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For every 100,000 babies born alive in Zanzibar, 221 mothers will die as a result of pregnancy or delivery.



The Problem


Zanzibar is a semi-autonomous island of Tanzania, just off the east coast of Africa with a population of almost one million, 44.4% of whom live below the poverty line. The maternal mortality ratio in Zanzibar is currently estimated at 221 maternal deaths per 100,000 live births. While maternal and child health services are available in all health care facilities in Zanzibar, 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.


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.


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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