Tanzania: Innovative and Scalable Approach to Birth Care Saves More than 1,000 Newborn and Mothers’ Lives – New Study

• Scaling this bundle of care could have transformative impact on countries with highest burden of newborn and maternal death around the world
• The magnitude of women’s lives saved was an unexpected outcome of the study as the primary focus under investigation was perinatal death

A new study published today in the New England Journal of Medicine reveals that an innovative health program in Tanzania focused on regular on-the-job training of healthcare workers cut maternal deaths by 75% and early newborn deaths  [i] by 40%.

The report, the result of a three-year study across five regions, assessed approximately 300,000 mother-baby pairs across 30 high-burden healthcare facilities implementing the Safer Births Bundle of Care (SBBC) program. The program provides on-site and frequent simulation training for health workers, alongside innovative clinical tools to better monitor heartrates and perform resuscitation. These efforts are further enhanced with data use for continuous improvement.

Tanzania Minister of Health Jenista Mhagama: “A step change is required to turn the tide on the high burden of maternal and newborn deaths globally – including political leadership – and I am grateful to President Samia Suluhu Hassan’s commitment to prioritizing maternal and child health. This study shows how by working together through innovative partnerships to leverage cost-effective solutions, we can strengthen health systems, improve birth outcomes and save lives. As we now scale these efforts across Tanzania, we have the opportunity to have transformative impact on lives, livelihoods and future prosperity of countries.” 

With Tanzania’s nationwide expansion plans in 2025, the success of the SBBC program has also drawn interest from other countries, including Nigeria and Ethiopia, as they look for cost-effective, scalable solutions to reduce birth-related deaths.

The period around late pregnancy and birth is a particularly vulnerable time for women and newborns. The newborn period accounts for almost half of deaths of children under the age of five, and most of those preventable deaths occur in low- and lower-middle-income countries – where almost 95% of all maternal deaths also occur [ii] .

Most stillbirths, newborn and maternal deaths are preventable if quality care is provided. In 2020, an estimated 4.5 million combined deaths (stillbirths, newborn and maternal) occurred globally; 300,000 maternal deaths, 2.3 million newborn deaths, [iii]  and 1.9 million stillbirths. [iv]    Ten countries, including Tanzania, account for 60% of this burden. [v]

Ghai Abuya, Midwife in the Tabora Regional Hospital:  “After taking part in this program, we have the knowledge, skills and confidence to act quickly and save lives. I have personally seen mothers and babies survive situations that would have been fatal before, thanks to the training and teamwork we’ve developed.”

A Model for Sustainable Change

The Safer Births Bundle of Care program is the result of over a decade of research and collaboration between global and local, public and private partners, including Haydom Lutheran Hospital in rural Tanzania, where it was first launched in partnership with the Tanzanian government.

In 2019, the Global Financing Facility for Women, Children and Adolescents (GFF) partnered with Norad – the Norwegian Agency for Development Cooperation, UNICEF and Laerdal for an Innovation-to-Scale initiative to scale-up and test promising innovations with high impact potential. Out of 320 proposals, Safer Births Bundle of Care was rated to have the highest impact potential.

Laerdal Global Health collaborated to develop innovative clinical tools and training simulators, all designed to support healthcare workers to manage the leading causes of newborn and maternal mortality. The GFF – a trust fund housed at the World Bank – helped de-risk the innovation through grant financing that funded the first scaling of SBBC to 30 hospitals as well as funding the research.

As a result of the positive findings, these efforts are being further scaled to over 150 hospitals through a private-public partnership with Haydom.

Åsmund Aukrust, Minister of International Development, Norway: “Every mother deserves a safe delivery, and every newborn deserves a chance at life. Norway is proud to support Tanzania’s leadership through our partnership with the Global Financing Facility, as it aligns with our commitment to strengthening health systems and reducing preventable deaths. The results from Tanzania show that with the right investments, innovations and partnerships, including with the private sector, we can create real change and ensure healthier futures.”

Dr. Paschal Mdoe, Executive Director, Haydom Lutheran Hospital: “The Safer Births Bundle of Care program is transforming how we approach maternal and newborn health in Tanzania – and could transform health outcomes globally. This impact would not be possible without the support of our partners and funders, whose investment is not just saving lives today but is also building a stronger, more resilient healthcare system for the future.”

Hege Ersdal, Professor in Global Health and Simulation and lead co-author of the study: “With the Safer Births Bundle of Care, we have proven that it is possible to implement combined training and quality improvement efforts that lead to dramatic and sustained reductions in newborn and maternal deaths. I believe this marks a game-changing moment for women and newborns everywhere.”