Safe Motherhood: A Review - Family Care International

Tanzania
Situated on the east coast of Africa, the
United Republic of Tanzania is bordered
by Kenya and Uganda on the north; Rwanda,
Burundi, and the Democratic Republic of the
Congo on the west; and Zambia, Malawi,
and Mozambique in the south. To the east
lies the Indian Ocean. Population distribution
in Tanzania is extremely uneven. Density
varies from 1 person per sq km (3/mi²) in
arid regions to 51 per sq km (133/mi²) in the
mainland’s well-watered highlands. More than
80% of the population is rural, with much of
the livelihood dependent on agriculture. 71 The
population is ethnically diverse, consisting of
over 120 ethnic groups.
Tanzania’s population is estimated at 36.1
million (2004) of whom 51% are female and
47% are under 15 years of age. With the
economy growing in real terms by 6.7% in
2004, Tanzania has one of the highest per
capita income growth rates in Africa.
Ministry of Health (MOH) statistics and
national surveys offer some indication of
the magnitude of women’s health problems
in Tanzania. According to DHS (2004) data,
25% of all women in Tanzania are currently
using a contraceptive method and 17% are
using modern methods. The National AIDS
Control Program estimates the 2003 national
HIV prevalence at 8.8%. Antenatal care
attendance is high at 94% and has remained
at roughly this level since 1992. 72 In 2005,
only 46% of deliveries were attended by a
health professional at a health facility; this
is a decline from 53% in 1992. Less than 2%
of deliveries were conducted by cesarean
section in 2004–2005 as compared to 3% and
2% in 1999 and 1996 respectively. 73
In terms of data on maternal mortality
and morbidity, the Tanzanian government
estimates that for the period 1995–2004
the maternal mortality ratio was 578; in the
preceding ten years, the MMR was recorded
at 529 deaths per 100,000 births. 74 Because
of the statistically insignificant difference
between these figures, it is difficult to
conclude whether national maternal mortality
levels have improved or deteriorated in the
last 20 years. While there is little data on
maternal morbidity in Tanzania, it is estimated
that between 150,000 to 450,000 women
and girls suffer from pregnancy-related
morbidities annually. 75
Despite the high rates of maternal mortality,
it is believed that there is significant
underreporting, with many deaths occurring
outside of health facilities. Many of these
unreported deaths are due to unsafe abortion,
which are not disclosed for fear of stigma
and/or prosecution. Reflecting a recent rise
in mortality from anemia, malaria, and HIV/
AIDS in Tanzania, an increased proportion of
maternal deaths (approximately 40–50%) are
due to indirect causes.
71 United Republic of Tanzania/Ministry of Health. “National Policy Guidelines for Reproductive and Child Health Services.” May
2003.
72 United Republic of Tanzania/ National Bureau of Statistics. Tanzania Demographic and Health Survey, 2004.
(Summary)/1999/1996.
73 United Republic of Tanzania/ National Bureau of Statistics. Tanzania Demographic and Health Survey, 2004. 2004/1999/1996.
As a proportion of all births in a population, C-sections should account for not less than 5% nor more than 15%.
74 Op. cit.
75 Maternal and Neonatal Program Effort Index (MNPI) Tanzania. POLICY Project. Washington DC: 2002.