A Dissertation submitted to the School of Public Administration and Management
in Partial Fulfillment of the Requirements for Awards of Master’s Degree of
Health in Monitoring and Evaluation of Mzumbe University.
Background: Emergency obstetric care is one of the strategies for reducing the maternal
mortality as pregnancy related complications are unpredictable. However, maternal
death due problems related to unimproved comprehensive obstetric has been
documented.
Objectives: The aim of this evaluation was to assess the implementation process more
specifically on the community awareness with regards to emergency obstetric and
neonatal care (EmONC).The goal of the project has been to improve maternal and child
health age in a population by ensuring provision of quality health services by utilization
of EmONC services by the community of Uvinza District Council.
Methods: The study was conducted in four villages of Uvinza district in Kigoma region.
A cross sectional descriptive study was conducted involving 120 respondents. Semistructured
questionnaire was used to capture information related to implementation
process of World Lung Foundation. The focus was collected information on several
issues such as assessing the level of community awareness in accessing EmONC
services, identifying the roles of traditional birth attendants and challenges encounter by
health care workers in facilities providing EmONC services. Evaluator randomly
selected the participants to be included in the study.
Results: The evaluation revealed institutional deliveries increased by 87.5% at
CEmONC health centers, and 70% deliveries by caesarean section, the highest ever
recorded. The level of community awareness in accessing EmONC services was high
among the evaluation participants. Majority (87.5%) of the health care workers had
received training supported by World lung foundation. The findings also revealed that
traditional birth attendants have been undertaking early referrals of pregnant women to
health facilities providing EmONC.
Conclusion: The issue of 3 Ds (Delay in decisions making when to seek care, Decision
of earlier referral and Decision on what time to start treatment) all these cut across as
limitations to achieve millennium development goal number 5. Findings revealed that
the maternal mortality rate (MMR) in all facilities decreased by 44% between January
2011 and June 2013(WLF report, 2013). Furthermore, there was a 70% increase in
institutional deliveries in Project-supported facilities compared to a 30% decrease in
non-Project-supported facilities; there were increased awareness of community in
accessing care to health facilities providing EmONC services.