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