Temeke Municipality Research Articles

Barriers to engaging fathers in supporting exclusive breastfeeding by HIV positive mothers in Temeke, Dar es Salaam, Tanzania

Background/Aims The low rate of exclusive breastfeeding among mothers living with human immunodeficiency virus (HIV) has been attributed to limited spousal support, and evidence shows that support from a male partner has a positive influence on HIV positive mothers' adherence to exclusive breastfeeding. There is a lack of research data on fathers' experiences of barriers to supporting their HIV-positive partners with exclusive breastfeeding for the first 6 months. This paper reports the results of a study that aimed to explore barriers to fathers' engagement in supporting exclusive breastfeeding by HIV-positive mothers in an urban setting in Tanzania. Methods A qualitative case study design was used in Temeke Municipal Council, at clinics for the prevention of mother to child transmission of HIV in four public health facilities. Purposive sampling was used to select 30 participants who took part in in-depth interviews. Data were digitally recorded, transcribed verbatim and translated from Kiswahili to English before being thematically analysed. Results Barriers to fathers' engagement in supporting exclusive breastfeeding included unstable income, inconvenient clinic hours, gender stereotypes, less emphasis on postpartum male involvement in prevention of mother-to-child transmission of HIV and stringent work regulations that provide very limited paternity leave. Conclusions This study has generated some insight into the main barriers to fathers' engagement in supporting exclusive breastfeeding among mothers with HIV. This knowledge can be applied to strengthen the role of fathers in prevention of mother-to-child transmission of HIV.

School Quality Assurance Guidelines: Its Implementation and Challenges in Public Secondary Schools in Temeke Municipality, Tanzania

Quality assurance guidelines are indispensable elements in quality effectiveness and maintenance. The guidelines put more consideration on strengthening and promoting the quality of the teaching and learning process. This study aimed at assessing the implementation of quality assurance guidelines in promoting the quality of teaching and learning. It was guided by two research objectives; to describe the status of school quality assurance implementation, and to identify the challenges encountered by the internal and external School Quality Assurance Officers during quality assurance exercises. The study adopted a Mixed Methods research approach and a descriptive survey design. The targeted sample was drawn from Temeke Municipality and included six public secondary schools, 60 students, 34 teachers, 6 head of schools, 3 ward district officers, 1 district education officer and 6 district quality assurance officers. Data was analyzed using descriptive statistics and cross-tabulation. A synthesis of the findings revealed that public secondary schools in Temeke Municipality were exposed to quality assurance exercises by the school quality assurance officers. The findings also revealed that quality assurance reports were only shared to Education officer, Head of school, and teachers. Other stakeholders like students and ward education officers were not given the reports. On the basis of the findings, it was concluded that quality assurance guidelines are fairly implemented in secondary schools in Temeke Municipality. However, challenges such as shortage of funds, shortage of staff, lack of working facilities, overcrowded classrooms, and lack of transport and materials for SQAOs made it impossible for the guidelines to be effectively implemented and thus impeded the acquisition of educational competencies among students in public secondary schools in Temeke Municipality, Tanzania. Therefore, educational stakeholders should ensure adequate provision of resources to schools to facilitate the effective implementation of the quality assurance guidelines as stipulated in the NSQAF, (2017).

The Effectiveness of Guidance and Counseling Practices on Students’ Career Development in Secondary Schools in Temeke Municipality

This study intended to examine The Effectiveness of Guidance and Counseling Practices on Students’ Career Development in Secondary Schools in Temeke Municipality using embedded research design. It was undertaken in Temeke Municipality, Dar es Salaam Region, Tanzania. The target population was heads of secondary schools, teachers, students, and ward educational officers. The sample size used comprised of 15 teachers, equivalent to 10% of the 150 teachers in the selected secondary schools, three school heads, and 120 students as 10% of 1,200 students from Forms III and IV. Probability and non-probability sampling tactics were employed in the selection of respondents from the targeted population. Observation method, documentary review, interview guide and questionnaires were used to collect primary data while secondary data were obtained in the documents. Data were analyzed both quantitatively and qualitatively. The findings reveal the existing lack of specialized personnel in the field of career guidance and counseling. Instead, teachers are randomly picked to hold that position; a teacher seen to be morally upright and religious is appointed and tries to do the best possible to support these students. Through the study, there was glaring evidence that the tight school timetable does not give room for students to consult their teachers –particularly the time table for extra-curricular activities. It has been established, according to the survey, that guidance and counseling practices face limited teaching and learning materials, counseling offices, negative perception from students and limited support from the government. The findings also show that students experience little support from parents and teachers. Schools in the sample lacked special counseling rooms and even confidentiality from teachers. It is, thus, recommended that special in-service training and seminars should be provided to teachers expected to be school guidance-counselor and there should be financial support from parents, government and the community at large.

The Role of Traditional Methods and Case Management Approach in Preventing Teenage Pregnancy in Tanzania: A Case of Temeke Municipality, Dar es Salaam Region

This article presents an empirical evidence-based analysis of traditional methods that include initiation ceremonies and a modern approach called case management approach in preventing teenage pregnancy in Tanzania. It is based on a qualitative study with a sample size of 20 participants. The first objective was niched around the premises of assessing traditional methods of preventing teenage pregnancy, premised on cultural norms and values, which have been weakened. The second objective was focused on a case management approach (introduced by the researcher) as a child protection mechanism and behavioral control that filled the gap left by traditional methods. The findings indicate that, through symbolic interactionism, traditional values and norms that held the community together are on the wane. Therefore, case management approach has proven to help in controlling early pregnancy to teenage girls. This study recommends that by combining traditional methods and a case management approach, pregnant teenagers will be actively involved in decision making and being part of the solution and change agents for community's attitudes and perceptions. The study concludes that case management is increasingly becoming important as the social fabric on which traditional methods are anchored in preventing teenage pregnancy.

Proper Use of Latrine and Handwashing Facilities among Primary School Students. A Case of Peripheral Schools in Temeke District

Background: Each year two million students die from diarrheal diseases, making it the second most serious killer of students under the age of five (WHO, 1998). The use of sanitation facilities is known to interrupt the transmission of faeco oral related disease. This study assessed proper use of latrine and handwashing facilities among primary school students as the potential behavior aspect for transmission of microbes. Methods: A descriptive cross sectional study was conducted involving 307 students and 12 Teachers who are heads of health clubs, making a total of 319 participants. The study was conducted at Mbagala charambe which is found in Temeke Municipal at Mbagala ward in Dar es Salaam region which involved primary schools which were Nzasa, Chemchem, kilamba ,St Mary’s international, Rangi tatu and charambe primary. Observation method, interview and questionnaire methods of data collection were employed. All the data were analyzed by the use of STATA to obtain proportional and percentages whereby they were presented in terms of table, graph and charts. Results: Most of the participants 66% were female and 34 % were male but also almost 51.5% of the schools had soap for hand washing in their latrine. Inhibitors which makes the proper use of latrine being infringe at schools were lack effective water supply as the main inhibitor followed by lack of knowledge and broken of the facilities. No school had fixed HWF. Conclusion: The study shows the need for further improvement of the existing sanitation programs like CLTS and FOLLOW – UP MANDONA to equip with the behavior aspect which will have a potential change on the proper use of latrines and HWF hence will assist most into affecting attitudes hence attain the behavior change maturity. But to have a scaling up U plan for schools which will address various issues such as the crosscutting issue of menstrual hygiene. So it is only the proper use of the latrine which will make student abstain from diarrheagenic or ill health cycle

Knowledge of Child Sexual Abuse Warning Signs among Secondary School Children in Temeke – Tanzania

The study aimed at assessing the level of warning sign knowledge as the primary prevention measure among secondary school children in Temeke Municipal. Specifically, the study intended to establish the knowledge level of warning signs as well as identifying common and least known warning signs among children. This study was a descriptive in nature which employed a sample size of 175 research subjects. Data was collected through self-administered questionnaire; where the study was carried out in five secondary schools in Temeke. The study findings revealed that children have limited knowledge of warning signs; though, scores among identified warning signs had marginal differences. Further, fear of some people or places, developing lying habit and the knowledge of good, bad and confusing touching were identified by the research subjects as the common warning signs while developing new names of the genital was identified as the least known warning sign among others. Thus, the study recommends for programs geared towards imparting knowledge of warning signs in order to combat incidents of child sexual abuse.

LEVEL OF PARTICIPATION IN DOMESTIC SOLID WASTE MANAGEMENT AMONG RADIO LISTENERS IN DAR ES SALAAM CITY, TANZANIA

Effective management of domestic solid waste (DSW) is vital for human health and environmental protection. This can be achieved by involving various stakeholders, especially the local people, where knowledge and awareness of the effective management of DSW are required. Also, a positive attitude towards the issue of management with a good perception of cleanliness is among the fundamental factors that influence effective participation in domestic solid waste management (DSWM). The main objective of this paper is to determine the level of radio usage, awareness, perception, attitude, and participation in DSWM among radio listeners in Dar es Salaam City, Tanzania. This study tested the effectiveness of development communication theory (DevCom-theory) in disseminating DSWM information through radio programs. The study employed a quantitative research design, using the survey method with a questionnaire as the research instrument for data collection. A total of 392 respondents from Temeke Municipality participated in this study. The results show positive and significant levels of radio usage, awareness, perception, attitude, and participation in DSWM. Participation in DSWM was the highest-rated variable compared to the other variables. In addition, almost all items of the tested variables revealed insignificant differences by categories of gender, education, and household income.

Biomass to liquefied petroleum gas cooking energy: A solution to indoor pollution ailments in Temeke Municipality, Dar-Es-Salaam

In 2010 World Health Organization estimated that three people per minute die prematurely in Sub-Saharan Africa from diseases attributable to Indoor Air Pollution (IAP). About 95% of Tanzanians still use biomass cooking fuels (BCF) which is the main source of IAP. Promotion of Liquefied Petroleum Gas (LPG) was done since mid-2000s to substitute BCF. However, the use of LPG accounts for only 7.2% of Tanzanians to date. Therefore this paper examined factors influencing use of LPG in Temeke municipality - Dar-es-Salaam. Data were collected from 160 respondents using questionnaires and analysed by using Probit regression model. Results revealed that education level of a household head, household income and time saved for cooking had significant effect on use of LPG at a probability level of P<0.1. The probability of using LPG increased by 3.4% with an increase of one more year of education for household heads attaining formal education. Moreover, the probability of using LPGs increased by 11% among household heads whose monthly income increased by 1million Tanzanian Shillings (USD 409). Surprisingly, the probability of using LPG decreased by 0.2% as households saved an additional minute compared to using biomass fuels. It is recommended that the government, private sector and development partners promote LPG use through awareness creation; incorporating LPG use in education and energy policy and conducting research on ‘value engineering of LPG cooking facilities’ to reduce costs for users.

Assessment of women food vending and local soap making micro enterprises in Temeke Municipal: A Costs Benefit Analysis approach

Assessment of women food vending and local soap making micro enterprises in Temeke Municipal: A Costs Benefit Analysis approach

Human Resources Management in the Implementation of School Mapping and Micro Planning of Public Primary Schools in Temeke Municipality, Tanzania

The paper examines human resources management in the implementation of School Mapping (SM) and Micro Planning (MP) of public primary schools in Temeke Municipality, Tanzania. The study was guided by the main question "How was the critical capacity of human resources during the implementation of SM and MP?” The approach used in the study was qualitative employing multiple case studies design. The respondents of the study were 92 while the selected public primary schools were 10. The respondents selected were primary school teachers, head teachers, school committee members and education officers at ward and educational level. Methods of data collection were semi-structured interview, focus group discussion, non-participant observation and documentary review. Data were analyzed using qualitative content analysis. The research findings revealed that there was improvement in the management of human resources as attested in the aspects of recruitment of head teachers, qualifications, training, professional development and motivation in schools. The study concluded that the critical capacity of human resources in public primary school can be enhanced by the implementation of SM and MP. The study recommends that the implementation of SM and MP of public primary school should be an ongoing process as it improves the management of human resources the decentralized level.

The Application of Para Social Work Training in Physically and Sexually Abused Girls Under 18 Years of Age in Tanzania: A Case Study of Temeke Municipality, Dar es Salaam Region

The article presents a case of Para Social work training which basically aim at explaining how this training is essential in providing care and support to young Girls who are physically and sexually abused in Tanzania. It attempts to explain how the victims’ families with the help of Para Social workers can be linked to much-needed services. The objective of this study was to examine the application of Para Social work training in physically and sexually abused girls in Temeke Municipal, Dar es Salaam region. The study was also set to explore possible measure used to reduce the risk of physically and sexually abuse among young girls in addition to Para Social work training in Temeke Municipal, Dar es Salaam region. A major framework of sociological theory was used. The symbolic interactionism was employed in this study to explore symbolic meanings that community members developed and used in the process of social interaction. The family members of abused girls would interpret the behaviour of the young girls and therefore form the social bond which later was used to inform the community members about the problem that they were facing. This theoretical perspective helped the Para Social worker to make sense of the life experiences of young girls’ and understand their coping strategies including the increasing capacity of Para Social workers to access resources for improving care for young girls and their families. Further the theory increased capacity to understand how Para Social workers could generate the Eight (8) Years Plan for Development which was used in protecting young girls against physical and sexual abuse within their community. The theory enlightens community volunteers and Para Social workers in planning for various interventions in violence against children in Tanzania. Further, the study confirmed that community volunteers and Para Social workers suggested on the use of National Plan of Action for their interventions especially in emerging issues that needed their attention especially in reducing the problem of violence against children in their communities. This perspective helped to capture the behaviour of young girls and how they symbolically navigate their lives. The meaning and significance of young girls and the effect of abuse enable us to capture the social reality of those who dealt with the abuse and the measurement to reduce the problem using their own perspectives. This study used qualitative approach which included in-depth Interview and Focus Group Discussion (FGD). Also purposive sampling was used whereby 50 informants were selected as a sample size of this study. The informants came from Temeke district in Dar es Salaam region.The Findings revealed that, since the development of Para Social work trainings in 2006, most vulnerable children especially young girls have enabled Para Social workers to be fully equipped and be able to apply relevant social policies effectively. Such policies include Sexual Offences Provisional Act of 1988(SOSPA), Child Development Policy of 2008 and the Law of the Child Act number 21 of 2009. Furthermore the Para Social work training has facilitated the process of identifying young girls who is abused. Thereafter Para Social workers have helped the girls’ families to develop and implement a plan of support.The study recommends to Para Social workers that young girls need to be understood in terms of situation and be protected from hazardous condition including physical and sexual abuse within their communities. Further the study recommends that it is important to strengthen child protection systems so that all kinds of abuse are addressed and worked on clearly in their communities. As for policy makers and law makers’ young girls have to be in their agenda for change. Para Social workers participation in this training is important as there are no enough staffs at the ward and village levels who could work for social workers. The availability of Para Social workers will facilitate linkages to available resources which are important for young girls’ growth and development. The attitude and perceptions towards using Para Social workers to help community members including the parents and other family members of young girls need to be changed for the benefit of the community members they serve.

Medication challenges for patients with severe mental illness: experience and views of patients, caregivers and mental health care workers in Dar es Salaam, Tanzania

BackgroundManagement of patients with mental disorders is inadequate in the majority of low and middle income countries. The main treatment modality for patients with severe mental disorders in these countries is mainly pharmacological approach. Patients face many challenges in meeting medication needs. In this context, high percentages of individuals who have severe mental disorders are not treated. Regular and adequate supplies of appropriate, safe and affordable medications are some of the important aspects required for provision of quality mental health services. Psychotropic medications are an important component of holistic care that provides treatment options for those suffering from mental illnesses. In Tanzania, mental health services face many challenges including inadequate mental health care providers, infrastructure, and medication supply. Relapse is a common problem among patients attending mental health facilities. This study is aimed at exploring views and experiences of patients, caregivers and mental health care providers on the psychotropic medication in Dar es Salaam, TanzaniaMethodsA qualitative study was conducted, involving two focus group discussions with seven and nine caregivers in each group. Eleven in-depth interviews with four patients and seven mental health care providers at Temeke Municipality, Dar es Salaam, were conducted. Convenient sampling procedure was used to select participants for the study. Discussion and interview guides were used during data collection. Interviews were audio-recorded in Kiswahili with all study participants. The recorded interviews were transcribed and qualitative content thematic analysis was used to analyze data after translation.ResultsFour themes were identified. These include attitudes of patients towards psychotropic medication, availability of psychotropic medications, financial concerns towards psychotropic medications, and coverage of free treatment policy.ConclusionThe availability and affordability of psychotropic medications to patients are big problems. This was partly attributed to insufficient funds to support the budget of health facilities and technical challenges contributed by both the health facilities and other stakeholders. To improve mental health services in the country, it is important to ensure adequate supply of psychotropic medications in the health facilities. Access to psychotropic medications is essential in addressing the public health problem of untreated mental illnesses. These findings call for the government and other stakeholders to increase funding for essential psychotropic medications.

The psychosocial problems of families caring for relatives with mental illnesses and their coping strategies: a qualitative urban based study in Dar es Salaam, Tanzania.

BackgroundMental illness may cause a variety of psychosocial problems such as decreased quality of life of the patient’s family members as well as increased social distance for the patient and the family caring for the patient. Psychosocial challenges are enhanced by the stigma attached to mental illness, which is a problem affecting not only the patient but also the family as a whole. Coping mechanisms for dealing with mentally ill patients differ from one family to another for a variety of reasons.The aim of the study was to determine the psychosocial problems of mental illness on the family including the coping strategies utilized by family members caring for a person with mental illness.MethodA qualitative study was conducted, involving four focus group discussions and 2 in-depth interviews of family members who were caring for patient with mental illness at Temeke Municipality, Dar es Salaam. Purposive sampling procedure was used to select participants for the study. Audio-recorded interviews in Swahili were conducted with all study participants. The recorded interview was transcribed and qualitative content thematic analysis was used to analyse the data.ResultsFinancial constraints, lack of social support, disruption of family functioning, stigma, discrimination, and patients’ disruptive behaviour emerged as the main themes in this study. Acceptance and religious practice emerged as the major coping strategies used by family members.ConclusionFamilial care for a person with mental illness has its advantages, yet it has multiple social and psychological challenges. Coping strategies and skills are important for the well-being of the caregiver and the patient. Addressing these psychosocial challenges requires a collaborative approach between the health care providers and government so that the needs of the family caregivers and those of the patients can be addressed accordingly.

A Physico-Chemical and Bacteriological Investigation of Groundwater Quality for Domestic Supply, A Case Study of Temeke Municipal

A Physico-Chemical and Bacteriological Investigation of Groundwater Quality for Domestic Supply, A Case Study of Temeke Municipal

Access to Mass Media and Rejection of Gender Inequitable Norms among Unmarried Youth in Dar es Salaam, Tanzania

Despite extensive evidence on the link between gender norms and adolescent sexual and reproductive health (ASRH), less research has been conducted to assess the role that access to mass media plays in shaping these norms. This article is based on a study that sought to contribute to filling this research gap. The primary objective of the study was to determine young males’ and female’s attitudes and perceptions towards traditional gender norms. The second objective was to investigate the association between mass media consumption by youth and rejection or acceptance of gender equitable norms. Using a scale called Gender Equitable Men (GEM), this study conducted a cross-sectional survey among 777 unmarried youth (52.1% male and 47.9% female) in selected wards of Temeke municipality in Dar es Salaam, Tanzania between December 2011 and January 2012. The results show that youth support to gender equitable norms is relatively high (91% male and 83% female). Also, there are important correlations between youth’ support for gender-equitable norms and their background characteristics. Comparatively, unmarried male youth have higher support to gender equitable norms than unmarried female youth. However, the relationship between access to mass media and support for gender equitable norms is not linear. The conclusion is that access to mass media alone is not sufficient to determine support to gender equitable norms, which later impact on adolescent sexual and reproductive health. Thus, more attention needed on broad social contexts that mediate linkage between the two. Programmatic and policy implications of these findings are also discussed.

Knowledge on management of fever among mothers of undertens in Dar Es Salaam, Tanzania.

To explore on mothers' knowledge on fever and its management as well as assess treatment received by under 10 year-old children (undertens) having fever prior to being presented in outpatient departments at two Municipal hospitals. Data were collected using a semi-structured questionnaire interviews among mothers of undertens, who had problems of fever and presented at the two Municipal hospitals viz. Mwananyamala and Temeke Municipal hospitals, in Dar es Salaam. A total of 301 respondents were interviewed. Of those, 151 had male and 150 and female undertens, whose ages ranged from 1 month to 10 years-old with median of 2 years. Minority (32%) of the interviewees were unaware of possible causes of fever, while 52% attributed it to malaria. About 25% of the respondents regard fever as a minor health problem, thus they did not seek medical attention unless other severe symptoms were manifested. Majority (88.4%) of the respondents self-medicated, and out of those 24% used antimalarials and antipyretics, while 7.6% used both antipyretics and antibiotics for alleviation of fever. On arrival in OPDs, only 62.4% of the respondents were prescribed with antimalarial agents. Approximately 18% of the interviewees admitted to have had changed medications due to unresponsiveness to the previously prescribed drugs. Pharmacies were the main sources of the self-medicated drugs (n = 272; 90.4%). Fever is a public health concern among undertens, which contributed to high rate of self-medication and irrational use of medicines. However, respondents demonstrated adequate knowledge on fever and on its management though fever was associated with underlying causes.

Knowledge and perception of mothers and caregivers on childhood diarrhoea and its management in Temeke Municipality, Tanzania

Diarrhoea is an increase in volume of stool or frequency of defecation. It is one of the most common clinical signs of gastrointestinal diseases, but also can reflect primary disorders outside of the digestive system. This cross-sectional descriptive survey was conducted in Temeke Municipality, Dar es Salaam over a 4-month period to investigate on knowledge and perception of mothers/caregivers of underfives on childhood diarrhoea. Specifically, the study focused on frequency of diarrhoeal episodes and their risk factors as well as effectiveness of traditional remedies used for its management prior to seeking medical attention. A semi-structured questionnaire was used for data collection, through which a total of 161 mothers were interviewed. Of those, 74 (46%) had female and 87 (54%) had male underfives with median age of 2-years. Frequency of diarrhoeal episodes was high among the underfives and was comparable between females and males (87 vs 74; P<0.05). Medicinal plants were the most common traditional remedies employed by majority (71%) of the interviewees, which have been purported to be effective in management of childhood diarrhoea. Guava (leaves and fruits) was the most commonly used remedy in the treatment of diarrhoea. Mothers' knowledge on predisposing factors of childhood diarrhoea was poor, which was directly correlated with education level. Only about one-third of the respondents (31%) were aware of risk factors for childhood diarrhoea that cited poor sanitation and water as the main factors. Diarrhoeal episodes were perceived wrongly as normal growth stage and that were caused by several other "illnesses". It is important that further studies on traditional remedies should be carried out to validate their usefulness in the treatment of childhood diarrhoea.

Family perceptions in caring for children and adolescents with mental disabilities: a qualitative study from Tanzania

Observations have shown that the provision of services to children and adolescents with mental disability (CAMDs) is not responding to the needs of this population. This community based study was carried out in Temeke Municipality in Tanzania and aimed to explore factors that influence family perspectives in the provision of care to CAMDs. This is a qualitative study of 52 respondents from 29 families involved in the daily care of CAMDs, chosen through convenient sampling. A semi-structured questionnaire was used in the interviews. The text was analysed using thematic content analysis. The results of the study revealed family characteristics; deficient knowledge about mental disability (MD); and lack of health care facilities and resources for caring for CAMDs. The community and families of CAMDs had poor knowledge on MD and appropriate care, and about availability of resources and quality care. Families were not supported in the care of their children. Some children in consequence did not receive adequate health care. Some suffered from physical problems due to inadequate care; others were being locked in their room during periods when no-one was able to look after them. These factors were related to socio-economic characteristics of the families as well as to lacking service facilities. “Patient”-oriented, community/family-based health services to support management of chronic or life-long conditions such as MD are needed. The support of caregivers to children with MDs has to be improved. A well worked-out strategy would improve health care of CAMDs through provision of guidance and supervision to the families. Community and family/home-based care in the study area would benefit families of CAMDs.

Unsafe abortion in urban and rural Tanzania: method, provider and consequences

To describe unsafe abortion methods and associated health consequences in Tanzania, where induced abortion is restricted by law but common and known to account for a disproportionate share of hospital admissions. Cross-sectional study of women admitted with alleged miscarriage: 278 in rural Tanzania and 473 in urban Tanzania. Women who had undergone a clandestinely induced abortion were identified by an empathetic approach and interviewed in detail about the procedure. Information about complications was obtained from the patient file. Sixty-two per cent in rural Tanzania and 63% in urban Tanzania stated that they had had an unsafe induced abortion. The abortion had been induced by an unskilled provider in 46% of rural women and 60% of urban women. Herbs and roots had commonly been used for induction, in 42% of rural and 54% of urban women. The method most often associated with abortion complications was catheter/roots, whereas the method least often associated with complications was herbs. The large number of women identified as having had unsafe abortion together with the prevalent use of herbs calls for attention.

A longitudinal study on different models of postabortion care in Tanzania.

To identify women having unsafe abortions and elucidate whether an acceptable follow-up rate among these women can be retrieved. One thousand three hundred and fifty-seven women attended Temeke Municipal Hospital, Dar es Salaam with an abortion-related diagnosis. Women having unsafe abortions were identified by an empathetic dialogue, offered a contraceptive service and asked to return for follow-up. Three different ways of achieving follow-up information were tested. In phase 1, a combination of hospital-based and home-based interviews was utilized, in phase 2, an additional 1-month control visit was added to the protocol, and in phase 3, the contraceptive counseling and service was provided by technically well-skilled counselors. Seven hundred and eighty-eight women were identified as having had unsafe abortions and 491 women as spontaneous abortions. Women having unsafe abortions were younger, more often single and of higher parity than women having spontaneous abortions. The follow-up rate achieved varied from 47%-72%, being lowest in phase 1 and highest in phase 3. The two most common reasons for loss to follow-up were the interviewer's inability to locate the respondent's house either because of an unspecific or a remote address (58%) and migration (29%). If hospital-based and confidential home-based interviews are used combined and if the women having unsafe abortions are counseled by technically well-skilled counselors, it is possible to achieve a reasonable follow-up rate among women having unsafe abortions.