TRCHS 1999

Tanzania Reproductive and Child Health Survey

(TRCHS) 1999

Preliminary findings presented by

The RCHS Unit, MOH

TRCHS 1999

Introduction

• National surveys of women and men, and health facilities (1991/92, 1994, 1996, & 1999)

• Presentation will be on indicators from the 1999 survey and trends from prior surveys

• Results presented are preliminary

TRCHS 1999

Main Points

• Comparison of Tanzania to other sub-Saharan African countries

• Knowledge and behaviour regarding HIV/AIDS

• Family planning

• Maternal and child health

• Quality of health facilities

TRCHS 1999

Comparison of Tanzania to Other Sub-Saharan

African Countries

TRCHS 1999

Female Education

4

5

5

10

14

27

28

29

42

67

Mozambique

Malawi

TANZANIA

Eritrea

Uganda

Madagascar

Zambia

Kenya

Zimbabwe

South Africa

Percent of females 15-49 who attended secondary school

TRCHS 1999 2.9

4.0

4.7

5.6

5.6

6.0

6.1

6.1

6.9

South Africa

Zimbabwe

Kenya

TANZANIA

Mozambique

Madagascar

Zambia

Eritrea

Uganda

Number of children per woman

Total Fertility Rate

TRCHS 1999

55

42

32

17

14

14

10

8

5

4

South Africa

Zimbabwe

Kenya

TANZANIA

Malawi

Zambia

Madagascar

Uganda

Mozambique

EritreaPercent

Current use of modern method among married women age 15-49

Modern Contraceptive Use

TRCHS 1999

7

15

18

22

22

24

26

28

Mozambique

Zimbabwe

Zambia

TANZANIA

Uganda

Kenya

Madagascar

Eritrea

Percent currently married women 15-49 with unmet need

Unmet Need for Family Planning

TRCHS 1999

2

5

6

6

8

11

Eritrea

Zambia

Kenya

Malawi

TANZANIA

Zimbabwe

Percent of women using a condom at last sexual intercourse

Condom Use

TRCHS 1999

Percent of children 12-23 months who are fully vaccinated

81

80

78

68

65

63

47

47

41

36

Malawi

Zimbabwe

Zambia

TANZANIA

Kenya

South Africa

Uganda

Mozambique

Eritrea

Madagascar

Vaccination Coverage

TRCHS 1999

Deaths before age five per 1000 live births

59

77

112

136

147

147

159

197

201

South Africa

Zimbabwe

Kenya

Eritrea

TANZANIA

Uganda

Madagascar

Zambia

Mozambique

Under-Five Mortality

TRCHS 1999

Knowledge and Behaviour:

HIV/AIDS

TRCHS 1999

Knowledge of HIV Prevention Among Youth (15-24): 2+ ways

3034

4943 45

53

0

25

50

75

1994 1996 1999

Percent

Women 15-24 Men 15-24

Only half of youth know 2

or more ways of preventing HIV/AIDS

TRCHS 1999

Knowledge of Condoms as Protection Against Pregnancy and STDs

54

40

64

48

0

25

50

75

15-49 15-19

Women Men

Less than half of teenagers know that condoms

protect against pregnancy and

STDs.

Percent

TRCHS 1999

Condom Use WithNon-Regular Partners

23

1619

3229

34

0

10

20

30

40

1994 1996 1999

Women Men

Percent

TRCHS 1999

People Tested for HIV

34

78

1112

0

5

10

15

1994 1996 1999

Women Men

Percent

TRCHS 1999

HIV/AIDS Summary

• Knowledge of ways to prevent HIV has increased

• About half of youth not aware that condoms protect against pregnancy AND STDs

• Condom use with non-regular partners has increased slightly for women; remained about the same for men

• HIV testing has increased slightly

• Condom use and HIV testing are low

TRCHS 1999

Family Planning

TRCHS 1999

Coverage of Zinduka: Percent listening in previous 6

months

322523

4739

35

0

10

20

30

40

50

1994 1996 1999

Women Men

TRCHS 1999

Use of Modern Contraceptives Among All Women 15-49

1211

6

0

2

4

6

8

10

12

14

16

1991/92 1994 1996 1999

15Percent

TRCHS 1999

Contraceptive Method MixAmong All Women 15-49

1996

1999Long-Term

1.9 %

Condom

1.3 %

Injectables 3.7%

Pill 4.8 %

Pill

4.6 %

Long-Term

1.8 %

Condom

3.4 %

Injectables 5.3%

TRCHS 1999

Intention to Use Family Planningin Next 12 Months (among non-users)

3332

17

3127

21

12

0

5

10

15

20

25

30

35

40

1991/92 1994 1996 1999

Women Men

35

Percent

TRCHS 1999

Total Fertility Rates: Number of children per woman

5.65.86.3

0

1

2

3

4

5

6

7

1989-91 1994-96 1997-99

TRCHS 1999

Desired Number of Children

5.5 5.5

5.3

5.6

4.8

5

5.2

5.4

5.6

5.8

6

6.2

1991/92 1994 1996 1999

Women Men

6.0 6.0 6.0

n.a.

TRCHS 1999

Family Planning Summary

• Family planning messages are reaching more people

• Injectables and condoms have led to an increase in contraceptive use

• Among non-users, one-third of women and men intend to use family planning

• Total fertility rate is declining, BUT desired family size remains high

TRCHS 1999

Quality of Health Facilities

TRCHS 1999

Government Health Facilities Offering HIV Counseling and Testing

21

70

1

0

0 25 50 75 100

Percent

Dispensaries

Health Centres

Hospitals

ALL

TRCHS 1999

NGO Health Facilities Offering HIV Counseling and Testing

3

8

45

30

9

0

0 25 50Percent

Dispensaries

UMATI

Health Centres

Hospitals

ALL

Marie Stopes

TRCHS 1999

98

77

59

100 100

0

20

40

60

80

100

120

Hospitals HealthCentres

Dispensaries UMATI Clinics

Marie Stopes

Health Facilities With at Least One Provider Trained Since 1992

Percent

Gov. and NGO/Private Facilities Combined

TRCHS 1999

Facilities With at Least One Trained Provider in Integrated

RH and CH Clinical Skills

27

73

44

28

64

0 10 20 30 40 50 60 70 80

Percent

Gov. and NGO/Private Facilities Combined

Marie Stopes

UMATI Clinics

Dispensaries

Health Centres

Hospitals

TRCHS 1999

Health Facilities With Stockouts of Pills, Injectables, or Condoms

27

11

0

5

10

15

20

25

30

1996 1999

Percent

TRCHS 1999

Quality of Health Facilities Summary

• HIV counseling and testing is offered primarily at hospitals

• Health centers and dispensaries with trained staff in combined RH/CH skills low

• Stockouts of pills, injectables and condoms has declined

TRCHS 1999

Maternal and Child Health

TRCHS 1999

Assistance at Delivery by Trained Provider

5455

0

10

20

30

40

50

60

1991/92 1996 1999

Percent

56

TRCHS 1999

Exclusive Breastfeeding Children Under 6 Months

23

2932

0

10

20

30

40

1991/92 1996 1999

Percent

TRCHS 1999

Children (12-23 months) Fully Immunized

687171

0

10

20

30

40

50

60

70

80

1991/92 1996 1999

Percent

TRCHS 1999

Use of ORS Packets:For children under 3 with diarrhoea

0

10

20

30

40

50

60

70

1991/92 1996 1999

5849

55

Percent

TRCHS 1999

Trends in Under-Five Mortality

150137141

0

50

100

150

200

1987-91 1992-96 1995-99

Children per 1,000 live births

TRCHS 1999

Trends in Infant and Child Mortality

998892

55 5754

0

30

60

90

120

1987-91 1992-96 1995-99

Infant Child

Children per 1,000 live births

TRCHS 1999

Maternal and Child Health Summary

• Key child health indicators have remained the same since 1991

• Under-five mortality has recently increased

• Infant mortality makes up most of the increase in under-five mortality

TRCHS 1999

Achievements

• HIV knowledge and testing has increased

• More women are using condoms with non-regular partners

• Stockouts of contraceptives has declined

• Contraceptive use has increased

• Total fertility rate is declining

TRCHS 1999

Challenges

• Condom use and HIV testing are low

• Desired family size remains high

• Key child health indicators have remained the same since 1991

• High level of disposable glove reuse

• Infant, child, and under-five mortality have recently increased