HD-Background Selector

2011 In Article

"ETHNOPHARMACOLOGICAL RELEVANCE: Women in Tanzania use plants to induce abortion. It is not known whether the plants have an effect. AIMS OF STUDY: Collect data on plant use in relation to induced abortion and test the effect of plant extracts on uterine contraction. MATERIALS AND METHODS: During interviews with traditional birth attendants and nurses, plants were identified. Cumulative doses of plant extracts were added to rat uterine tissue in an organ bath, and the force and frequency of contractions recorded. Acetylcholine was used as positive control. RESULTS:21 plant species were tested for effect on uterine contraction. 11 species increased the force of contraction, and 12 species the frequency of contractions. The strongest contractions comparable to the maximum response obtained with acetylcholine were obtained with extracts of Bidens pilosa, Commelina africana, Desmodium barbatum, Manihot esculenta, Ocimum suave, Oldenlandia corymbosa and Sphaerogyne latifolia. 7 species increased both the force and frequency of contractions. CONCLUSION: Several of the plant species induced strong and frequent contractions of the uterus, and can be used to induce an abortion."

2005 In Article

INTRODUCTION: It is well recognized that unwanted pregnancies and unsafe abortion are significant public health problems in sub-Saharan Africa. At the International Conference on Population and Development held in Cairo in 1994, post-abortion care was prioritized as a means to reduce maternal morbidity and mortality associated with unsafe abortion. However, only a few post-abortion care programs have been implemented and most of them have been confined to urban settings. The present study describes the magnitude of the problem of unwanted pregnancies among women with incomplete abortion in urban and rural Tanzania and evaluates the outcome of a post-abortion care intervention. METHODS: Data were collected among 781 women admitted with incomplete abortion in Dar es Salaam region (urban Tanzania) and 575 women in Kagera region (rural Tanzania). RESULTS: Sixty-seven percent of the women in urban Tanzania and 42% in rural Tanzania stated that their pregnancy was unwanted. Contraceptive acceptance among women with unwanted pregnancies was high; 93% in urban Tanzania and 71% in rural Tanzania left with a contraceptive method. CONCLUSION: The high proportion of women with unwanted pregnancies in urban and rural Tanzania underlines the need of scaling up post-abortion contraceptive service.

2016 In Manuscript

Background: Postabortion care (PAC), is a package of services provided to women who have had an incomplete spontaneous or induced abortion. Knowing the users and non-users of PAC and reasons for use and none-use is important. Objective: The study aimed at identifying PAC service users and non-users and reasons for using or not using the PAC services. Methods: A total of 103 users and six non-users of PAC services were interviewed. Results: Most of the PAC users were young, not formally employed, single and educated to secondary or primary education. Information sharing about one’s health status; support from partner, relative or parents; privacy and absence of queues availability of PAC services and availability of transport enhanced utilization. Inability to pay for PAC services, fear of healthcare providers, fear of being arrested and avoiding stigma hampered utilization. Conclusion. Reducing abortion stigma and making PAC services affordable may increase its use. Key words: Postabortion care, utilization, abortion complications, non-user, Tanzania

2009 In Article

A post-abortion care program was implemented in 11 primary and secondary health facilities in rural Tanzania in order to decentralize comprehensive post-abortion care to community level by upgrading midlevel providers to perform manual vacuum aspiration (MVA). Information about evacuation procedure and family planning (FP) service provided was obtained from the health facilities. In all, 2025 evacuations had been performed with MVA and D&C accounting for 65.6% and 34.4%, respectively. Among the women admitted with abortion complications, 59.8% left with a FP method. The proportion of women offered FP service differed by evacuation procedure, hence the proportion was higher among women evacuated by MVA. Upgrading midlevel providers to perform MVA is an efficient means to address the problem of unsafe abortion in rural areas. However, the sustainability of MVA service provision remains a challenge. Moreover, FP services should be offered to all post-abortion clients regardless of evacuation procedure.

2012 In Article

"BACKGROUND: Bowel perforation though rarely reported is a serious complication of induced abortion, which is often performed illegally by persons without any medical training in developing countries. A sudden increase in the number of patients in our centre in recent years prompted the authors to analyze this problem. The study was conducted to describe our own experiences in the surgical management of these patients. METHODS: This was a retrospective study involving patients who were jointly managed by the surgical and gynecological teams at Bugando Medical Centre (BMC) for bowel perforation secondary to illegally induced abortion from January 2002 to December 2011. The statistical analysis was performed using SPSS version 17.0. RESULTS: A total of 68 patients (representing 4.2% of cases) were enrolled in the study. Their ages ranged from 14 to 45 years with a median age of 21 years. Majority of patients were, secondary school students/leavers (70.6%), unmarried (88.2%), nulliparous (80.9%), unemployed (82.4%) and most of them were dependent member of the family. Previous history of contraceptive use was reported in only 14.7% of cases. The majority of patients (79.4%) had procured the abortion in the 2nd trimester. Dilatation and curettage (82.4%) was the most common reported method used in procuring abortion. The interval from termination of pregnancy to presentation in hospital ranged from 1 to 14 days (median 6 days ). The ileum (51.5%) and sigmoid colon (22.1%) was the most common portions of the bowel affected. Resection and anastomosis with uterine repair was the most common (86.8%) surgical procedure performed. Complication and mortality rates were 47.1% and 10.3% respectively. According to multivariate logistic regression analysis, gestational age at termination of pregnancy, delayed presentation, delayed surgical treatment and presence of complications were significantly associated with mortality (P<0.001). The overall median length of hospital stay (LOS) was 18 days (1day to 128 days ). Patients who developed complications stayed longer in the hospital, and this was statistically significant (P=0.012). CONCLUSION: Bowel perforation following illegally induced abortion is still rampant in our environment and constitutes significantly to high maternal morbidity and mortality. Early recognition of the diagnosis, aggressive resuscitation and early institution of surgical management is of paramount importance if morbidity and mortality associated with bowel perforation are to be avoided."

2010 In Article
This study examined young women's attempts to control reproduction through contraception and fertility protection or promotion in rural Tanzania. It drew on participant observation in nine villages, group discussions and interviews in three others, and 16 health facility simulated patient visits from 1999-2002. Fertility was highly valued, but out-of-wedlock pregnancies were stigmatized. Many girls used traditional contraception, such as wearing charms or drinking ash solutions. Young single mothers sometimes used modern contraception, including Depo Provera, because injections were accessible, private, and infrequent. However, use was ambivalent and inconsistent for fear of side effects, such as infertility (hormonal contraceptives) and reduced male pleasure (condoms). Newly married women tried to conceive immediately. Traditional treatments were used for infertility, miscarriage, or difficult deliveries. These were attributed to physical causes (sexually transmitted infections; contraception; abortion) and/or supernatural causes (God's will; witchcraft; ancestral punishment). Improved reproductive health education and services are greatly needed. The potential of condoms to protect future fertility should be emphasised.