Abstract : In an exploratory study of illegal abortion in Tanzania, 455 women who presented to public hospitals in Dar es Salaam with incomplete or septic abortion were interviewed by hospital nurses. 33% were 14-19 years of age 46% had not been pregnant before and 24% claimed to have become pregnant at first intercourse. Close to a third of the teenagers reported a male partner 45 years of age or older. 45% were not aware of any method of contraception, presumably because of Tanzania's policy of restricting family planning information and services to married couples. Of the 17% who were using contraception at the time pregnancy occurred, 4% were using the pill, 4% the condom, 1% the IUD, 6% rhythm, and 1% withdrawal. The responsible male partner was the first person informed about the pregnancy in the majority (53%) of cases; male partners were also the informants most likely (56%) to urge abortion. The main reasons cited by subjects for terminating the pregnancy were student status, an insufficient time interval since the last birth, or economic hardship. 44% of male sexual partners paid for the abortion, yet female friends and close female relatives were most likely to facilitate arrangements for the procedure. Of the 384 abortionists described by subjects, 22% were identified as doctors (not validated), 65% as "other health workers," and 13% as "quacks." 56% of procedures occurred in a health facility and 42% were performed in a bedroom. 51% were advised by the abortionist to go to the hospital after the procedure and 35% were given medication. 84% were in fair or poor condition at admission; fever, heavy bleeding, genital trauma, and septicemia were the most frequent symptoms. Although no deaths occurred, 3 women required laparotomies. The cost to the Ministry of Health for a 1-day stay in the hospital for treatment of abortion-related complications is 7 times greater than the Ministry's annual health budget per person, and most stays exceed this. Involved health care workers expressed concern about this disproportionate yet preventable drain on the health budget and the social injustice that forces poor women to resort to unsafe abortion while more privileged women can afford private clinics. A reassessment of the ban on sex education for Tanzanian youth is urged, given their high level of sexual activity.
Source : source Reproductive Health Matters : http://www.rhmjournal.org.uk/.