Medical Teams International’s multi-faceted approach in refugee camps offers lessons for other countries.
First published May 6, 2024 by Medical Teams International.
Medical Teams International is thrilled to announce that it has achieved its fourth year straight of zero maternal deaths among the population within the refugee camps it serves in Tanzania. This success is the result of excellent coordination, collaboration, ongoing training, and focused determination within Medical Teams, alongside the Ministry of Health, U.N. agencies, community partners, and dedicated community health workers.
Tanzania has been home to forcibly displaced refugees in the Great Lakes Region since the early 1960s. Years of cyclical conflict and instability in the Democratic Republic of Congo and Burundi have caused hundreds of thousands of people to flee to Tanzania. The majority of refugees in Tanzania live in the country’s two refugee camps – Nyarugusu and Nduta, located in the Kigoma region near the Burundi border. At the end of 2023, Nyarugusu was hosting 136,346 refugees and Nduta was hosting 63,959 refugees.
Since 2020, Medical Teams has been working with UN agencies, national governments, and other health partners to provide access to health services and reproductive and child health, including maternal health services, medical referrals, and community health services. The following elements of the program have contributed to its success:
Antenatal & post-natal clinics
Medical Teams serves pregnant women in the camps during their pregnancy, childbirth, and postpartum period. We provide antenatal care (ANC) which prevents, treats, and controls health risks for mothers though periodic monitoring of pregnancies, disease screening, and vaccinations.
Through awareness programs, pregnant women at term have been encouraged to deliver at our health facilities, where skilled health workers are available to support hygienic and safe deliveries. As part of the ongoing effort to prevent malaria among pregnant women and newborns, Medical Teams provides health promotion messages, treated mosquito nets, and malaria prophylaxis to pregnant women at their ANC visits.
Family planning
The World Health Organization recommends that women space pregnancies at least 24 months before the next pregnancy to reduce infant and child mortality and to benefit maternal health. Medical Teams provides reproductive health education sessions in the camp that include information on the available methods of family planning in the health facilities. Women of reproductive age hear about at least three methods of family planning.
Deliveries by skilled health workers
Risks associated with complications may occur anytime in pregnancy that can lead to maternal deaths. Qualified nurses, midwives, and medical doctors work to address these risks. Health workers screen for pregnancies with potential risks during antenatal clinic visits and organize immediate medical referrals for all identified pregnancies with risks to the District or Regional Referral Hospitals, Zonal Hospital, or other local health partners.
Community health workers
Community health workers (CHWs) conduct house visits, reminding and encouraging mothers to attend antenatal and postnatal care appointments and plan to deliver at health facilities. They serve as an integral support network and source of guidance for mothers. The CHWs assist in calling for an ambulance if the mother experiences premature labor pains or an emergency and cannot make it in time to the facility.
Pregnant mothers receive “mama kits” with essential infant care supplies when they deliver at the facilities, contributing to raising the number of facility deliveries assisted by skilled health workers. The CHWs receive monthly incentives for the work they perform in the camps and speak about family planning during the house visits.
Capacity building: mentorship and training of health workers
Since 2020, numerous technical trainings and field exchanges to government facilities have been provided to health workers, community health workers, and other incentive workers. Trainings are also given on adolescent sexual and reproductive health, focusing on the physical and emotional wellbeing of adolescents and helping them to avoid unwanted pregnancy, sexual transmitted infections (including HIV/AIDS), and all forms of sexual violence and coercion.
CHWs and adolescents are also trained to prevent sexual gender-based violence in the camps and to use reporting mechanisms. To assure uniform, high quality maternal and newborn health service provision in the camps, health workers receive training materials, approved by the Ministry of Health, on Basic and Comprehensive Emergency Obstetric and Newborn Care.
Meetings on reproductive and child health
Monthly meetings convened by the District Medical Officer occur to review progress and plans. Public Health Officers from the camp commandant office and health stakeholders in reproductive and child health discuss labor and maternity performance, among other topics. Key stakeholders, such as UN agencies, health partners, Ministry of Home Affairs representatives, health providers, and community members contribute to decisions.
Regional/Council Health Management Teams
On a quarterly basis the program offers onsite supportive supervision and mentorship by experienced specialists from Maweni Regional or District Hospitals. This includes participation by experienced obstetricians that have been providing continuing medical education.
About Medical Teams International
Founded in 1979, Medical Teams International provides life-saving medical care for people in crisis, such as survivors of natural disasters and refugees. We care for the whole person— physical, emotional, social and spiritual. Daring to love like Jesus, we serve all people—regardless of religion, nationality, sex or race. Learn more at medicalteams.org and on social media using @medicalteams.