Fabiola Moshi is a teacher, a nurse, a researcher, and an expert in health policy and management. Since completing high school, Moshi has earned a diploma from Dar es Salaam Teachers College to teach chemistry and biology, a degree in nursing from Muhimbili University of Health and Allied Sciences (MUHAS), and a Masters in Health Policy, also from MUHAS. Now, the 39-year-old mother of three is completing a PhD.
As a faculty member at the University of Dodoma, where she is the counterpart to GHSP Nurse Educator Elisa Vandervort, Moshi applies her multiple degrees, specialties and roles to a single purpose – expanding human resources for health and improving health outcomes in Tanzania, especially for women and children.
“We are suffering from not having enough human resources,” Moshi explained earlier this year, when talking about a cervical cancer screening program. “So we thought we could increase the human resources by organizing a training, both for hospital staff and for our students. Because if we train the students, they will go all over the country after they graduate and bring the knowledge with them. So by investing in the students – rather than just training the people at the hospital and helping the people of Dodoma alone – we can assist in improving the health of Tanzanians as a whole.”
Moshi is currently teaching courses in Leadership and Management and Reproductive Health. Her passion for improving maternal and child health in Tanzania is expressed not only in the courses she teaches but also in the research she conducts and encourages her students to pursue.
For her Master’s dissertation, Moshi studied the socio-cultural barriers that lead couples to run the higher risk of having their babies at home rather than with the assistance of skilled birth attendants at a health facility.
She conducted separate interviews with women and their male partners in a region that has the highest levels of both home deliveries and maternal deaths in Tanzania. She found that women often delivered their babies at home because their male partners, who control the family’s finances, typically don’t take part in antenatal care and training, don’t learn about the risks of giving birth, and don’t feel welcome at the health facilities.
“So when I discussed it with them,” Moshi said, “the male partners denied their responsibility. They will provide financial support in case of an emergency, but they don’t take part in deciding on a safe place for their wives to have their babies.”
Now, for her PhD dissertation, Moshi plans to test an intervention designed to reduce maternal mortality by encouraging male partners to participate in antenatal care and support their wives in delivering their babies at health facilities.
She plans to work with health facilities “to provide antenatal education and a user-friendly environment for men” in the same region where she conducted her earlier research – a region where less than a third of deliveries take place at health facilities and the maternal mortality rate is over 860 deaths for every 100,000 live births, double the national average in Tanzania and more than 170 times the rate in Japan.
Male partners will be invited to come to the health facility with their wives and to take part in two training sessions designed to answer their questions and make them feel comfortable and involved. A tent will be set up to provide a place where male partners can stay. And after the couples’ babies are born, Moshi will compare knowledge and birth outcomes for couples who participated in this intervention with other couples who just received brochures with birthing information.
“I wanted to do something that will be useful for the country,” Moshi said. “I am trying to look for an effective strategy that can be used by policymakers to improve the reproductive health system in Tanzania and increase the number of births with skilled birth attendants.”
“Now, plans for reproductive centers in the country are set by looking at the women only and forgetting the husbands. But the husbands in our culture are the ones who control the family economy. They are the ones who decide whether their wife should use the health facility or not. If this intervention proves effective, we may contribute to improving the health of these women who are losing their lives because of the health system we have.”