Year of Publication



Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Dr. Corrine Williams

Committee Member

Dr. Kathryn Cardarelli

Committee Member

Dr. Mark Swanson


Maternal mortality is one of the greatest health disparities facing the world today. A disproportionate number of women who die from pregnancy-related complications live in developing countries: the average maternal mortality in developed nations is 12/100,000, compared to 239/100,000 in developing nations; this rate is even higher in several sub-Saharan African nations. Reasons for this disparity include a lack of providers, inaccessibility to care, and poor quality of treatment in developing nations. Women living in the sub-Saharan country of Tanzania face many of these barriers, and as a result the country’s maternal mortality rate is 398/100,000. Antenatal care is an important method to improve birth outcomes and decrease maternal mortality. The Lady Health Worker Programme (LHWP) is a community-based intervention aimed at improving access to antenatal care in predominantly rural environments. The program trains local women to be community health care workers who are capable of providing preventative primary care in their communities. These women also help foster communication between the community and healthcare professionals. The LHWP will be implemented in three healthcare facilities in Ngara District, Tanzania. Thirty trained Lady Health Workers (LHWs) will be responsible for providing care to a total of 4500 households with reproductive-age women. Based on current data, the LHWP in Ngara anticipates reaching roughly 450 pregnant women per year. The program targets improved access to and early initiation of antenatal care, as well as recognition and referrals of pregnancy complications associated with maternal morbidity and mortality. LHWs will treat women in the district, recording their interactions in logbooks and submitting the data for analysis every six months to determine trends of the performance measures. These analyses, together with a comparison of outcomes before and after implementation, will determine the effectiveness of the LHWP. If successful, utilization of antenatal will improve in pregnant women of Ngara district, which will eventually decrease maternal mortality in the area.

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