Abstract
BackgroundTanzania has one of the highest maternal mortality ratios in the world, and unsafe abortion is one of its leading causes. Yet little is known about its incidence.ObjectivesTo provide the first ever estimates of the incidence of unsafe abortion in Tanzania, at the national level and for each of the 8 geopolitical zones (7 in Mainland plus Zanzibar).MethodsA nationally representative survey of health facilities was conducted to determine the number of induced abortion complications treated in facilities. A survey of experts on abortion was conducted to estimate the likelihood of women experiencing complications and obtaining treatment. These surveys were complemented with population and fertility data to obtain abortion numbers, rates and ratios, using the Abortion Incidence Complications Methodology.ResultsIn Tanzania, women obtained just over 405,000 induced abortions in 2013, for a national rate of 36 abortions per 1,000 women age 15–49 and a ratio of 21 abortions per 100 live births. For each woman treated in a facility for induced abortion complications, 6 times as many women had an abortion but did not receive care. Abortion rates vary widely by zone, from 10.7 in Zanzibar to 50.7 in the Lake zone.ConclusionsThe abortion rate is similar to that of other countries in the region. Variations by zone are explained mainly by differences in fertility and contraceptive prevalence. Measures to reduce the incidence of unsafe abortion and associated maternal mortality include expanding access to post-abortion care and contraceptive services to prevent unintended pregnancies.
Highlights
With the 2015 Millennium Development Goals (MDG) deadline upon us, countries are evaluating their progress in reaching their targets
Measures to reduce the incidence of unsafe abortion and associated maternal mortality include
The primary data for this study come from two surveys conducted by the authors: a Health Facilities Survey (HFS) to measure the number of abortion complications treated in health facilities, and a Health Professionals Survey (HPS) to estimate the likelihood of women experiencing abortion complications and of obtaining treatment at a health facility
Summary
With the 2015 Millennium Development Goals (MDG) deadline upon us, countries are evaluating their progress in reaching their targets. In national consultations on the post-2015 development agenda, reducing maternal mortality was upheld as one of the ten key goals. This cannot be achieved without addressing one of its leading causes, unsafe abortion. Global and regional estimates of abortion incidence indicate that abortions are no less common, and much more likely to be unsafe, in settings with restrictive laws than in settings with liberal laws [5]. According to regional estimates, in 2008 there were 2.4 million unsafe abortions, or 36 per thousand women of reproductive age, in East Africa [6]. Tanzania has one of the highest maternal mortality ratios in the world, and unsafe abortion is one of its leading causes.
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