title: Staff experiences of providing maternity services in rural southern Tanzania - a focus on equipment, drug and supply issues.
abstract: BACKGROUND
  The poor maintenance of equipment and inadequate supplies of drugs and other items contribute to the low quality of maternity services often found in rural settings in low- and middle-income countries, and raise the risk of adverse patient outcomes through delaying care provision. We aim to describe staff experiences of providing maternal and neonatal care in rural health facilities in Southern Tanzania, focusing on issues related to equipment, drugs and supplies.
  
  
  METHODS
  Focus group discussions and in-depth interviews were conducted with different staff cadres from all facility levels in order to explore experiences and views of providing maternity care in the context of poorly maintained equipment, and insufficient drugs and other supplies. A facility survey quantified the availability of relevant items.
  
  
  RESULTS
  The facility survey, which found many missing or broken items and frequent stock outs, corroborated staff reports of providing care in the context of missing or broken care items. Staff reported increased workloads, reduced morale, difficulties in providing optimal maternity care, and carrying out procedures with potential health risks to themselves as a result.
  
  
  CONCLUSIONS
  Inadequately stocked and equipped facilities compromise the health system's ability to reduce maternal and neonatal mortality and morbidity by affecting staff personally and professionally, which hinders the provision of timely and appropriate interventions. Improving stock control and maintaining equipment could benefit mothers and babies, not only through removing restrictions to the availability of care, but also through improving staff working conditions.
authors: Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. Suzanne.Penfold@lshtm.ac.uk
authors: Suzanne
authors: S
authors: Penfold
authors: Donat
authors: D
authors: Shamba
authors: Claudia
authors: C
authors: Hanson
authors: Jennie
authors: J
authors: Jaribu
authors: Fatuma
authors: F
authors: Manzi
authors: Tanya
authors: T
authors: Marchant
authors: Marcel
authors: M
authors: Tanner
authors: Kate
authors: K
authors: Ramsey
authors: David
authors: D
authors: Schellenberg
authors: Joanna Armstrong
authors: JA
authors: Schellenberg
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D004864:Equipment and Supplies / Q000600:supply & distribution*; D005260:Female; D017144:Focus Groups; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008283:Maintenance; D008297:Male; D008427:Maternal Health Services / Q000458:organization & administration*; D008875:Middle Aged; D004364:Pharmaceutical Preparations / Q000600:supply & distribution*; D036301:Qualitative Research; D019035:Rural Health Services; D013636:Tanzania; D055815:Young Adult
chemical_list: D004364:Pharmaceutical Preparations