A postnatal care solution for reducing neonatal mortality in Tanzania

Worldwide, an estimated 2.3 million newborns do not survive their first month each year, and Sub-Saharan Africa has the highest neonatal mortality rate at 27 per 1,000 live births (WHO, 2024). In Tanzania, neonatal mortality rates have ranged between 26 and 40 per 1,000 live births over the past three decades with significant disparities across regions (Mangu, Chacha D et al., 2021).

Although the World Health Organization (WHO) recommends four postnatal checkups within six weeks after birth (WHO, 2013), only 31% of women and 13% of newborns in Tanzania receive the necessary postnatal care. Socioeconomic and geographic inequities further hinder access to these essential healthcare services (Sacks et al., 2022).

In Tanzania, initiatives like NEST360 and the Safer Birth Bundle of Care (SBBC) have improved hospital-based care through service enhancements and clinician training. However, one remaining challenge is ensuring that newborns continue to receive care after leaving the hospital. Most research focuses on immediate postnatal care, but barriers to care after the first 24 hours have yet to be fully addressed (Sacks et al., 2022).

To address these barriers, Touch Health is expanding its efforts through the launch of watotoCare. Building on their M-mama program, which provides emergency transportation for maternal and newborn care, watotoCare seeks to ensure that newborns continue to receive critical follow-up care after leaving the hospital. The same community drivers are enrolled to facilitate home-based follow-up visits for neonates.

With support from FID, Touch Health is launching the watotoCare pilot in the Sengerema district of Tanzania’s Mwanza region to enhance postnatal care continuity.

The watotoCare system introduces an innovative approach to postnatal care, targeting neonatal health within the critical first 28 days. It uses a risk-based categorization model with newborns classified as low, medium or high risk each receiving tailored healthcare interventions:

• For low-risk cases, watotoCare Educate provides mothers with essential health information and encourages regular checkups.

• Medium-risk newborns are supported through watotoCare Telehealth, a telemedicine service that facilitates WHO-recommended checkups at key intervals (24 hours, 2-3 days, 6-7 days, 6 weeks).

• High-risk neonates benefit from watotoCare Transports, a community-driven emergency transport service modeled on m-mama, ensuring transport services to healthcare facilities for more in-depth examinations.

To coordinate these interventions, the system uses a mobile application that supports patient management and newborn care monitoring, while being integrated with Sengerema’s digital systems for data handling and scheduling. This innovative system launched at Sengerema District Hospital in July 2024.

WatotoCare aims to improve neonatal health by ensuring timely follow-up of newborns, increasing post-discharge care coverage and enabling early identification of health risks. The project’s transport and teleconsultation services seek to improve access to care, while educating caregivers on postnatal care and danger signs strengthens monitoring of newborns and response to their needs. These efforts aim to enhance care continuity and promote healthier outcomes for newborns over time.

Photo: © Stefano Bianco / AFD