‘Without ultrasound you can’t reach the best decision’ – Midwives’ experiences and views of the role of ultrasound in maternity care in Dar Es Salaam, Tanzania

摘要

Highlights ? Midwives viewed obstetric ultrasound as crucial in management of complicated pregnancies. ? Lack of ultrasound machines and skills seemed to restrict adequate management of pregnancy complications. ? The midwives identified an increasing interest in ultrasound among pregnant women. ? Investment in ultrasound needs to be balanced with advanced clinical skills training. Abstract Objective To explore Tanzanian midwives’ experiences and views of the role of obstetric ultrasound in relation to clinical management of pregnancy, and in situations where maternal and fetal health interests conflict. Method In 2015, five focus group discussions were conducted with midwives (N?=?31) at three public referral hospitals in the Dar es Salaam region as part of the CROss Country Ultrasound Study (CROCUS). Results Ultrasound was described as decisive for proper management of pregnancy complications. Midwives noted an increasing interest in ultrasound among pregnant women. However, concerns were expressed about the lack of ultrasound equipment and staff capable of skilful operation. Further, counselling regarding medical management was perceived as difficult due to low levels of education among pregnant women. Conclusion Ultrasound has an important role in management of pregnancy complications. However, lack of equipment and shortage of skilled healthcare professionals seem to hamper use of obstetric ultrasound in this particular low-resource setting. Increased availability of obstetric ultrasound seems warranted, but further investments need to be balanced with advanced clinical skills’ training as barriers, including power outages and lack of functioning equipment, are likely to continue to limit the provision of pregnancy ultrasound in this setting.