title: Introducing eHealth strategies to enhance maternal and perinatal health care in rural Tanzania.
abstract: BACKGROUND
  Globally, eHealth has attracted considerable attention as a means of supporting maternal and perinatal health care. This article describes best practices, gains and challenges of implementing eHealth for maternal and perinatal health care in extremely remote and rural Tanzania.
  
  
  METHODS
  Teleconsultation for obstetric emergency care, audio teleconferences and online eLearning systems were installed in ten upgraded rural health centres, four rural district hospitals and one regional hospital in Tanzania. Uptake of teleconsultation and teleconference platforms were evaluated retrospectively. A cross sectional descriptive study design was applied to assess performance and adoption of eLearning.
  
  
  RESULTS
  In 2015 a total of 38 teleconsultations were attended by consultant obstetricians and 33 teleconferences were conducted and attended by 40 health care providers from 14 facilities. A total of 240 clinical cases mainly caesarean sections (CS), maternal and perinatal morbidities and mortalities were discussed and recommendations for improvement were provided. Four modules were hosted and 43 care providers were registered on the eLearning system. For a period of 18-21 months total views on the site, weekly conference forum, chatroom and learning resources ranged between 106 and 1,438. Completion of learning modules, acknowledgment of having acquired and utilized new knowledge and skills in clinical practice were reported in 43-89% of 20 interviewed health care providers. Competencies in using the eLearning system were demonstrated in 62% of the targeted users.
  
  
  CONCLUSIONS
  E-Health presents an opportunity for improving maternal health care in underserved remote areas in low-resource settings by broadening knowledge and skills, and by connecting frontline care providers with consultants for emergency teleconsultations.
authors.affiliation: Thamini Uhai Program, Dar es Salaam, Tanzania.|Tanzanian Training Centre for International Health, Ifakara, Tanzania.|Saint Francis University College for Health and Allied Sciences, Ifakara, Tanzania.
authors.forename: Angelo
authors.identifier: 0000-0002-1987-8134
authors.initials: A
authors.lastname: Nyamtema
authors.affiliation: Thamini Uhai Program, Dar es Salaam, Tanzania.
authors.forename: Nguke
authors.initials: N
authors.lastname: Mwakatundu
authors.affiliation: Thamini Uhai Program, Dar es Salaam, Tanzania.
authors.forename: Sunday
authors.initials: S
authors.lastname: Dominico
authors.affiliation: Thamini Uhai Program, Dar es Salaam, Tanzania.
authors.forename: Mkambu
authors.initials: M
authors.lastname: Kasanga
authors.affiliation: Thamini Uhai Program, Dar es Salaam, Tanzania.
authors.forename: Fadhili
authors.initials: F
authors.lastname: Jamadini
authors.affiliation: Thamini Uhai Program, Dar es Salaam, Tanzania.
authors.forename: Kelvin
authors.initials: K
authors.lastname: Maokola
authors.affiliation: Thamini Uhai Program, Dar es Salaam, Tanzania.
authors.forename: Donald
authors.initials: D
authors.lastname: Mawala
authors.affiliation: Tanzanian Training Centre for International Health, Ifakara, Tanzania.
authors.forename: Zabron
authors.initials: Z
authors.lastname: Abel
authors.affiliation: Thamini Uhai Program, Dar es Salaam, Tanzania.|Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
authors.forename: Richard
authors.initials: R
authors.lastname: Rumanyika
authors.affiliation: Thamini Uhai Program, Dar es Salaam, Tanzania.|Maweni Regional Hospital, Kigoma, Tanzania.
authors.forename: Calist
authors.initials: C
authors.lastname: Nzabuhakwa
authors.affiliation: Thamini Uhai Program, Dar es Salaam, Tanzania.|Leiden University Medical Centre, Leiden, The Netherlands.|Athena Institute, VU University Amsterdam, Amsterdam, The Netherlands.
authors.forename: Jos
authors.initials: J
authors.lastname: van Roosmalen
keywords: EHealth; Maternal health; Rural settings; Tanzania; Teleconference; Teleconsultation; eLearning