Objective: To evaluate the impact of an educational intervention to introduce the principles of evidence based obstetric care and encourage mobility during labour in government hospitals in Dar es Salaam.
Design: An observational study.
Setting: Four government hospitals; two in Dar es Salaam and two in coastal region of Tanzania.
Results: Following implementation of the workshops, practice changed significantly for mobility during labour at the district and regional hospitals; midwives at these hospitals appeared to be aware of the benefits and were willing to encourage women to be mobile during labour. Practice changed little at the referral hospital. Most women delivering at the referral hospital had been transferred from regional or district hospitals with complications.
Conclusion: This small study demonstrates the potential of using educational workshops to change childbirth practice at the district and regional level in Tanzania. Institutionalisation of practice changes involves influencing policy-makers, engaging opinion leaders to disseminate evidence and advocacy for change among their peers, as well as developing mechanisms to overcome barriers to practice change at the hospital level. Results from this study will feed in to a project to develop evidence-based guidelines for childbirth care, involving policy makers, practitioners and hospital managers.