Village-level pregnancy registers: Improving pregnancy and post-partum data collection in rural Tanzania

This study presents the results of a pilot project to develop and implement a pregnancy register for completion by low-literacy traditional birth attendants (TBAs). The pilot is part of a USAID-funded Child Survival project implemented by Minnesota International Health Volunteers (MIHV) in rural Tanzania. Despite an international goal to ensure safe delivery though assistance by skilled birth attendants, the majority of women (approximately 70% in rural Tanzania) continue to deliver at home unassisted or with a TBA. The register supports the Ministry of Health and Social Welfare's goal to establish a reliable birth registration system including collection of data at the community level.

Developed in collaboration with district and national partners, the register includes simple pictures, Swahili descriptions, and yes/no boxes to record 11 antenatal, 10 birth, and 10 postnatal maternal/infant indicators, including mother's name, antenatal visits, location, date and place of birth, and post-partum visits (0-3, 7, 28 and 42 days).

Thirty-two TBAs were trained to record pregnancy and birth-related information for all births (n = 407) occurring in eight villages during a five-month period. A sub-sample of the records in four randomly selected villages was cross-checked for accuracy through maternal interviews.

The register has the potential to contribute to a reliable method of tracking pregnancy indicators from initial TBA contact through 42 days post-partum. An accurate database, including maternal and newborn morbidity/mortality at the village level, is essential for national planning efforts and will contribute to monitoring and evaluation of interventions and policies related to maternal/ newborn care.