"If really we are committed things can change, starting from us": Healthcare providers' perceptions of postpartum care and its potential for improvement in low-income suburbs in Dar es Salaam, Tanzania.
OBJECTIVE
To explore healthcare providers' perceptions of the current postpartum care (PPC) practice and its potential for improvement at governmental health institutions in low-resource suburbs in Dar es Salaam, Tanzania.


METHODS
Qualitative design, using focus group discussions (8) and qualitative content analysis.


METHODS
Healthcare institutions (8) at three levels of governmental healthcare in Ilala and Temeke suburbs, Dar es Salaam.


METHODS
Registered, enrolled and trained nurse-midwives (42); and medical and clinical officers (13).


RESULTS
The healthcare providers perceived that PPC was suboptimal and that they could have prevented maternal deaths. PPC was fragmented at understaffed institutions, lacked guidelines and was organized in a top-down structure of leadership. The participants called for improvement of: organization of space, time, resources, communication and referral system; providers' knowledge; and supervision and feedback. Their motivation to enhance PPC quality was high.


CONCLUSIONS
The HCP awareness of the suboptimal quality of PPC, its potential for promoting health and their willingness to engage in improving care are promising for the implementation of interventions to improve quality of care. Provision of guidelines, sensitization of providers to innovate and maximize utilization of existing resources, and supportive supervision and feedback are likely to contribute to the sustainability of any improvement.
School of Nursing and Midwifery/TIHE, Aga Khan University, P.O. Box 38129, Ufukoni Road, Dar es Salaam, Tanzania; International Maternal and Child Health/IMCH, Department of Women's and Children's Health, Uppsala University, Akademiska Sjukhuset, SE 751 85 Uppsala, Sweden. Electronic address: eunice.pallangyo@kbh.uu.se.
Eunice N
EN
Pallangyo
School of Nursing, Department of Community Health, Muhimbili University of Health and Allied Sciences/MUHAS, Dar es Salaam, Tanzania.
Columba
C
Mbekenga
International Maternal and Child Health/IMCH, Department of Women's and Children's Health, Uppsala University, Akademiska Sjukhuset, SE 751 85 Uppsala, Sweden.
Carina
C
Källestål
International Maternal and Child Health/IMCH, Department of Women's and Children's Health, Uppsala University, Akademiska Sjukhuset, SE 751 85 Uppsala, Sweden.
Christine
C
Rubertsson
International Maternal and Child Health/IMCH, Department of Women's and Children's Health, Uppsala University, Akademiska Sjukhuset, SE 751 85 Uppsala, Sweden.
Pia
P
Olsson
D000328:Adult; D001291:Attitude of Health Personnel; D002947:Cities; D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D017144:Focus Groups; D006268:Health Facilities; D006282:Health Personnel; D006801:Humans; D007182:Income; D063130:Maternal Death; D008875:Middle Aged; D009721:Nurse Midwives; D011181:Postnatal Care / Q000592:standards*; D011203:Poverty; D011247:Pregnancy; D036301:Qualitative Research; D058996:Quality Improvement; D011787:Quality of Health Care; D013383:Suburban Population; D013636:Tanzania
Focus group; HCP; Postpartum care; Quality of care; Tanzania