Abstract
Globally, every year 529,000 maternal deaths occur, 99% of which in developing countries with majority being in Sub-Saharan Africa. Maternal, Newborn and Child Health (MNCH) services depend on the accessibility, availability and quality of antenatal care (ANC), delivery and postnatal services. The aim of this study was to assess the health facilities’ capacity and readiness to provide MNCH services in Unguja Island, Zanzibar. 
 
 A facility-based cross-sectional survey was conducted from May to June 2015 at public health facilities providing MNCH services. Data was collected by using the modified Service Availability and Readiness Assessment tool. 
 
 Eighteen health facilities were assessed, two-thirds (66.7%, n = 12) of which were offering both maternity and reproductive and child health (RCH) services, 4 (22.2%) RCH services only, and 2 (11.1%) maternity services only. Readiness score for ANC services was 66% with high readiness scores in diagnostics services (89%) and equipment (69%). Overall, 14% offered all seven signal functions. Overall, delivery service readiness score was 48%. Overall readiness for comprehensive emergency obstetric and neonatal care services was 13%. Staff training and guidelines readiness score was 11%, while medicine and commodities score was 9%.
 
 The health facilities’ readiness in providing MNCH services remains inadequate in Unguja Island. Readiness in providing services was low for delivery and emergency obstetric and neonatal care services. Basic and advanced delivery services need to be improved in parallel with provision of necessary equipment, medicines and commodities and staff training for better MNCH service delivery.
Highlights
In Africa maternal healthcare service delivery is a huge challenge
Eighteen health facilities were included in the study, of which 11 (61%) were primary health centre units plus (PHCU+), 4 (22.2%) primary health centre units (PHCUs), 1 (5.6%) tertiary hospital, 1 (5.6%) special maternity hospital and 1 (5.6%) primary health care centre (PHCC)
The few MCH aides were mainly found in primary health care units (PHCUs)
Summary
In Africa maternal healthcare service delivery is a huge challenge. This is compounded by inadequate and poor distribution healthcare facilities, lack of equipment and drugs (Obi et al, 2013; Singh et al, 2014). Like other African countries, faces some challenges in addressing maternal and newborn healthcare services (WHO, 2014). The performance of the health sector remains unsatisfactory even though geographical coverage of the health facilities is considered equitably distributed to all regions and districts, and accessible to 95% of the population. The major challenges in the reduction of maternal mortality include limited access to quality health services, a weak referral system and poor health-seeking behaviour among women (WHO, 2014)
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