Cohort profile: Medical Birth Registry at Kilimanjaro Christian Medical Centre (KCMC), Tanzania 2000-2023
Authors: Buckley Daire , Khashan Ali , Mboya Innocent , Mitao Modesta , Nkya Gustav , Senkoro Allen , Lyimo Allen , Pima Francis M. , Munishi Lucy , Woodworth Simon , Manongi Raheli , Masenga Gileard , Mahande Michael , Tarimo Clifford Silver , Daltveit Anne Kjersti , Lie Rolve Terje , Mchome Bariki , Mmbaga Blandina T. 
Published: January 2025

Purpose

Birth registry data is integral to healthcare providers, and policymakers. The primary aim of the data is to record, track, and monitor maternal and new-born outcomes. The objectives of the Kilimanjaro Christian Medical Centre (KCMC) medical birth register are to serve as tools for monitoring births and key obstetric outcomes such as caesarean sections, and maternal and perinatal deaths for clinical, administrative and research purposes. (1) Subsequent births and births can also be followed to serve to bridge a gap in maternal and new-born health information within the Kilimanjaro Region of Tanzania.

Participants

Participants are women who give birth at the Obstetrics and Gynaecology Department of The Kilimanjaro Christian Medical Centre (KCMC) in the Moshi Municipality, Kilimanjaro Region, Northern Tanzania.

Methods

The KCMC Medical Birth Registry was established in 2000. Initially, it was based on a desktop database. In 2020 it was transformed into a digital system, Castor EDC platform, and in January 2024 it was moved to the open-source DHIS2 system. There were over 60,000 births from 2000-2019 were recorded. A total of 8,042 births were recruited from the KCMC facility from January 2020 to December 2023. Participants were interviewed by trained research midwives within 24 hours of giving birth. A standardised questionnaire is used during interviews to capture relevant information on maternal and paternal background characteristics, maternal information before and during the current pregnancy, and obstetric/ clinical information about births (including singletons and multiple births).

Findings to date

Of the total cohort, 4002 (49.8%) participants had a spontaneous vaginal delivery, while almost a third of participants delivered by caesarean section. Instrumental assistance was primarily in the form of a forceps delivery (11.9%), followed by ventouse delivery (1.3%). Additional neonatal outcomes included child status (live/stillborn), and the Apgar score among a long list of variables. A varied proportion of data was missing (ranging from 3% to 7%) from both clinical and postpartum variables. Since 2000, more than 40 peer-reviewed papers have been published using this database.

Future plans

As the methods of the birth registry data collection continue to improve, the data that is collected from the birth registry systems will aid policymakers in monitoring the country’s progression and develop targets for strengthening healthcare systems at both a national and international level. From a research perspective, the data is available for international collaboration for conducting high-quality research into the cause and prevention of adverse pregnancy outcomes in low-resource settings.