Originally posted on the CCBRT blog


“My interest is in helping women give birth – I love what I’m doing,” says Dr. Timothy.

Dr. Timothy Mushi has worked on CCBRT’s Maternal and Newborn Healthcare Capacity Building team since 2013. As a clinical trainer, he supports health workers in 22 capacity building sites to deliver high quality care to mothers and newborns. His most recent training program – held in a series of sessions earlier this year – focused on vacuum-assisted deliveries.

Meet Dr. Timothy

“Mothers in labor need to deliver within a certain time frame,” Dr. Timothy explains. “Prolonged labor isn’t healthy for the mother – it leaves her exhausted and can cause fistula or death. And it certainly isn’t good for the newborn, because it can cause birth asphyxia.” If a woman is eligible, trained nurses and doctors can use a vacuum device to ensure that babies are delivered during the appropriate window of time. Put simply, “when vacuum rates go up, fistula goes down.”

The procedure only takes 10 to 15 minutes, requiring much shorter preparation and recovery time than a Cesarean section. “The vacuum can have negative side effects if done poorly,” warns Dr. Timothy, “so that’s why we focus on training.” In this latest round, Dr. Timothy worked with 97 providers in seven of the busiest Dar es Salaam health facilities. His sessions consist of a brief classroom-like training to identify existing skills, followed by on-the-job training to fill knowledge gaps and give health workers a chance to perform the procedure with his assistance. From March to April, 42 vacuum-assisted deliveries were done under his supervision. Average skill scores of participants increased from 53% to 85% at the conclusion of the training.

Stories from the field demonstrate just how important this work is. Dr. Timothy recalls entering a busy labor ward one morning, where the doctor on-call was finishing his eighth Cesarean section since the night before. Exhausted, he asked Dr. Timothy to look after the final woman waiting for surgery.

“I reviewed the client and discovered that the baby was low enough for a vacuum extraction,” says Dr. Timothy. He performed a successful vacuum-assisted delivery, avoiding the need for surgery altogether. “The doctor observed my procedure and insisted that he would not leave until he learned how to do one, too. And the mother had not wanted an operation – she was so thankful for our help.”