Health Policy Project

The Health Policy Project has ended, but work continues under a new USAID five-year project, Health Policy Plus (HP+).


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Fighting for the Right to Safe Motherhood

Rose Mlay leads push for improved working conditions for midwives, better health for mothers and children in Tanzania

September 9, 2011 

 Image of Rose Mlay
Rose Mlay, a lifelong advocate for safe motherhood.
Photo by Rankin, 2007

Rose Mlay has been a dedicated advocate for maternal and child health ever since she decided to become a midwife in 1974. Seventeen years later, Rose began to teach maternal and child health courses at a national university and went on to establish the White Ribbon Alliance in Tanzania, where she works as the national coordinator.

While she has been involved in various professional medical and healthcare roles throughout her life, a common thread in her work is to ensure safe motherhood for all women in Tanzania. She believes this is something they deserve, saying “it is the right of every woman to receive care by a qualified healthcare provider who can save the life of the mother and the life of the baby.”

In Tanzania, health clinics are often overcrowded, understaffed, and not equipped with enough supplies to provide proper services to their patients. Many times, pregnant women arrive at the clinic only to be told that they must purchase their own delivery kits from a pharmacy or store before they can be admitted. Government leaders have pledged free healthcare services for all pregnant women and children under the age of five, but are not fully aware of the service gap caused by limited supplies and insufficient numbers of trained birth attendants.

“Midwives are the frontline caretakers 24 hours a day,” says Rose. “If they have no supplies, it creates a big problem. If a pregnant woman is asked to purchase something because it is not available in the health facility, they don’t understand and become angry. This destroys the midwives’ image in the country.”

With support from USAID through the Health Policy Project, Rose and the White Ribbon Alliance have inspired Parliamentarians to form the Parliamentary Group for Safe Motherhood (PGSM). As part of its advocacy strategy, the White Ribbon Alliance organized a meeting between the PGSM and a group of midwives in August 2011. During the discussion, midwives made their case to Parliamentarians by illustrating how difficult working conditions, counterproductive messages, and a lack of resources harm their image and act as a barrier to safe motherhood.

As a result, government leaders began to actively raise the issue of promoting an enabling environment for safe delivery conditions for midwives and their patients during the first Parliament session following the advocacy meeting. The initial progress has led to a joint effort among the White Ribbon Alliance, women lawyers, and members of Parliament to begin drafting a Safe Motherhood Bill, which will aim to further enforce current government health policies and ultimately increase midwifery workforce numbers and medical supplies in Tanzanian delivery rooms.

Challenges remain, but Rose continues to champion the cause on behalf of all women and children and the midwives who serve them, and has now gained support from government leaders in her campaign to improve the quality of maternal and child healthcare in Tanzania.

“Life is a human right that nobody should deny,” says Rose. “When women are denied this right, it is unfair.” 

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The Health Policy Project is a five-year cooperative agreement funded by the U.S. Agency for International Development under Agreement No. AID-OAA-A-10-00067, beginning September 30, 2010. The project's HIV-related activities are supported by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR). It is implemented by Futures Group, in collaboration with Plan International USA, Avenir Health (previously Futures Institute), Partners in Population and Development, Africa Regional Office (PPD ARO), Population Reference Bureau (PRB), RTI International, and White Ribbon Alliance for Safe Motherhood (WRA). The information provided on this Web site is not official U.S. Government information and does not represent the views or positions of the U.S. Agency for International Development or the U.S. Government.

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