Administrator Power Delivers Remarks on the Nationwide Expansion of M-mama in Tanzania

ADMINISTRATOR SAMANTHA POWER: Thank you so much. I have the privilege of being the Administrator of USAID. And USAID is an Agency, as some of you know, that has Missions in about 80 countries, and programs in more than 100 countries – programs of all kinds. In every sector, agriculture, clean energy, climate adaptation, education, PEPFAR – some of you know well. 

I can think of no program or project that I have visited anywhere in the world that is as exciting and as cost effective as m-mama – it’s extraordinary. I want to recognize the honorable Vice President Dr. Phillip Mpango, the honorable Ministers, and other government officials, who have done so much to make all of this possible. It is extraordinary and it is only going to get more impactful with time, it is only going to save more lives of mothers and newborns as more mothers know about it and more volunteers emerge to help drive vulnerable mothers or their vulnerable children to medical care. 

What Tanzania has achieved with m-mama is not only a success story that we talk about here in Tanzania and that, in fact yesterday, I talked about with President Ruto and his team in Kenya. It is a story and an achievement that we talk about all around the world – in Asia, in Latin America, and across sub-Saharan Africa. I’m honestly in awe of what has been accomplished in such a short period of time. To see this program, though, for the first time, first hand – to actually be with nurses who are themselves the ones responding to the emergency calls, to meet the drivers who have volunteered to support mothers and babies in their communities – that really brings it home, for me and for my team who has traveled here from the United States. 

Thank you to the incredible partners that have made this happen. The Vodacom Foundation; their partners, the Touch [Touch] Foundation and Pathfinder; and again, the leaders across the Tanzanian government who have taken m-mama from a promising pilot project to now a staple of Tanzanian health care that is saving lives across the country. 

To single out a few individuals by name because they deserve it, Minister Nnauye has been instrumental in building the digital infrastructure that is the backbone of m-mama. Minister Kairuki has developed remarkable leadership in organizing and funding community drivers throughout this large country. Minister Mwalimu has been a strong champion for maternal and child health. And of course our most honorable guest, Vice President Mpango, and President Samia have put the lives of women and their children at the center of their agenda for this great country. The results speak for themselves.

I just got to see a demonstration, along with the Vice President and the ministers gathered here, of an m-mama call here at the hospital dispatch center. You see the big screen, you know, like a flat screen TV like a map of the world, then you hone in on Tanzania, then you see flickering red lights where mothers right now have made phone calls and are in some form of distress trying to get to medical care to save themselves and their children. I got to meet with the m-mama drivers who deliver moms to safety, when ambulances – which are in over demand here – are not available. I met a few of the nurses who rush to provide the care that is needed and make really important judgment calls about what the conditions are and where a mother should be sent to provide optimal care, consistent also of the urgency of getting the mother to the right place in time for that care to be administered.

The testimonials of mothers like one that I met are, again, awe inspiring. A young mother that I met was having her first baby, began to experience complications, traveled where she could to a dispensary and it was very clear that there was not going to be an ability to provide the care that she needed for a very complicated, prolonged labor process. So the nurse, who we met with, used m-mama to be able to ensure that a community driver could come transport this young women, and sure enough she was able to deliver her healthy son, who’s named Imran. So her first child, as well, was with us today. He was not able to thank m-mama just yet, but we know when Imran grows up, this is something that he too will be grateful for. 

Our team, at USAID, fanned out even more broadly and visited a lot of facilities like this, talked to a lot of nurses, drivers, and mothers. One mother told our team that when she was about to give birth to her second baby, she made sure to get herself to a local clinic. But when she arrived, they told her that she was suffering from obstructed labor and needed a C-section – which she could only get at the city hospital. She had no car and she had no money to pay for a ride. She knew the dangers of childbirth all too well – she’d been pregnant once before, and lived through the agony of losing her first baby in childbirth. I can’t imagine the fear that that mother would have felt with a second chance to give birth to a healthy baby, and yet again an extreme form of complication. The nurses explained m-mama to her and rushed her into a car but before they even arrived at the city hospital, she had lost consciousness. She awoke to learn that the m-mama driver had gotten her to the hospital in time for her to have a C-section. She was healthy and safe – and nurses were able to introduce her to her brand new baby girl. She named her baby Baraka, for “blessing” – because, as she put it, “This child is a blessing from God through m-mama.” 

So many of the people here today helped create that miracle – and thousands more like it. In fact, while the Vice President and I were having substantive discussions earlier today on m-mama and a range of other aspects to the U.S. and Tanzania partnership, Tanzania celebrated a milestone, which is that during our meeting, the 25,000 patient received m-mama transport services. So 25,000 individuals in Tanzania have been transported through this service, and those numbers are only going to go up, up as the program scales across the country and as more and more people talk about what m-mama offers. 

You, collectively, are showing the Tanzanian people what it actually looks like for democracies to deliver. To actually deliver for their people – for government officials to listen to and to understand citizens’ most urgent needs, to draw on the diverse ideas and innovative power of the people to find solutions, and to bring all citizens in a show of solidarity into the shared work of implementing these solutions – that is what makes life better for their communities. 

Tanzania’s citizens demanded safer childbirth for moms and babies, and Tanzania’s leaders have listened. Tanzania has about 200,000 complicated births a year – and about 25 percent of them, or about 50,000 mothers – require emergency transportation to get the care that they need. So, to meet that need, the Tanzanian people and USAID worked in partnership to design an innovative solution that not only met initial expectations, but blew them out of the water – with mortality from childbirth falling 38 percent in the pilot region of Shinyanga over four years. 

Citizens and companies across Tanzania jumped at the chance to help their communities. Drivers stepped up to serve – some of whom weren’t even cab drivers but private car owners, like those we met today, who themselves had lived, in some instances, through the pain of losing a loved one in childbirth and simply wanted to help others avoid such agony. Vodacom invested in cell tower expansion to broaden mobile coverage. In remote areas to bring m-mama to rural populations, they donated radio slots to spread awareness, and offered their mobile money service m-pesa so the government of Tanzania could handle driver payments. 

And, critically, President Samia threw the full weight of the Tanzanian government behind m-mama’s success. She led the government’s efforts to build out the tech for m-mama, and set up 1-1-5 – a number that any health facility where m-mama operates can call to get an expectant mother to safety – a hotline that is already a lifeline for Tanzania’s moms and what we hope will become an example for other countries seeking to adopt this technology. She worked with local government leaders to help them take full ownership of m-mama in their communities, covering everything from driver payments to system maintenance. 

When the m-mama team began an effort to bring m-mama to nine regions of the country by 2025, President Samia said, “no, not nine regions, we can do better.” So, just nine months ago at the UN General Assembly, I stood with Vice President Mpango and announced that we would work together to implement m-mama nationwide in Tanzania during 2023. Already, m-mama as of today, covers about 60 percent of the population of this country and all of Zanzibar. Nine months is a long time when you are carrying a baby to term, but it’s a very short time when you are scaling a government initiative as ambitious as m-mama. Arusha, where we are today, went live just in March as we heard here. And now, m-mama is on track to be available everywhere in just a few months. 

I mentioned that about 50,000 moms need emergency transportation during childbirth. Well, we are setting up m-mama to have the capacity for 54,000 transports next year – meaning that next year, m-mama should meet the entire magnitude of the need for emergency transportation for Tanzania’s moms. 

And this program is coming at an extremely low cost. The ongoing cost per year to the Tanzanian government is just $2 million – less than the cost of bringing 10 new ambulances into the system.

And now, this Tanzanian innovation, as I indicated, is being exported around the world. What began in Tanzania is spreading. Already, Lesotho has launched their own m-mama program where it is seeing significant success. And Kenya and President Ruto announced yesterday that they too would like to launch m-mama and we are working together to begin a pilot project and then to scale across the country.

So today, in closing, the world knows: democracy is delivering – delivering, get it? 

Democracy is delivering, right? – for the people of Tanzania. 

Democracy is delivering moms to the hospital in their moments of greatest need.

And democracy is delivering healthy babies – babies who are already benefiting from the ingenuity, compassion, and dedication of the Tanzanian people even before those babies take their first breaths. 

I thank you so much. It is a personal privilege to be associated with this initiative. Thank you.