Tanzania sees improvement in child health, while risky sexual behavior remains common
DAR ES SALAAM, Tanzania. The 2004-05 Tanzania Demographic and Health Survey (TDHS) released on Wednesday revealed that health indicators for Tanzanian children have improved markedly in the past five years, while family planning and fertility rates are unchanged from the last survey conducted in 1999. Knowledge of HIV/AIDS is high, but less than one-third of men and women know how to prevent maternal-to-child transmission of HIV/AIDS.
The following is a summary of key findings from the survey:
Fertility and Reproductive Health
- The fertility rate in Tanzania has not changed in ten years. Tanzanian women continue to have an average of 5.7 children. This is one of the higher fertility rates in East Africa. Fertility is lower in urban areas (3.6) than rural areas (6.5) and highest in the poorest households (7.3) and among women with no education (6.9).
- More than one quarter of young women age 15-19 have already begun childbearing; 20 percent of women age 15-19 are already mothers and 7 percent are pregnant with their first child.
- One in four married women uses a method of family planning. This is the same rate found in the 1999 survey, but use of modern methods of family planning increased slightly from 17 to 20 percent. This is lower than the use of modern family planning found in Kenya and Malawi, but higher than that found in Uganda, Ethiopia and Rwanda.
- Unmarried, sexually active women were the most likely to use family planning; more than a third said they used a modern method and 15 percent used condoms.
- Most Tanzanian women receive antenatal care (ANC) during pregnancy, but many are not attending ANC within the first three months of pregnancy, as recommended.
- More than half of the births in Tanzania occur at home, and slightly less than half are assisted by a health professional (doctor, clinical officer, nurse, midwife or MCH aide). The majority of women who deliver at home (83 percent) do not receive postnatal care, which can help prevent complications after childbirth.
Child Survival and Child Health
- Infant and child mortality decreased markedly in the past five years. The infant mortality rate for the five-year period before the survey was 68 deaths per 1,000 live births. In 1999, infant mortality was 99 deaths per 1,000 live births. The 2004-05 TDHS found an under-five mortality rate of 112 deaths per 1,000 live births, compared to a rate of 147 five years ago. This is one of the lowest mortality rates in East Africa. Still, this means that currently one in every nine children in Tanzania dies before his or her fifth birthday.
- Other child health indicators also improved. More infants are being exclusively breastfed now than in 1999. Vitamin A supplementation, which helps prevent blindness and infection, rose three-fold since the last survey with almost half of children under age 5 now receiving vitamin A supplements. Young children are facing fewer nutritional challenges than they were five years ago, as the percentages of those too short for their height (stunted), too thin for their height (wasted) and underweight also declined.
- Children’s vaccination coverage did not change substantially. Currently, 71 percent of Tanzanian children have received all of the recommended vaccinations. Rwanda is the only country in East Africa with a higher rate of vaccination coverage.
- Diarrhoea continues to be a major health issue for many Tanzanian children. Although almost all mothers know about Oral Rehydration Salts (ORS), only about half of children who had diarrhea received ORS packets, and many were not given increased fluids as recommended.
- Only 14 percent of rural households own an insecticide-treated bednet (ITN) according to the recent survey results. Almost half of urban households own an ITN despite the fact that malaria is more common in rural areas. Doctors recommend that children under age 5 and pregnant women sleep under ITNs to prevent malaria. However, only 16 percent of young children and 16 percent of pregnant women slept under an ITN the night before the survey.
HIV Knowledge and Sexual Behaviour
- HIV prevention knowledge is still inconsistent in Tanzania. Only about three-quarters of men and women know that using condoms and limiting sex to one uninfected partner reduces the risk of getting HIV. Fewer know that maternal to child transmission of HIV can be reduced by the mother taking drugs during her pregnancy (only 31 percent of women and 36 percent of men). This level of knowledge is similar to that seen in other East African countries.
- Many men and women continue to have higher risk sex (sex with a non-marital, non-cohabiting partner). About one quarter of women and almost half of men reported having higher risk sex. Less than half of them report using a condom at last higher-risk sex.
- Premarital sex is common among young people. Almost 30 percent of young unmarried women (age 15-24) and 43 percent of young unmarried men (15-24) had sex in the year before the survey. About one third of these women and half of these men used a condom the last time they had premarital sex.
The 2004-05 TDHS was based on interviews with over 10,000 women and over 2,600 men. The survey was carried out by the National Bureau of Statistics and funded by a variety of donors through the pooled fund of the Poverty Eradication Division (PED) of the Vice President’s Office. Technical assistance was provided by U.S.-based ORC Macro and funded by the United States Agency for International Development (USAID). The 2004-05 TDHS is the sixth in a series of national surveys carried out through the MEASURE DHS project.
About the MEASURE DHS project: The Demographic and Health Surveys (DHS) project is a global data collection effort funded by USAID and carried out by ORC Macro and in-country implementing organizations. These nationally representative household surveys collect data on demographic patterns, fertility, health, and nutrition for policy and program planning.