Browsing by Author "Moshi, Fabiola V"

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    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, 2020-09-24) 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.
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    Predictors for the uptake of optimal doses of sulfadoxine-pyrimethamine for intermittent preventive treatment of malaria during pregnancy in Tanzania: further analysis of the data of the 2015–2016 Tanzania demographic and health survey and malaria indicator survey
    (Springer Nature, 2021-12-06) Mushi, Vivian; Mbotwa, Christopher H; Zacharia, Abdallah; Ambrose, Theresia; Moshi, Fabiola V
    Background In Tanzania, the uptake of optimal doses (≥ 3) of sulfadoxine-pyrimethamine for intermittent preventive treatment of malaria (IPTp-SP) during pregnancy has remained below the recommended target of 80%. Therefore, this study aimed to investigate the predictors for the uptake of optimal IPTp-SP among pregnant women in Tanzania. Methods This study used data from the 2015–16 Tanzania demographic and health survey and malaria indicator survey (TDHS-MIS). The study had a total of 4111 women aged 15 to 49 who had live births 2 years preceding the survey. The outcome variable was uptake of three or more doses of IPTp-SP, and the independent variables were age, marital status, education level, place of residence, wealth index, occupation, geographic zone, parity, the timing of first antenatal care (ANC), number of ANC visits and type of the health facility for ANC visits. Predictors for the optimal uptake of IPTp-SP were assessed using univariate and multivariable logistic regression. Results A total of 327 (8%) women had optimal uptake of IPTp-SP doses. Among the assessed predictors, the following were significantly associated with optimal uptake of IPTp-SP doses; education level [primary (AOR: 2.2, 95% CI 1.26–3.67); secondary or higher education (AOR: 2.1, 95% CI 1.08–4.22)], attended ANC at the first trimester (AOR: 2.4, 95% CI 1.20–4.96), attended ≥ 4 ANC visits (AOR: 1.9, 95% CI 1.34–2.83), attended government health facilities (AOR: 1.5, 95% CI 1.07–1.97) and geographic zone [Central (AOR: 5, 95% CI 2.08–11.95); Southern Highlands (AOR: 2.8, 95% CI 1.15–7.02); Southwest Highlands (AOR: 2.7, 95% CI 1.03–7.29); Lake (AOR: 3.5, 95% CI 1.51–8.14); Eastern (AOR: 1.5, 95% CI 1.88–11.07)]. Conclusions The uptake of optimal IPTp-SP doses is still low in Tanzania. The optimal uptake of IPTp-SP was associated with attending ANC in the first trimester, attending more than four ANC visits, attending government health facility for ANC, having primary, secondary, or higher education level, and geographic zone. Therefore, there is a need for health education and behavior change interventions with an emphasis on the optimal use of IPTp-SP doses.
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    Predictors of condom use among unmarried sexually active women of Reproductive age in Tanzania
    (National Insititute of Medical Research (NIMR), 2022-08-10) Mbotwa, Christopher H; Moshi, Fabiola V; Mosha, Idda H; Kibona, Shadrack E; Ezekiel, Mangi J; Kazaura, Method R
    Background: Condom is one of the methods for prevention against Human Immunodeficiency Virus and other Sexually Transmitted Infections. It is also considered an effective method for preventing unwanted pregnancies. Despite the several interventions that have been put to promote condom use, still, a large proportion of women do not use condoms during sexual intercourse. Objectives: This study aimed at determining predictors of condom use among unmarried sexually active women of reproductive age in Tanzania. Methods: This study used secondary data from the 2015-16 Tanzania Demographic and Health Survey and Malaria Indicator Survey (2015-16 TDHS-MIS). It involved unmarried sexually active women aged 15-49 years. Multiple binary logistic regression was used to determine predictors for condom use at last sexual intercourse. Results: Overall, a lower proportion (31.1%) of unmarried sexually active women used condoms at last sexual intercourse. The odds of using condoms during last sexual intercourse were lower for older women (aOR=0.67 and aOR=0.65 for women aged 20-24 and 25+ years respectively). Women who reported higher age (18+ years) at first sex had higher odds (aOR=1.65) of using condoms compared to those who started having sex before 15 years old. Women from rich households (aOR=1.5) and those owning phones (aOR=1.44) had higher odds using condoms at their last sexual intercourse. Also, higher odds of using condoms were observed for women in the Southern, South West highlands, and Eastern zones compared to the Central zone. Conclusion: The level of condom use among unmarried women in Tanzania is very low and varies by age, age at sex intercourse, household wealth index status, ownership of a phone and domicile zones. Targeted interventions are needed to promote condom use among unmarried women to mitigate the risk of HIV and unintended pregnancies.
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    Predictors of condom use among unmarried sexually active women of reproductive age in Tanzania
    (National Institute of Medical Research, 2022-08) Mbotwa, Christopher H; Moshi, Fabiola V; Mosha, Idda H; Kibona, Shadrack E; Ezekiel, Mangi J; Kazaura, Method R
    Background: Condom is one of the methods for prevention against Human Immunodeficiency Virus and other Sexually Transmitted Infections. It is also considered an effective method for preventing unwanted pregnancies. Despite the several interventions that have been put to promote condom use, still, a large proportion of women do not use condoms during sexual intercourse. Objectives: This study aimed at determining predictors of condom use among unmarried sexually active women of reproductive age in Tanzania. Methods: This study used secondary data from the 2015-16 Tanzania Demographic and Health Survey and Malaria Indicator Survey (2015-16 TDHS-MIS). It involved unmarried sexually active women aged 15-49 years. Multiple binary logistic regression was used to determine predictors for condom use at last sexual intercourse. Results: Overall, a lower proportion (31.1%) of unmarried sexually active women used condoms at last sexual intercourse. The odds of using condoms during last sexual intercourse were lower for older women (aOR=0.67 and aOR=0.65 for women aged 20-24 and 25+ years respectively). Women who reported higher age (18+ years) at first sex had higher odds (aOR=1.65) of using condoms compared to those who started having sex before 15 years old. Women from rich households (aOR=1.5) and those owning phones (aOR=1.44) had higher odds using condoms at their last sexual intercourse. Also, higher odds of using condoms were observed for women in the Southern, South West highlands, and Eastern zones compared to the Central zone. Conclusion: The level of condom use among unmarried women in Tanzania is very low and varies by age, age at sex intercourse, household wealth index status, ownership of a phone and domicile zones. Targeted interventions are needed to promote condom use among unmarried women to mitigate the risk of HIV and unintended pregnancies.