Study reveals cost of unsafe abortions in Tanzania

A new medical study has revealed that undercover abortion in Tanzania is common and is a major contributor to maternal death and injury in the country.
According to the study, unsafe abortions pose a major health problem in Tanzania, with lake zone regions recording the highest numbers of unintended pregnancies in the country largely due to low contraceptive use.
Researchers said Tanzania's average national abortion rate was 36 abortions per 1,000 women of reproductive age, which is higher than the abortion rates in Ethiopia (23), Rwanda (25) and Malawi (24).
However, Tanzania's abortion rate is lower than some of its east African neighbours, including Kenya (48 per 1,000) and Uganda’s (37).
Women obtained approximately 405,000 induced abortions in Tanzania in 2013, according to a study conducted by researchers at the US-based Guttmacher Institute and Tanzania’s National Institute for Medical Research (NIMR) and the Muhimbili University of Health and Allied Sciences (MUHAS).
"Zanzibar has the lowest abortion rate at 10.7 per 1,000 women. The Lake zone has by far the highest abortion rate of 51 abortions per 1,000 women," said part of the study titled "Incidence of Induced Abortion and Post-Abortion Care in Tanzania."
"In the Lake zone, the high abortion rate is most likely a consequence of low contraceptive use (lowest in the country) and high unmet need, which are also responsible for the highest unintended pregnancy rate in the country."
Women with unmet needs are described as those capable of producing offspring and sexually active but are not using any method of contraception, and report not wanting any more children or wanting to delay the next child.
The concept of unmet need points to the gap between women's reproductive intentions and their contraceptive behaviour.
The pregnancy rate for Tanzania is 245 per 1,000 women of reproductive age, while the unintended pregnancy rate is somewhat lower at 92.7 per 1,000 women of reproductive age.
The study uncovered that the vast majority of abortions in the country are clandestine procedures that put women’s well-being at risk because of an abortion law that is both highly restrictive and ambiguous.
The researchers, who conducted surveys of health facilities and health professionals and reviewed population and fertility data, estimate that 66,600 women received post-abortion care in health facilities for complications resulting from unsafe abortions in 2013.
However, almost 100,000 women who experienced complications did not receive the medical attention they needed.
The researchers hope that these findings will help inform Tanzania’s ongoing efforts to decrease its maternal mortality ratios, which remain among the highest in the world.
Unfortunately this is an all too common theme across Africa where it is estimated that 1.7 million women are hospitalised due to unsafe procedures, and 29,000 maternal deaths occur each year.
There are only three countries in Africa where abortion is permitted without restriction -- Cape Verde, South Africa, Tunisia.
Even though over 6.4 million abortions happen on the continent every year, only 3% of these happen under safe conditions because of the limitations imposed by legislation. W
omen, particularly those who are underage or unmarried, are more likely to look for a cheaper rate in a dodgy backstreet clinic or visit a “traditional doctor” to assist them in the termination of the pregnancy.
In 2008 the WHO estimated that 14 percent of all maternal deaths on the continent - approximately 29,000 women - were due to unsafe abortion.
For those who survive, there can be complications afterwards - the WHO estimates that about 1.7 million women in Africa are hospitalised annually for complications of unsafe abortion.
Restrictive laws have also meant that hospitals are not properly equipped to provide post-abortion care, common shortcomings include, delays in treatment, shortages of trained health workers and medical supplies, use of inappropriate procedures and judgmental attitudes among clinic and hospital staff towards the patient.

SOURCE: The Guardian
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