African Health

Publications

Access to institutional delivery care and reasons for home delivery in three districts of Tanzania

Exavery A, Kanté AM, Njozi M, et al. International Journal for Equity in Health 2014;13:48

Delivering at health facilities enables women to receive proper medical attention and care during childbirth, and is encouraged as a single most important strategy in preventing maternal and neonatal deaths. This study assesses facilitators and barriers to institutional delivery in the Rufiji, Kilombero and Ulanga districts of Tanzania. Multivariate analysis showed that institutional delivery is relatively high and significantly dependent on the quality of antenatal care (ANC), better socioeconomic status and between-partner communication about family planning.

 

The Tanzania Connect Project: a cluster-randomized trial of the child survival impact of adding paid community health workers to an existing facility-focused health system

Ramsey K, Hingora A, Kante M, et al. BMC Health Services Research 2013;13(Suppl 2):S6.

Tanzania has been a pioneer in establishing community-level services, yet challenges remain in sustaining these systems and ensuring adequate human resource strategies. Utilization for many services proven to reduce child and maternal mortality is unacceptably low. Tanzanian policy initiatives have sought to address these problems by proposing expansion of community-based providers, but the Ministry of Health and Social Welfare (MoHSW) lacks evidence that this merits national implementation. The Tanzania Connect Project is a randomized cluster trial located in three rural districts with a population of roughly 360,000 (Kilombero, Rufiji and Ulanga).

 

How mistimed and unwanted pregnancies affect timing of antenatal care initiation in three districts in Tanzania

Exavery A, Kanté AM, Hingor A, Mbaruku G, Pemba S, Phillips JF. BMC Pregnancy and Childbirth 2013;13:35.

Early antenatal care (ANC) initiation is a doorway to early detection and management of potential complications associated with pregnancy, and consequently reduces potential maternal and newborn morbidity and mortality. Although the literature reports various factors associated with ANC initiation such as parity and age, pregnancy intentions is yet to be recognized as a possible predictor of timing of ANC initiation. Late ANC initiation is a significant maternal and child health consequence of mistimed and unwanted pregnancies in Tanzania. Appropriate counseling to women, especially those who happen to conceive unintentionally, is needed to minimize the possibility of delaying ANC initiation.

 

Role of condom negotiation on condom use among women of reproductive age in three districts in Tanzania

Exavery A, Kanté AM, Jackson E, et al. BMC Public Health 2012;12:1097.

In regions such as sub-Saharan Africa where women are disproportionately infected with HIV, women are reportedly less capable of negotiating condom use. While knowledge of condom use for HIV prevention is extensive among men and women in many countries, including Tanzania, evidence is limited about the role of condom negotiation on condom use among women in rural Tanzania.This study addresses this gap with the following objectives: (1) to determine the proportion of women with confidence to negotiate condom use with their sexual partners, (2) to describe the prevalence of condom use at the last sexual intercourse and (3) to assess the linkage between condom negotiation and condom use among 15- to 49-year-old women in three districts (Rufiji, Kilombero and Ulanga) in Tanzania. Results show that confidence to negotiate condom use is a significant predictor of actual condom use among women in rural Tanzania.