Too busy to care? Analysing the impact of system-related factors on maternal mortality in Zanzibar's Referral Hospital.

This study analyses the contribution of system-related factors to maternal mortality in the low-resource setting of Mnazi Mmoja Hospital in Zanzibar, Tanzania. It is a retrospective cohort study including all maternal deaths (MD,  = 139) and maternal near-misses (MNM,  = 122) in Mnazi Mmoja Hospital with sufficient documentation during 2015 to 2018 (MD) and 2017 to 2018 (MNM). The number of admissions and surgical interventions per health care provider on the day of admission and the number of times vital signs were monitored per day were compared between MNM and MD cases using logistic regression.

Journey to facility birth in Zanzibar: a questionnaire-based cohort study of patients' perspectives on preparedness, access and quality of care.

Introduction: Tackling substandard maternity care in health facilities requires engaging women's perspectives in strategies to improve outcomes. This study aims to provide insights in the perspectives of women with severe maternal morbidity on preparedness, access and quality of care in Zanzibar's referral hospital.

Methods: In a prospective cohort from April 2017 to December 2018, we performed semistructured interviews with women who experienced maternal near-miss complications and matched controls.

"I lost my happiness, I felt half dead and half alive" - a qualitative study of the long-term aftermath of obstetric near-miss in the urban district of Zanzibar, Tanzania.

Background: This study aims to explore the stories of three women from Zanzibar, Tanzania, who survived life-threatening obstetric complications. Their narratives will increase understanding of the individual and community-level burden masked behind the statistics of maternal morbidity and mortality in Tanzania. In line with a recent systematic review of women-centred, qualitative maternal morbidity research, this study will contribute to guidance of local and global maternal health agendas.