Strengthening Systems for Sustainable Maternal Mental Health Care
Dear WAJAMAMA Community,
January was a milestone month for WAJAMAMA as we advanced our mission to ensure Group Care Model (GCM) services are recognized as a sustainable part of Zanzibar’s health system.
For GCM to become a long-term, government-supported service, it must be delivered and recorded through the Ministry of Health’s official systems. This month, we collaborated with the government to integrate GCM user requirements into ZanEMR, Zanzibar’s electronic medical record platform, which is being rolled out across the archipelago.
Fast-Tracking Rollout in Bwejuu and Chukwani
In Zanzibar, we have been supporting the integration of digital health systems. As the Ministry of Health rolls out ZanEMR across Zanzibar, WAJAMAMA has been working closely on the system's backend to ensure GCM data points are included. Last year, we collaborated with the Ministry of Health’s Information and Communications Technology (ICT) unit, UNICEF, PharmAccess, and HIPZ to design and integrate these data points into the new system. By supporting the integration of GCM data points, WAJAMAMA is investing in the infrastructure needed to eventually scale GCM across the archipelago–ensuring that the transition is sustainable, the data is fully integrated into national health reporting, and the Ministry of Health maintains ownership.
Coders from the Ministry of Health’s ICT team working hard at WAJAMAMA to include GCM data points into ZanEMR.
At the front end, WAJAMAMA is supporting our pilot sites in Bwejuu and Chukwani. At these two locations, we will be providing the infrastructure needed to support the Ministry in rolling out ZanEMR, including internet, tablets, and training. These resources will allow staff to enter data in real time and deliver GCM services effectively, supporting reproductive and child health, outpatient care, pharmacy, and bloodwork. By combining backend integration with front-end readiness, WAJAMAMA is helping ensure a smooth rollout and laying the groundwork for sustainable GCM scale-up.
Advancing Maternal Mental Health
Last month, WAJAMAMA successfully advocated for the integration of the Edinburgh Postnatal Depression Scale (EPDS) into ZanEMR to screen for maternal mental health in group care settings.
Last year, the World Health Organization (WHO) supported a national pilot of the PHQ-4, a screening tool used across healthcare settings in Zanzibar to assess general anxiety and depression. The PHQ-4 will continue to play an important role in routine care, including one-on-one antenatal visits, as the Ministry explores how mental health screening can be sustainably integrated into standard services.
This moment is especially significant for WAJAMAMA because we advocated for the inclusion of EPDS alongside PHQ-4, recognizing the need for a more comprehensive tool tailored to the perinatal period. EPDS is globally recognized for detecting perinatal and postpartum depression, allowing providers to better identify women who may be struggling during pregnancy and after birth.
WAJAMAMA team members with PharmAccess, the Mental Health Department at Kidongo Chekundu Mental Health Hospital, and the Ministry of Health after a powerful discussion about implementing EPDS into routine maternal healthcare in Zanzibar.
Having both tools available strengthens the health system’s ability to identify women at risk, provide timely support, and improve maternal and child health outcomes. Importantly, this data will be accessible to both the Ministry and WAJAMAMA, creating streamlined maternal health reporting that will improve how care is delivered, how data is analyzed, and ultimately, the future of births in Zanzibar.
January reaffirmed that systems change is possible when evidence, partnerships, and persistence come together. We are proud of the progress made and excited for the next steps in scaling GCM sustainably across Zanzibar. This is only the beginning of an exciting journey!
With love and light,
The WAJAMAMA Team