Giving Birth in Tanzania are the hospitals + Doctors Professional

Hi Paul,

You have asked the right person if you want to know about medical things and TZ, and having a baby in TZ.  We have our 3 kids. ages 4, 3, and 1, We went back to the U.S 6 weeks before delivery and returned to TZ 6 weeks after our last was born. I researched all possibilities of having a baby here- at a hospital, at home with my bedroom set up like a hospital, and having the baby in Kenya at the Nairobi Hospital. You will never get a clear picture of what the health care is Really  like here from the internet. It is one of those things that you just have to see, and experience.

I am an American RN so i am a little more critical of the heath care in TZ, comparing the US to  TZ, and I have had to learn to adjust my standards ALOT.

I only do personal nurse work here and TZ , mostly education, with friends and personal contacts, I don't volunteer in any hospitals, but visit them on occasion. Some things that I have seen.

A lab technician drawing blood from someone, knowing that one of the blood test is for HIV, and he doesn't bother to put on a pair of gloves, even though they are in the glove box sitting next to him.

A nurse giving a pt. a shot and then leaving the used syringe and needing laying around.

The Gov.  hosp. in town which is cheaper for the normal TZ, that lives on less than $100 usd a month, is one of the most horrible places I have ever been, I can't even begin to describe it.

But there are private hospitals for the "richer" expats, and higher class of TZ citizens that can afford it. Sad really. :-( In Dar it is Aga Khan, in Arusha it is the Selian Lutheran Hospital. Health care cost are very cheap compared to America, but what is cheaper in cost is usually cheaper in quality also.

Really it all depends on your standard of care, are you American?  Where are you moving? What type of job ?

I have spoken with a few expats that have delivered their babies at the Selian Lutheran Hospital and said it was wonderful, great care, so i think it really depends on what you expect. They have an operating room for emergencies, so does Aga Khan. They have some modern equipment. The facility looks new and is in good condition.

But for me, the quality of health care is not as good in the way of the knowledge of the nursing staff and Doctors. I have had a Dr.  prescribe an antibiotic (Cipro) to my 2 yr. old. I double checked to see if this was right, and sure enough it could have caused his kidneys and liver to fail b/c you don't give Cipro to a child. Little things like that. :-(

I have also heard of the nurse not removing the placenta after delivery and the mother bleeding out and dying. Most doctors don't deliver the babies here, it is the nurse or a midwife. Not trying to scare you, just wanted to emphasize that you need to educate yourself about childbirth, and double check what is being done.

Also little things that might be different is  sharing the delivery room with another women, so the 2 of you are lying next to each other screaming :-) oh but their may be a sheet curtain between you.

Long story short.- It is not the same as America by any means, BUT if you have to, there are adequate places to have the baby and have things be just fine, just don't put your trust in ANYONE, the Dr. or the nurse, double check everything that they do. Don't let them intimidate you, for some reason some like to act as if they have all the answers weather they do or not.

Another option that some expats do is deliver in Kenya, at the Nairobi Hospital. they are suppose to have better quality health care, I have never been there, but friends have gone there for test on various things, and said their health care is better. But when it comes to babies, it is hard to predict when to go to Kenya to get ready for the baby, and then hard to travel back home. And for us it was hard b/c we didn't want to leave or other 2 kids with someone for that long, while we waited for the delivery.

I asked an expat midwife, she is living here TZ, where should I have my baby?, I was ready for here to tell me to have it all natural at home, but instead she told me- Do Not have the baby at home, don't even have it in TZ, go to Kenya. An American Dr. friend who lives here, and has a clinic (but not one that delivers babies) said that it would be fine delivering here in TZ, but in a hospital not at home in case of an emergency.
That is what advice I got.
After all was said and done, we chose to go ahead and go back to the states to have the baby, family really wanted us there anyways. It worked out fine, no complications, and it would have probably been fine to deliver here in TZ.

Something else to consider is that pain in TZ patients is not treated the same as in American, including child birth pain. They don't do epidurals, and even if they did, there is no way that you could trust someone to stick something in your spinal cavity, not here, no way. But this can be a positive thing if she is wanting a more natural birth, and not even have the option of an epidural tempting her. :-) 

The bottom line is that you have to agree together on the best thing to do, and be confident in your decision and be able to deal with the "what if's " if that should happen, where ever you are. You would never want one of you to say, well if you wouldn't have made me .....

Now my prenatal care here was Wonderful. I went to a "backwoods" clinic near my home, the Dr. was great, and I even got to have an Ultrasound for $8 usd. You can have lab work done, and your Dr.s visit really cheap. Again just educate yourself, and you will be fine with prenatal care. The internet and google is my lifesaver here.

The only thing that I would caution is that she Doesn't  take the anti-malaria medication while preg. Some prenatal Drs. say that you should take the malaria med while preg to prevent complications after delivery. I would maybe recommend this for a TZ bush woman, but for someone that takes extra caution while preg, sleeps under a mosquito net, sprays the house/windows to keep the mosq out, etc. then the risk of the damage that the malaria med could do to the baby out weighs the risk of malaria complications.

Does all this make sense at all?

Sorry to ramble, I am trying to write a quick note before bed, but somehow my quick notes turns into mini books, with lots of typos. :-)


Please write me back if you have any more questions.

I hope i have helped in some way. EastAfricaMissions@me.com

BonnieTZ

Bonnie,

I must thank you very much for your informative message to us on the forum.

I am at work now in the Middle East and my company has informed me that my next contract will most possible be in Tanzania expected start date September 2010.

My wife will be 6 months pregnant at this stage.

I am going to forward the information you have kindly provided to my wife and we will discuss later and again contact you if this ok.

We are not American citizens but Irish of course we have contacted our embassy in Tanzania as Ireland has a lot of missions and charitable work in Tanzania.

I think the best option maybe to go out to Tanzania and check the hospitals we have been researching the hospitals such as the Agha Khan and IST Clinic but have found no reference for a Lutheran hospital but this we have no checked on line.

We are aware of the malaria problem as well as the H.I.V virus and this we will of course make our preventions against such.

I agree with your statement that the doctor does not always know best and will have no problem in outlining to them our concerns if there is something wrong with their administrating of procedures. I think it is very commendable that you do this and took the check on the Cipro antibiotic that would have caused damaged to your Childs kidneys and well I do not want to imagine the worst possible outcome associated with this cipro antibiotics for children Thank God it was all ok for you and family.

So Bonnie I will discuss this message from you with my wife upon arrival home after the working day.

I would think that maybe my wife will want to contact you to discuss some matters.

I again thank you for the reply it is great to hear from you on this really important matter for us as you said your just the right person with a husband & family of 3 ages 4 - 3 and 1 living in Tanzania.

We will be in touch again soon

God Bless

Take care

Paul + Niamh

Hello Paul and Niamh

I am Irish and living in Tanzania for the past 8 and a half years.  I am pregnant and due in the end of October 2010.  I am planning to give birth here in Dar es Salaam at the Aga Khan hospital and at the moment I am going to ante natal appointments and ultrasound scans there.  I have talked to two sets of ex-pat couple friends who have also given birth in the Aga Khan and both had good experiences - one had a normal birth and the other had a c-section because the baby was the wrong way up, both were perfectly fine.  I also have met several middle class Tanzanian women who gave birth at the Aga Khan who had no problems.  The Tanzanian women I know of who have had problems gave birth in Government hospitals or not in hospital at all.

It is true that the Government hospitals are really terrible here, but the Aga Khan in Dar es Salaam is fine.  They have important equipment like incubators and ventilators in case of pre-mature babies.  They do offer epidurals but these are not common here and anyway I want to have as natural a birth as possible but to have equipment and expertise on hand in case of emergency only.

Actually I have read a lot of bad things about giving birth in the USA - they induce labour with drugs and do c-sections and other artificial interventions without good medical reasons in the USA just for the convenience of the medical staff.

Feel free to contact me if there is any information I can help you with.

Best wishes
Elaine Baker

Elaine,

Thanks for the reply we hav been checking the Aga Khan Hospitals on line.

I am at work at the moment and will discuss this later with Niamh.

Great to hear back from someone that is well in the same postion as us.

Niamh is Due in December.

Talk soon.

Paul + Niamh

Hi everyone,

I am 4 months pregnant and have been reading these posts with great interest as we too are considering delivery here. May I ask Elaine how it went? Could you tell us a little about your experience? And Paul, where did you end up choosing to delivery the baby?

Any help would be appreciated,

Kind regards
NIeves

Hello

Yes I delivered a healthy baby girl in November in the Aga Khan and she is doing well.  I had a natural childbirth with no painkillers which is what I wanted.  There was very thorough history and checking on admittance, I was allowed to spend time walking around hospital in early stages of labour, then was brought into delivery room later.  Overall staff were very professional and helpful and nice.  I was mostly with a nurse, with a doctor checking on me from time to time and my ob/gyn came once and then again to do an episiotomy.  There were some things I would have preferred done differently, like being obliged to be on my back at the last stages.  I was allowed to hold baby as soon as born, then she was taken with her father for cleaning and then I asked for her back for first breastfeed (which happened within an hour).  Got millet porridge after the birth which was lovely.  Stayed overnight, baby slept in nursery (at my request so I could sleep knowing nurses keeping an eye on her), then in the morning she stayed in a cot beside me, pediatrician checked baby in the morning and we were discharged in afternoon.  I had a room shared with one other lady.

Overall I felt safe and well-looked-after throughout my stay in the Aga Khan.

Have taken baby for immunisations there also - they follow the free Government immunization program.  One thing to consider would be to get the more modern acellular version of the whooping cough vaccine (at IST clinic) as the Tanzanian Government program has an older one with more side effects (crying for hours) - we didn't know this at the time.

I am also aware of two other ex-pats who have given birth at Aga Khan (one c-section, one normal birth), both fine.

Best wishes
Elaine

Congratulations Elaine! I'm happy to hear all went well. Thanks for your comforting reply.

Warm regards
Nieves

The Selian Lutheran hospital in Arusha is wonderful. I'm not sure of the childbirth aspect of it but the hospital itself is great and the doctors are very knowledgable. I think it is the closest to excellent care you will find in this area. Also I don't find the healthcare to be horrible here. What they lack in technology they make up for in bedside manner and knowledge. Even the clinic I went to when I had malaria, though norhing like a clinic in the US, was very professional and effective. Best of luck! Do look into the Lutheran hospital more they're very good but I think if you both are nervous about it it may be a better bet to have the baby home where you know the standard of care and you will both be comfortable.

Best,
Adrianne

Ahh nevermind I didn't look at the date. No doubt by now you've had to make that decision already. I hope everything went well!

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Dear expats of Dar es Salaam,

I would like to renew the subject, all posts were very helpful, but surely someone can have a more recent opinions on of giving childbirth in Tanzania.

I'm expecting a child in June and I would like to give birth in the Aga Khan in Dar es Salaam. Any doctor recommendation? Any advices? Opinions of of giving birth in this hospital?

Dear expats mothers, I'm counting on you! 

Just to say I also went on to have a second baby at the Aga Khan in 2012, again natural childbirth.  My doctor the second time was in my opinion better than the doctor I had first time around, he respected my wishes more about positions to be in, while expressing his opinions and reasons (for example on whether or not to break my waters), but waited for me to give the final go ahead.  Again I felt well looked after by professional nurses and doctors.

I also know there is now a German midwife in Dar who has facilitated at least two home births of expatriates in Dar es Salaam that I know of, with the Aga Khan as the backup hospital in case of emergency (which didn't happen).

Elainel, can you give me contact to doctor in Aga Khan which you talking about? What about laboratory tests, USG, during pregnancy, you were doing it all in the Aga Khan too? What about prices there?

Thank you for your help!

Hello, yes I had ante-natal care at the Aga Khan also.  You pay a fixed fee (about Tsh 400,000 at the time I think) for a package of ante-natal care which includes monthly check ups (weekly in the last month), one or two ultrasounds (although you can have more ultrasounds also for extra payment) and a few blood tests.  Extra ultrasounds were in the region of Tsh 40,000 as I remember.  Typical ante-natal appointment consists of urine test, weight check and blood pressure check with the nurses followed by brief consultation with your gyn doctor.  One thing about the ante-natal appointments is that the queues are long (there is a take-a-number queue system), so you can spend the whole morning there unless you get there at 7am.  Wasn't a problem for me as I would bring my laptop and work.

Then the delivery itself is about Tsh 400,000 for a normal delivery, couple of million for a c-section, if I am remembering correctly.  At the delivery you have a nurse with you, a "normal doctor" in and out, and the gyn comes to see you two or three times depending on need, including when the baby is actually coming out.  Normal delivery includes stay overnight after delivery.  In my case I delivered in the evening both times, and was discharged the next day after a pediatrician inspected the baby.  During early labour you are encouraged to walk around the hospital, then when things are moving faster you go into the delivery room where you deliver (this is a large private room), and after birth you are in a twin room with one other mother (though I think you can pay extra for a private room).

Note I can't remember exact prices and this was 2012, and my insurance (strategis/AAR) was paying so I wasn't really conscious of the prices besides signing off on them.

Hi all!
I hope they're are still a few people active in this thread. I am currently living in Zanzibar and am planning on giving birth in Dar es Salaam in October. I was wondering if anybody had any recent experiences/recommendations in regards to Dr's, hospitals, etc? Any advice would be greatly appreciated!
Thanks, Eva

Hello Eva, this is Elaine from above posts, I still live in Dar, let me know if you have any questions or I can help with anything, Elaine

Thanks Elaine!

If you have any up to date information on hospitals and doctors in Dar, that would be much appreciated! I'm due in Oct bit thought I'd start looking now
Eva

Hi Eva.

I recommend you go to Masani area, hospital name is Msasani Peninsula Hospital and ask for Doctor Shafeeq, he is the best in Dar, and his hospital is really good.

Hope this helps

Thanks.

Hi Elaine,

I was browsing and was happy to find this site and especially your messages.
I'm an expat in Tanzania since August 2016, and am now in my very early second pregnancy. I'm very much interested in having a home birth as I had my first child at home but this was in Europe, where things can be and generally are vastly different.

Is it possible for us to get in touch over the email? I've got some questions regarding a previous posts about the midwife from Germany and some other details.
Would you mind to write to me? ***
Thank you in advance :-)

Merel

Hello,

I'm in my early second pregnancy and am trying to look into having a home birth, as it was pleasant to have it that way with my first child.

Does anyone know any midwives that are willing to do a home birth?
Any other advices for someone who wants to have a home birth?

Thanks in advance,
Merel

Hi Eva, Msasani Peninsula Hospital is the best solution for your birth. It has very experienced doctors and specialists and state of the art equipment thats why it is the number one choice for expecting mothers.

Hi! Eva,
I'm maay from dar.....  I just want to ask about global hospital there in znz, im on my eight weeks still finding a better hospital and doctors....i had bad experience in dar last year.... Hope to hear from you soon
Thanks
Maay

Hi Elaine, I realize it's some time ago now since your experience at Aga Khan, but as I'm trying to research options for giving birth in Tanzania I see this is the only conversation about it. I'm wondering if you can tell me if you were happy with the skills and attitudes of the midwives and whether you had to give birth on a ward or of it was a private room?

Many thanks
Rebecca

@ rjsn522,

If you do not receive any information, please feel free to launch a new thread in the Tanzania forum.

Thanks,

Priscilla
Expat.com Team

Hey, me and my husband are going to Tanzania for 4 months from November 2022 to March 2023 and Im pregnant. Would also love to get some contacts from the German midwives and maybe hospitals for check ups.

Thanks in Advance,

Inib

@zoec hi sorry I'm so late replying here, I gave birth at sali international hospital with Dr Cuthbert. I was really happy with him and the midwives. He took the time to explain decisions to induce and make sure I was comfortable with the treatment plan.

I had a private room before and after birth and felt very cared for. The only thing I would check up on is that pediatricians are not 24 hrs, I wish I had asked about the procedure in place if there were complications for the baby out of hours. The whole inpatient cover cost under 2000.

Hello rjsn522,

Thanks for the update!!

Congratulations on the birth of your baby

Cheers,

Yoginee

Expat.com team

@Yoginee Thank you! if you have any other questions I'm happy to answer.

Best wishes

Rebecca

Hey @rjsn522,

congrats on the birth of your child! Thanks for your informations. Do you know by chance if the clinic also does check ups for pregnant woman?

Regards

@Inib1234 They do yes, theres a clinic every day monday to friday, but you can end up having to wait around depending on how many people are there.. 

Anyone has epidural options/experiences?

I think its available at both Sali and Aga Khan.

Hello All,

I am an expecting mother currently living in Dar and would like to have a homebirth. Can anyone share with me their experience here with homebirthing? And can anyone recommend a great local Midwife? And where I can obtain affordable prenatal care and ultrasounds? Any and all help is gretaly appreciated!

Thank you much, peace and blessings!

Hi I’m an expectant mother living in Arusha. Can anyone recommend the best hospitals for delivery here ? And what pain options they provide ? Thanks

@ElaineI

Hello , do you need to go with a card clinic during day of delivery and what if you don't have one at day of delivery

@Elaine

Hello I would like to ask , is it a must to have a clinic card  during day of delivery or will nursed ask for it and what happens If  you don't have one?

Thanks

Gee