True costs of poor maternal health care: Maternal deaths and their impacts on living children in Tanzania

Background: Maternal mortality is an alarming outcome and MMRs do not begin to capture the full extent of suffering caused by the loss of a woman's contribution at the familial and community levels. Maternal mortality is far from an inevitable tragedy. Methods: Using a mixed methods approach, qualitatively assess a range of outcomes affecting child well-being and quantify, using DSS data, the extent of any disproportionate morbidity and mortality for children who have lost their mother. Results (Preliminary results from Rufiji District, Tanzania): After maternal death, there is often family dissolution, with siblings dispersed to different homes (63%); Fathers often do not retain responsibility for the care of their children (63%); Less than half of fathers (45%) send financial support to guardians; 63% of guardians felt that they did not have a choice in having to care for orphans; 27% of families noted significant decreases in household income; Nutritional shortages; school drop-outs; early marriage and pregnancy of girl children; 72% families/guardians received no support from the community, government, NGO's, or extended family. Conclusions: Maternal mortality has greater far-reaching, negative intergenerational effects on families and communities than has previously been captured and described. As a result of recognizing the full cost of inaction with respect to maternal mortality, mobilization of efforts is required in both national contexts and international level to accelerate efforts to meet maternal health targets and support children and families where the mother has died, including crucial intra-partum interventions, family planning, and broader social initiatives.