Browsing by Author "Mbotwa, Christopher H."

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    Comparison of Mortality by Gender and Regions in Tanzania using Direct Standardized Death Rates (DSDR) Method
    (National Insititute of Medical Research (NIMR), 2020-07-24) Kibona, Shadrack E.; Mbotwa, Christopher H.
    Background: Comparison of mortality is very useful in assessing population health. Crude rates can easily be computed from the mortality but they are not good for comparison across groups of the population. The aim of this paper was to compare mortality in Tanzania by region and gender using the 2012 Tanzania Population and Housing Census. Methods: Age-specific death rates for regions, Tanzania Mainland, Tanzania Zanzibar and entire Tanzania were obtained from Mortality and Health monograph data downloadable from the National Bureau of Statistics website. The direct standardization method was used to compare the mortality for male and female populations across all regions of Tanzania Mainland and Zanzibar. Results: Findings show that the mortality is low in Arusha, Manyara, and Kilimanjaro compared to other regions in Tanzania mainland implying that health status for both male and female population in those regions is better than the other regions while it is the worst in Njombe, Iringa, and Kagera implying the poor health status for those regions as compared to the rest regions in Tanzania Mainland. In Tanzania Zanzibar, high mortality was observed in Kusini Unguja and the lowest in Kaskazini Unguja for both male and female populations. By national wise and for almost all regions, the mortality for the male population is higher than that for the female population. Conclusion: Direct standardization methods can save as the best way for comparing mortality because it takes into consideration both the population at risk and the age structure. However, in estimating mortality, crude death rates should be used to give the magnitude while direct standardized death rates should be used for comparison purposes.
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    Determinants for choice of home birth over health facility birth among women of reproductive age in Tanzania: an analysis of data from the 2015-16 Tanzania demographic and health survey and malaria indicator survey
    (Springer Nature, 2020-08-24) Moshi, Fabiola V.; Mbotwa, Christopher H.
    Background While evidence has shown an association between place of birth and birth outcomes, factors contributing to the choice of home birth have not been adequately investigated in Tanzania while more than 30% of deliveries occur outside of health care facilities, and more than 95% of those deliveries are assisted by non-medical providers who are often unskilled. The use of unskilled birth attendants has been cited as a factor contributing to the high maternal and neonatal mortalities in low-resources countries. This study aimed to identify determinants of choice for home birth over health care facility birth in Tanzania. Method: This study used the 2015-16 Tanzania Demographic and Health Survey and Malaria Indicator Survey (2015-16 TDHS-MIS) dataset. A total of 2286 women of reproductive age (15–49 years) who gave birth within one year preceding the survey were included in the analysis. Both univariate and multivariable regression analyses were used to determine predictors for the choice of home-based childbirth over health care facility delivery. Results A total of 805 (35.2%) women had a home birth. After adjusting for confounders, the determinants for choice of home birth were: the level of education (primary education [AOR = 0.666; p = 0.001]; secondary and higher education [AOR = 0.417; p < 0.001]), in reference to no formal education; not owning a mobile phone (AOR = 1.312; p = 0.018); parity (parity 2–4 [AOR = 1.594; p = 0.004], parity 5 and above [AOR = 2.158; p < 0.001] in reference to parity 1); inadequate antenatal visits (AOR = 1.406; p = 0.001); wealth index (poorest (AOR = 9.395, p < 0.001); poorer (AOR = 7.701; p < 0.001); middle (AOR = 5.961; p < 0.001); richer (AOR = 2.557; p < 0.001)] in reference to richest women; and Zones (Southern Highlands, [AOR = 0.189; p < 0.001]; Southern, [AOR = 0.225; p < 0.001]; Zanzibar, [AOR = 2.55; p < 0.001]) in reference to Western zone. Conclusions A large proportion of women birth at home. Unskilled providers such as traditional birth attendants (TBAs), relatives or friends attend most of them. Predictors for home-based childbirth included lack of formal education, poor access to telecommunication, poor uptake of antenatal visits, low socio-economic status, and geographical zone. Innovative strategies targeting these groups are needed to increase the use of health care facilities for childbirth, thereby reducing maternal and neonatal mortality in Tanzania.