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SOCIAL DETERMINANTS OF HEALTH
Angela Kimweri
Overview
• Introduction to SDH
• Core SDH issues in Tanzania
• SDH policies and strategies
• Results from INTREC research
• Recommendations
Objectives of the workshop
• Workshop outcome
Understanding about SDH
Research that link social Determinants of Health and healthcare outcomes;
Social determinants of health conceptual framework
“Social Determinants of Health in
Tanzania” • Social-Physical-Economic-Services Determinants Gender Age Geographical location Malnutrition Poor budget allocation for health care Lack of human resource for health Social inequality Lack of social protection and specialized care for
elderly Unequal distribution of income and resources Education for children Poor link between policy and practices
(Source: By Rose Kalage, INTREC student 2012: Mapping SDH)
Relevant SDH polices and strategies
• National strategy for Growth and Poverty Reduction (II)
• National Health Policy
• National Aging Policy
• Tanzania Development vision 2025
• Multisectoral approach to SDH
Results
Research Title: Assessing the association between gender of the household head and adolescent pregnancy in Tanzania.
Methods: A cross section survey, using DHS 2010 , conducted with 2019 currently pregnant adolescents.
Data analysis: we applied bi-variate and multi-variate logistic regression technique to find out how gender of the household head and other social determinants factors associated with teenage pregnancy.
Results Table 2. Percent distribution of adolescent by background
characteristics in Tanzania
Variable % of adolescents who are currently pregnant
P-values
Marital Status Single Married Ever married
3.4 10.8 11.8
<0.001
Education No education Primary Secondary
11.3 8.6 1.4
0.015
Place of residence Urban Rural
4.6 10.2
<0.001
Religion Muslim Catholic Protestant None
6.4 8.7 11.8 10.7
0.021
Sex of the household head Male Female
9.7 6.2
0.035
Results cont…..
Multivariate logistic regression of factors associated with adolescent pregnancy in Tanzania
Variable Odds ratio (OR) 95% confidence interval (CI)
P-value
Sex of the household head Male (ref) Female
1 0.71
0.44-1.44
0.165
Marital status Single (ref) Married Ever married
1.00 2.88 3.68
1.71-4.86 1.82-7.46
<0.001 <0.001
Education No education (ref) Primary Secondary
1.00 0.90 0.18
0.63-1.25 0.02-1.38
<0.001
Place of residence Rural (ref) Urban
1.00 1.93
1.18-3.20
0.009
Survey year 1991 (ref) 1996 1999 2004 2009
1.00 0.76 0.79 1.54 1.39
0.50-1.35 0.42-150 1.03-2.33 0.89.219
0.038
Conclusion
• Various factors are interconnected • Adolescent are both affected by marital status,
Education, religion, and place of residence. • Early marriage as one significant factor for
adolescent pregnant • No significant effect between head of household
and adolescent pregnant however need further analysis
Recommendation
• Government
• • Incorporate SDH in all its major programmes and in the programmes of other ministries/sectors
• • Commitment/political will
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