Date of Award

3-2023

Document Type

Dissertation

Degree Name

Master of Medicine (MMed)

First Supervisor/Advisor

Muzdalifat Abeid

Second Supervisor/Advisor

Columba Mbekenga

Third Supervisor/Advisor

Neelam Ismail

Department

Family Medicine (East Africa)

Abstract

Background

There are drastic changes in patient care with respect to maternity due to the COVID-19 pandemic with negative impact to health care workers. With Interruption of everyday basic services, arose the need to redistribute the scanty health care workers across health care facilities in sub-Saharan Africa. Its effects and involvement on maternity practice in Sub-Saharan Africa are nevertheless to be analyzed. This study aims to explore the likely ramifications for obstetrics and gynecologic practice in Tanzania. At present there are limited studies looking at impacts of COVID-19 in sub-Saharan Africa and Tanzania. No study has been carried out to explore the effects of health care provision in maternity care by looking at experiences of health workers during the COVID-19 pandemic at different hospitals and health care centre’s in Tanzania.

Objectives

To study the health care workers’ experiences of providing maternal care during the COVID-19 pandemic at 5 hospitals in Dar es salaam, Tanzania.

Methods

This was a qualitative descriptive study design using Focus Group Discussions among health care workers. This study is a sub study of the PartoMa project, a step-wedged cluster randomized trial with embedded qualitative and economic analyses that is being undertaken in low resource maternity units in Tanzania (The PartoMa scale up study). Data was collected during co-creation workshops and involved five large maternity v units in Dar es Salaam namely: Amana Hospital, Temeke Hospital, Mwanyamala Hospital, Sinza Health Centre, and Mbagala Rangi Tatu Health Centre all located in Dar es Salaam Tanzania.

Results

Four FGD’S were conducted that involved 43 maternity HCWs who provided care across the different waves of COVID 19. They were of diverse age, cadres and level of experience. HCWs developed courage due to increased experience in managing COVID-19, but experienced burnout due to increased workload, staff shortages, and fear, leading to poor patient care and stigma. HCWs need psychotherapy to combat stress, depression and anxiety, increase budget allocated for health care, and motivate frontliners to fight the pandemic.

Conclusion

Study findings provide insights that point out on the importance of for preparedness, standard protocols, resources to support and protect health care workers during the pandemic. This is necessary to consider in the event of another pandemic to improve health care delivery and utilization in maternity units.

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