Improve Maternal and Newborn Health

Augment medical supplies to test for anemia

Red blood cells contain hemoglobin (Hb), a protein that carries oxygen throughout the body. During pregnancy, a woman needs double the normal amount to transport enough oxygen to meet both her and her fetus’ needs.

As documented in a 2018 retrospective study hemoglobin levels during early pregnancy play a role in predicting the risk of gestational diabetes mellitus (GDM), pre-eclampsia (PE) and preterm birth. Both GDM and PE contribute significantly to maternal, fetal and neonatal morbidity and mortality. Preterm birth is a major determinant of neonatal death. Plus, children who are born prematurely have a higher risk of cerebral palsy, cardiovascular disease, pulmonary illnesses or psychological diseases, and these conditions can persist throughout life.

A 2021 study found anemia in pregnancy to be persistently high and prevalent among 57% of pregnant women in Tanzania. Today many dispensaries in Ayalagaya and Arri do not have an Hb meter or sufficient Hb test strips to test pregnant women or those looking to become pregnant. We expect that more women are anemic, but are not being diagnosed and treated for their anemia.

To address this shortfall, Karimu is purchasing Hb meters for clinics that don’t have them as well as Hb test strips to use with the meters. We are working with the government to improve the availability of Hb test strips in the future, but it will take time to ramp up the availability of the supplies from the government.

The goals of this project are to test all expectant mothers for anemia and for the government to provide the resources to do so. We will be tracking the number of kits used, those provided by the government, and those provided by Karimu. We expect it will take 2-3 years to reach a steady state where the government is providing all the resources and all expectant mothers are routinely tested.

Update Dec 2022: As expected, Karimu provided the vast majority of hemoglobin tests since this was a new testing capability for most clinics with the Hemoglobins meters provided. Overall, Karimu provided 42% of the tests for Ayalagaya ward clinics and 98% for Arri ward clinics. Thankfully we only detected 3 cases of low hemoglobin across both wards.

Update Dec 2023: With the opening of the Dareda Kati Health Center and the corresponding attention and focus from the government, the health center was well stocked with all HB test kits used provided by the government. However the dispensaries both in Ayalagaya and Arri lagged making some improvements from 2022. Viewed by ward in Ayalagaya (includes Dareda Kati Health Center and Gajal Dispensary) Karimu provided 13% of the total kits used while in Arri (across three dispensaries) Karimu provided 79% of the kits used. When looking across all dispensaries across both wards, Karimu provided 82% of the test kits, so continued attention is needed.

Update November 2025: In 2025 the government provided almost all test kits used with two exceptions: Managha Dispensary finished using the kits provided by Karimu in 2024 which completed in May 2025. And there was a short-term problem in September when Tsaayo was unable to test pregnant women. They ordered kits compatible with the machine Karimu provided, but those were out of stock and the dispensary was not allowed to order the kits elsewhere. The government stocks a different kit that is less expensive, but Tsaayo did not have the compatible machine. So Karimu provided test kits for the machine we provided until their new test machine arrived from the government, ~ one month. Nevertheless, the trend is good with the government supplying the kits.

Benefits:

• Improve maternal and infant health

Cost: $4000

Learn more about Karimu Health Program .