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Contraception and the consequences of unwanted pregnancy in Zanzibar, Tanzania

Alison Norris, Johns Hopkins Bloomberg School of Public Health, 2010
See also executive summary.

Project abstract

In Zanzibar, a low-income and predominantly Muslim archipelago in Tanzania, east Africa, maternal mortality is high, contraceptive use is low, and currently almost no data exist about abortion and other consequences of unwanted pregnancy. The Zanzibar Ministry of Health has expressed a strong interest in researching unwanted pregnancy and induced abortion to design evidence-based efforts to increase contraceptive use and reduce the region's maternal mortality rate.

We propose new research to conduct a quantitative survey with women who present to the main tertiary care facility for post-abortion care. Post-abortion care is the leading cause for admission to the public hospital's gynecological ward, and yet almost nothing is known about the women who have abortions.

These survey data on the use, perceptions, and barriers to contraception use and the experiences and consequences of unwanted pregnancy in Zanzibar will build on formative, qualitative research previously done by our group. Our research will address contraceptive decision-making and the impact of recent unplanned pregnancies in a population of poor Muslim women.

Additionally, we will explore abortion stigma, as it manifests for patients and providers in Zanzibar. Quantitative surveys will be carried out using an empathic interview method by trained Zanzibari interviewers to 300 women receiving post-abortion care. Each woman's personal experiences with pregnancy, contraception, and unsafe abortion will be examined in detail by asking her comprehensive reproductive life history.

We know that our study's population has unmet contraceptive need and currently unexplored consequences of unwanted pregnancy. We seek funding to collect vital data about contraception and abortion in Zanzibar. Our collaborations with the Zanzibar Ministry of Health and health care providers will give our research findings unique leverage to improve programs for contraception and to provide policy-makers with information necessary to design interventions to reduce unsafe abortion morbidity and mortality.

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