Health professionals’ experiences and views on obstetric ultrasound in Tanzania: A cross-sectional study
Creators: name: Bergström, C
name: Ngarina, M
name: Abeid, M
name: Kidanto, H
name: Edvardsson, Kristina
name: Holmlund, Sofia
name: Small, Rhonda
name: Sengoma, JPS
name: Ntaganira, J
name: Lan, PT
name: Mogren, Ingrid
Publisher: name: La Trobe
Year: 2024
Subjects: classificationCode: 32
subject: Biomedical and clinical sciences
classificationCode: 3215
subject: Reproductive medicine
classificationCode: 4204
subject: Midwifery
classificationCode: 321502
subject: Obstetrics and gynaecology
classificationCode: 4206
subject: Public health
classificationCode: 4205
subject: Nursing
subject: FOS: Health sciences
classificationCode: 42
subject: Health sciences
classificationCode: 320222
subject: Radiology and organ imaging

description: Background: Obstetric ultrasound is considered important for determining gestational age, identifying single or multiple pregnancies, locating the placenta and fetal anomalies and monitoring fetal growth and pregnancy-related complications in order to improve patient management. Objectives: To explore health professionals’ perspectives on different aspects of obstetric ultrasound in Tanzania regarding self-reported skills in performing ultrasound examinations and what could improve access to and utilization of obstetric ultrasound in the clinical setting. Design: Cross-sectional study. Material and Methods: Data was collected between November and December 2017 using a questionnaire based on previous qualitative research results from the CROss Country UltraSound Study (CROCUS Study). Seventeen healthcare facilities in 5 urban and semiurban municipalities in the Dar-es-Salaam region were included, with 636 health professionals participating (physicians, n = 307 and midwives/nurses, n = 329). Results: Most health professionals (82% physicians, 81% midwives/nurses) believed that obstetric ultrasound was decisive in the clinical management of pregnancy. Results indicate proficiency gaps across disciplines: 51% of physicians and 48.8% of midwives/nurses reported no or low-level skills in assessing cervical length. Similarly, deficiencies were observed in evaluating the four-chamber view of the fetal heart (physicians: 51%, midwives/nurses: 61%), aorta, pulmonary artery (physicians: 60.5%, midwives/nurses: 65%) and Doppler assessments (umbilical artery: physicians 60.6%, midwives/nurses 56.1%). Compared to midwives/nurses, physicians were significantly more likely to agree or strongly agree that utilization would improve with more ultrasound machines (odds ratio (OR) 2.13; 95% confidence intervals (CI) 1.26–3.61), better quality of ultrasound machines (OR 2.27; 95% CI 1.10–4.69), more training for health professionals currently performing ultrasound (OR 2.11; 95% CI 1.08–4.17) and more physicians trained in ultrasound (OR 2.51; 95% CI 1.30–4.87). Conclusions: Improving the provision of obstetric ultrasound examinations in Tanzania requires more and better-quality ultrasound machines, enhanced training for health professionals and an increased number of physicians trained in ultrasound use. To further increase the accessibility and utilization of obstetric ultrasound in maternity care in Tanzania, it is essential to provide training for midwives in basic obstetric ultrasound techniques.