Keogh Sarah C, Kimaro Godfather, Muganyizi Projestine, Philbin Jesse, Kahwa Amos, Ngadaya Esther, Bankole Akinrinola
Guttmacher Institute, New York, United States of America.
National Institute for Medical Research (NIMR), Dar-es-Salaam, Tanzania.
PLoS One. 2015 Sep 11;10(9):e0133933. doi: 10.1371/journal.pone.0133933. eCollection 2015.
Tanzania has one of the highest maternal mortality ratios in the world, and unsafe abortion is one of its leading causes. Yet little is known about its incidence.
To provide the first ever estimates of the incidence of unsafe abortion in Tanzania, at the national level and for each of the 8 geopolitical zones (7 in Mainland plus Zanzibar).
A nationally representative survey of health facilities was conducted to determine the number of induced abortion complications treated in facilities. A survey of experts on abortion was conducted to estimate the likelihood of women experiencing complications and obtaining treatment. These surveys were complemented with population and fertility data to obtain abortion numbers, rates and ratios, using the Abortion Incidence Complications Methodology.
In Tanzania, women obtained just over 405,000 induced abortions in 2013, for a national rate of 36 abortions per 1,000 women age 15-49 and a ratio of 21 abortions per 100 live births. For each woman treated in a facility for induced abortion complications, 6 times as many women had an abortion but did not receive care. Abortion rates vary widely by zone, from 10.7 in Zanzibar to 50.7 in the Lake zone.
The abortion rate is similar to that of other countries in the region. Variations by zone are explained mainly by differences in fertility and contraceptive prevalence. Measures to reduce the incidence of unsafe abortion and associated maternal mortality include expanding access to post-abortion care and contraceptive services to prevent unintended pregnancies.
坦桑尼亚是全球孕产妇死亡率最高的国家之一,不安全堕胎是主要原因之一。然而,其发生率鲜为人知。
首次在坦桑尼亚全国层面以及8个地理政治区域(大陆7个区域加桑给巴尔)分别估算不安全堕胎的发生率。
开展了一项具有全国代表性的医疗机构调查,以确定医疗机构中治疗的人工流产并发症数量。对堕胎专家进行了一项调查,以估算妇女出现并发症并获得治疗的可能性。利用人工流产发生率并发症方法,通过人口和生育率数据对这些调查进行补充,以获取堕胎数量、率和比例。
2013年,坦桑尼亚妇女进行了略超过40.5万例人工流产,全国人工流产率为每1000名15 - 49岁妇女中有36例堕胎,每100例活产中有21例堕胎。在医疗机构接受人工流产并发症治疗的每一名妇女,有6倍之多的妇女进行了堕胎但未接受护理。各区域的堕胎率差异很大,从桑给巴尔的10.7到湖区的50.7不等。
堕胎率与该区域其他国家相似。区域差异主要由生育率和避孕普及率的差异来解释。降低不安全堕胎发生率及相关孕产妇死亡率的措施包括扩大堕胎后护理和避孕服务的可及性,以防止意外怀孕。