental design study in Morogoro, Tanzania.

Background: Sexual violence against women and children in Tanzania and globally is a human rights violation and a developmental challenge.

Objective: The aim of this study was to assess the impact of training health professionals on rape management. The specific objectives were to evaluate the changes of knowledge and attitudes toward sexual violence among a selected population of health professionals at primary health care level.

A community-based intervention for improving health-seeking behavior among sexual violence survivors: a controlled before and after design study in rural Tanzania.

Background: Despite global recognition that sexual violence is a violation of human rights, evidence still shows it is a pervasive problem across all societies. Promising community intervention studies in the low- and middle-income countries are limited.

Objective: This study assessed the impact of a community-based intervention, focusing on improving the community's knowledge and reducing social acceptability of violence against women norms with the goal to prevent and respond to sexual violence.

Knowledge and attitude towards rape and child sexual abuse--a community-based cross-sectional study in rural Tanzania.

Background: Violence against women and children is globally recognized as a social and human rights concern. In Tanzania, sexual violence towards women and children is a public health problem. The aim of this study was to determine community knowledge of and attitudes towards rape and child sexual abuse, and assess associations between knowledge and attitudes and socio-demographic characteristics.

Community perceptions of rape and child sexual abuse: a qualitative study in rural Tanzania.

Background: Rape of women and children is recognized as a health and human rights issue in Tanzania and internationally. Exploration of the prevailing perceptions in rural areas is needed in order to expand the understanding of sexual violence in the diversity of Tanzania's contexts. The aim of this study therefore was to explore and understand perceptions of rape of women and children at the community level in a rural district in Tanzania with the added objective of exploring those perceptions that may contribute to perpetuating and/or hindering the disclosure of rape incidences.

Maternal near-miss and death and their association with caesarean section complications: a cross-sectional study at a university hospital and a regional hospital in Tanzania.

Background: The maternal near-miss (MNM) concept has been developed to assess life-threatening conditions during pregnancy, childhood, and puerperium. In recent years, caesarean section (CS) rates have increased rapidly in many low- and middle-income countries, a trend which might have serious effects on maternal health. Our aim was to describe the occurrence and panorama of maternal near-miss and death in two low-resource settings, and explore their association with CS complications.