Midwife-Led Mobile Antenatal Clinic: An Innovative Approach to Improve Utilization of Services in Pwani, Tanzania

Abstract

Participating in antenatal clinics is a major determinant in reducing poor maternal and neonatal birth outcomes. We aimed to evaluate the utilization of antenatal clinic (ANC) services provided by a mobile clinic led by skilled midwives and determine the acceptability in the Pwani region, Tanzania. For a year, the mobile clinic, nicknamed "Mkunga Kitaani" and equipped with necessary tools and staff, served seven villages in the Kisarawe district that lacked health facilities. The research was conducted using a descriptive study design, incorporating both qualitative and quantitative methods. Qualitative and quantitative data were collected through 12 interviews and 214 medical records among pregnant women, respectively. The results show that approximately 17% of the women initiated ANC early, while 36% made their visit during their third trimester. Participants generally preferred the mobile clinic over traditional facilities due to its provision of comprehensive care. However, challenges such as clinic unreliability during the rainy season and limited availability of tests, including obstetric ultrasounds, were noted. Despite hurdles, the study highlighted increased ANC access and community engagement, suggesting potential for expansion to other underserved rural areas. The findings underscore the importance of innovative approaches to ANC delivery in regions with limited healthcare infrastructure.

Keywords: Sub-Saharan Africa; antenatal care; midwifery-led; mobile clinic; utilization.

Figure 1

Number of ANC visits among pregnant women for each ANC contact.

Figure 2

Number of women detected with obstetric danger signs.