From Classrooms to Communities: How Canada’s Investment in Midwifery Is Saving Mothers and Newborns in Tanzania

In Tanzania, every skilled midwife makes a difference between life and death while attending to a pregnant woman in a process of giving life . Each year, thousands of women face complications during pregnancy and childbirth that are  preventable with timely, skilled midwifery care. Recognizing this urgent reality, the Government of Tanzania, in partnership with the United Nations Population Fund (UNFPA) through the financial support of Global Affairs Canada (GAC) , is leading a nationwide transformation of midwifery education, professional development, and community engagement to ensure that every pregnant woman and newborn receives quality, respectful care in the process of giving life .

“Canada is pleased to support this national transformation—one that harnesses modern technology and the expertise of partners such as the Canadian Association of Midwives to equip midwives with the knowledge and tools they need to deliver life‑saving care” said High Commissioner of Canada in Tanzania, Her Excellency Emily Burns. “By strengthening training systems, expanding digital learning, and elevating professional standards, we are helping ensure that more women and newborns experience safer births and healthier beginnings.”

Central to this transformation is the strengthening of Tanzania’s midwifery education system. In June 2025, the Ministry of Health and UNFPA convened  a meeting that was attended by 52 national stakeholders from government, academia, and regulatory bodies to endorse the revised NTA Level 4–6 Nursing and Midwifery curriculum. The updated curriculum integrates modern competency-based learning, person-centered care approaches, and practical case-based teaching to ensure students graduate fully prepared to handle real-life maternal and newborn emergencies.

“The progress and transformation we are witnessing in midwifery care is remarkable,” said Mark Bryan Schreiner, UNFPA Tanzania Representative. “By equipping midwives with the skills, tools, and support they need, ensure safe childbirth is no longer a privilege but a reality for every pregnant woman and newborn in Tanzania.”

Following this, 32 educators and clinicians developed standardized Facilitator Guides and Student Manuals to support consistent teaching across institutions. Tutors received specialized training in simulation technologies and skills-lab management. Master trainers and tutors from institutions including the Muhimbili University of Health and Allied Sciences were equipped to deliver high-fidelity clinical simulations, allowing students to practice life-saving interventions before entering real maternity wards. The result is a validated national training system designed to produce midwives with hands-on clinical competencies crucial for reducing maternal and newborn deaths.

While strengthening pre-service education builds the workforce of tomorrow, upgrading the skills of practicing midwives is saving lives today. During the reporting period, 180 midwives from 131 health facilities in Dar es Salaam and Shinyanga received intensive training in managing obstetric and neonatal emergencies, focusing on postpartum hemorrhage management, safer childbirth practices, and Respectful Maternity Care. These trained midwives now serve as first responders—equipped with the knowledge and practical skills to prevent up to 80 percent of maternal and newborn deaths through timely interventions.

On the frontlines, midwives are witnessing the impact firsthand. “The training and support we now receive have completely changed the way we work,” said Grace Wilfred, a midwife in Shinyanga. “I feel more confident saving lives, mentoring students, and ensuring that every pregnant woman and newborn in my facility receives the care they deserve.”

“I’ve seen young mothers arrive scared and uncertain, and leave with hope because we can now provide comprehensive midwifery care,” added Anastazia Gerald, a midwife in Dar es Salaam. “These programs have transformed how we deliver midwifery care and strengthened trust between our facilities and the communities we serve.”

Tanzania is also embracing digital learning to ensure no midwife is left behind. Six accredited Midwifery Emergency Skills Training modules were uploaded to the national health e-learning platform managed by the Ministry of Health. Covering lifesaving procedures such as assisted breech delivery, shoulder dystocia management, and newborn resuscitation, these modules are accessible nationwide, including remote areas, ensuring that life-saving skilled midwife is always within reach.

Saving lives requires more than clinical skills—it requires a healthy workforce that is supported, protected, and equipped to provide comprehensive and respectful care. More than 100 midwives and tutors have received training in psychosocial support, stress management, and gender-based violence screening. This equips providers to identify and respond to cases of gender-based violence, sexual exploitation, and violence against children, ensuring survivors receive timely care and referral support within health facilities.

At the community level, 591 community members including local leaders participated in structured dialogues to assess and improve services in 21 health facilities. During the structured dialogy, they identified challenges such as staff shortages and essential medicine stock-outs, and developing joint action plans. Through community health workers, health education was  provided to 9,615 households, and more than 2,000 people received services including HIV testing, malaria screening, and family planning information and services.

Peer-led initiatives are reshaping social norms. Across Shinyanga and Dar es Salaam, 14 male adolescent and youth clubs were established to promote positive masculinity and encourage young men to support women’s health and reproductive rights. Peer educators facilitate discussions on family planning, respectful relationships, and gender equality, helping shift attitudes that previously limited women’s access to care.

The policy and leadership framework supporting these interventions is equally robust. The Tanzania Nursing and Midwifery Council finalized updated national guidelines defining the scope of practice for nurses and midwives, strengthening professional accountability. The Tanzania Midwives Association finalized its five-year strategic plan (2025–2030), providing a roadmap for advocacy, professional leadership, and long-term sustainability. These milestones were celebrated during the 2025 International Day of the Midwife, attended by more than 800 participants and featuring recognition of outstanding midwives through the National Midwifery Awards.

The results are already measurable. Joint monitoring visits documented a 41.6% increase in facility-based deliveries in Ushetu District and a 70% decline in the Maternal Mortality Ratio at Amana Regional Referral Hospital since 2022. These outcomes demonstrate how strategic investments in midwifery education, workforce capacity, and community engagement can rapidly translate into safer childbirth and stronger health systems.

Across Tanzania, midwives are stepping into maternity wards better trained, better supported, and more connected to the communities they serve. From upgraded curricula and digital learning platforms to community accountability systems and youth engagement, the country is building a comprehensive ecosystem that supports safe motherhood. For donors and partners, the message is clear: investing in midwives is one of the most effective ways to reduce maternal and newborn deaths. And in Tanzania, those investments are already paying off as pregnant women can now access quality services during childbirths.

These achievements are part of the Thamini Uzazi Salama – Strengthening Midwifery in Tanzania (SMIT) Project, a 7-year initiative designed to transform maternal and newborn health outcomes. Through the collaboration between UNFPA, Amref Canada, and the Canadian Association of Midwives, the project aims to equip nurse midwives with midwifery skills in the three districts in Shinyanga and three municipal councils in Dar es Salaam. By increasing the number of skilled midwives, enhancing their education and training, and partnering with local stakeholders, the Thamini Uzazi Salama Project aims to strengthen the healthcare delivery and ensure the  provision of comprehensive, high-quality reproductive, maternal, newborn, child, and adolescent health (RMNCAH) services—ensuring that more Tanzanian mothers and children survive and thrive.

Investing in midwives saves lives. In Tanzania, that investment is already transforming communities—one birth, one midwife, and one community at a time.