Tanzania has made important progress in maternal health, yet preventable deaths remain a challenge, especially in rural areas. The maternal mortality ratio declined from about 980 deaths per 100,000 live births in 2000 to 276 in 2023. At the same time, the number of skilled birth attendants has risen sharply in recent years, with national surveys indicating that skilled health providers attended approximately 85% of live births in 2022. These gains show what is possible when facility delivery, trained staff, and essential supplies reach more mothers.

Distance to facilities, shortages of midwives and nurses and inconsistent supplies continue to limit quality care for many women. National strategies highlight the need to strengthen the workforce and ensure integrated services from antenatal through postnatal care. Assessments indicate that Tanzania has not yet achieved the health worker density necessary to meet population needs, which impacts the availability and quality of care in remote districts.

World Bank Support

Through a results-based approach, the World Bank has supported primary health care programs in Tanzania with a strong focus on maternal, newborn and child health. A 2022 financing package under the Tanzania Maternal and Child Health Investment Program is helping improve the quality of essential services and scale up delivery, while 2023 documents outline support for expanding the Safer Births Bundle of Care (SBBC) from antenatal to postnatal services. These efforts aim to improve performance at the facility and local government levels and to strengthen supervision and data use.

Integrating Care Where Women Live

USAID’s Boresha Afya program supported the Government of Tanzania to provide integrated reproductive, maternal, newborn and child health services together with family planning, malaria, TB, HIV and nutrition. A midterm evaluation describes implementation across three zones and documents support to more than 1,800 health facilities in the Lake and Western zones, along with community outreach and system strengthening. Implementing partners include Deloitte, Jhpiego, EGPAF, and others working with regional and district teams to improve the quality and continuity of care.

More Facilities, Better Data, Safer Births

National health information shows rising institutional deliveries and better reporting from facilities, which supports targeted supervision and supply chains. Reported institutional deliveries increased substantially from 2016 to 2020, and by 2022, more facilities were consistently reporting on key maternal and newborn indicators. Expanding midwife training and respectful maternity care, together with improved logistics, is critical to sustaining these gains.

The Future

Investing in skilled birth attendance, timely referrals and postnatal care saves lives. Evidence links higher rates of facility delivery and skilled attendance to lower maternal and newborn mortality, and Tanzania’s recent progress reflects this pattern. Continued investment in primary care, workforce capacity, and integrated services can accelerate the decline in maternal deaths and close rural gaps.

World Bank and USAID-supported programs, in conjunction with national strategies such as One Plan III, are expanding access to quality prenatal and delivery care. Strengthening rural facilities, staffing them with trained midwives, and ensuring respectful, integrated services can transform outcomes for mothers and newborns in underserved regions. Indeed, with steady financing and local ownership, Tanzania can continue to reduce maternal deaths and deliver healthier starts for families.

– Joseph Hasty

Joseph is based in Winter Park, FL, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr