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For every 100,000 babies born alive in Tanzania, 398 mothers will die as a result of pregnancy or delivery.



The Problem


In Tanzania, infections are one of the main direct causes of maternal death. The country did not make sufficient progress to attain its Millenium Development Goal of reducing MMR to 193 per 100,000 live births.

While maternal and child health services are available in health care facilities,  poor quality of service due to lack of equipment and low levels of qualified staff limits service. Only 44% of births in health facilities in Tanzania are ‘water-and-sanitation-safe’.


Our Work


Since 2014, Soapbox has been working with partners to improve health service quality and contribute to efforts to reduce infection rates and improve maternal health. A needs-assessment carried out in 2014, in collaboration with the Pemba Public Health Laboratory (PHL-IdC), the Ministry of Health (MoH) and WaterAid Tanzania, highlighted gaps in key resources and knowledge around hand hygiene at the time of delivery.

Since December 2015, Soapbox has been collaborating with PHL-IdC and the MoH to understand hand hygiene compliance and factors that influence compliance during labour and delivery, across 10 busy maternity units. The aim of this research project is to develop ideas for interventions to improve hand hygiene compliance at the time of birth.

Soapbox has supported workshops and focus groups in Zanzibar to interpret the research findings of the project. Interventions such as the introduction of hand gel will be tested as the project continues.


Our Impact


The needs assessment carried out in 2014 led to two major projects managed by the Zanzibar MoH:

  • Formal training of cleaning staff on infection prevention and control to address the lack of training formerly available;
  • Installation and/or repair of sinks to ensure that all maternity units have at least one functional sink available.

The needs assessment also supported the successful application for funds to the Medical Research Council for the current hand hygiene research project.

In 2017, a new paper led by Soapboxer Giorgia Gon focussing on hand, cord and birth-surface hygiene in Zanzibar maternity units was been published in Health Policy and Planning.


Our Partners


  • WaterAid Tanzania
  • Zanzibar Ministry of Health & Social Welfare
  • Pemba Public Health Laboratory  – Ivo de Carneri Foundation
  • University of Aberdeen
  • London School of Hygiene and Tropical Medicine


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