East African Journal of Public Health

The Contribution of the Improved Community Health Fund on the Utilization of Outpatient Healthcare Services in Singida Municipal Council

2023-10-16T08:15:33+00:00

Introduction: The government of Tanzania established the Community Health Fund (CHF) in 1996 and the improved Community Health Fund (iCHF) in 2018 to provide financial protection for outpatient healthcare services for rural and informal-sector populations. However, utilization of outpatient healthcare services remains a challenge in Tanzania. This study aimed to assess the contribution of the iCHF on the utilization of outpatient healthcare services and associated factors in the Singida Municipal Council.

Methods: A sequential mixed-methods design was employed to conduct a before-and-after outcome evaluation of the iCHF. The questionnaire was used to collect quantitative data, while key informant interviews were used to collect qualitative data. A Chi-square test was used to assess the association between iCHF and outpatient healthcare service utilization. Thematic analysis approach was used to analyse health facility factors contributing to outpatient healthcare service utilization among iCHF members.

Results: The utilization of outpatient healthcare services has increased by 7% compared to the period of CHF. Age (p=0.047), sex (p=0.000) and level of education (p=0.015) were significantly associated with increased utilization of outpatient healthcare services. Availability of a clear framework for the enrollment procedure, an advanced information system, a broadened benefit package, availability of essential medicines, medical equipment and implementation of clients’ retention mechanisms were the contributing factors to the utilization of outpatient healthcare services.

Conclusions: The findings highlight an increase in healthcare services utilization following the introduction of iCHF and the factors associated with this change. However, healthcare services utilization among iCHF members remains relatively low due to low enrollment. Therefore, efforts are needed to increase iCHF enrollment to improve outpatient healthcare.

Prevalence and Factors Associated with Modern Contraceptive Use among Married Women of Reproductive Age in Tanzania: Evidence from the 2022 Tanzania Demographic and Health Survey

2026-02-04T15:15:31+00:00

Introduction: In Tanzania, there is limited evidence on the modern contraceptive use among married women. This study determined the prevalence and factors associated with modern contraceptive use among married women aged 15-49 years.

Methods: This study analyzed secondary data, including a total weighted sample of 9,252 married women from the 2022 Tanzania Demographic and Health Survey (TDHS). A dependent variable was modern contraceptive use, while independent variables were demographic and socio-economic characteristics of married women. Chi-square test and modified Poisson regression were performed. A significance threshold of p-value <0.05 was used.

Results: The prevalence of modern contraceptive use among married women was 31.1% (95% CI: 29.7-32.0). After controlling for other covariates, married women with secondary or higher education (APR=1.24; 95%CI:1.07-1.44), those from the richest households (APR=1.53; 95%CI:1.15-1.59), and those who had 5 or more parity (APR=10.13; 95%CI:5.46-18.76) had a higher prevalence of using modern contraceptives than their counterparts. Married women who were residing in the Southern zone (APR=1.66; 95%CI:1.49-1.85), those who were working (APR=1.23; 95%CI:1.12-1.35), and those who desired to have more children after two or more years (APR=2.01; 95%CI:1.79-2.27) had a higher prevalence of using modern contraceptives than their counterparts. Equally, married women who resided in rural areas (APR=0.84; 95%CI:0.76-0.93) and those who experienced a terminated pregnancy (APR=0.89; 95%CI:0.80-0.98) had a lower prevalence of modern contraceptive use than their counterparts.

Conclusion: The use of modern contraceptive was low and associated with women’s parity, education level, wealth index, working status and fertility preferences. Tailored programmes targeting women to improve their health education are crucial for increasing the use of modern contraceptives.

Discriminatory Attitudes towards People Living with HIV and its Associated Factors among Adolescent Girls and Young Women in Tanzania: A Nationwide Cross-Sectional Study

2025-10-09T06:19:13+00:00

Introduction: Widespread discriminatory attitudes (DAs) discourage HIV testing and undermine adherence to antiretroviral therapy. This study determined the proportion and factors associated with DAs towards people living with HIV (PLHIV) among adolescent girls and young women (AGYW) in Tanzania.

Methods: A secondary data analysis was conducted using data from the 2022 Tanzania Demographic and Health Survey and Malaria Indicator Survey. A total weighted sample of 5,810 AGYW aged 15 to 24 years was used. Data were analyzed using STATA version 18.0. The strength of the association was measured by using the adjusted odds ratio (AOR) and its associated 95% confidence interval (CI).

Results: The overall DAs towards PLHIV among AGYW in Tanzania were 30.5% (95%CI: 28.7-32.3). Although the proportion of DAs was higher among adolescent girls, 33.0% (95%CI:30.7-35.3), than among young women, 27.7% (95%CI:25.5-30.12). Factors significantly associated with DAs included being aged 15-19 years (AOR=1.21, 95%CI:1.01-1.44), urban residence (AOR=1.80, 95%CI:1.46-2.22), informal education (AOR=1.84, 95%CI:1.35-2.51) and primary education (AOR=1.30, 95%CI:1.04-1.63), poor quintile (AOR=1.39, 95%CI:1.09-1.79), insufficient knowledge on HIV (AOR=1.97, 95%CI:1.58-2.44), never tested for HIV (AOR=1.27, 95%CI:1.07-1.51), having no knowledge on HIV prevention methods (AOR=1.27, 95%CI:1.05-1.55), and never watched television (AOR=1.46, 95%CI:1.17-1.82).

Conclusion: The DAs toward PLHIV among AGYW were 30.5%. This was mostly associated with age, limited knowledge of HIV, residing in urban areas, low education levels and economic status. The study underscores the need for targeted education initiatives to mitigate DAs and enhance understanding of HIV among AGYW in Tanzania.

The Prevalence and Determinants of Emotional Violence and Controlling Behaviours in Intimate Relationships During Pregnancy: Insights from an Analytical Cross-Sectional Study in Central Tanzania

2026-03-19T13:30:11+00:00

Introduction: Pregnancy is a period of increased vulnerability to intimate partner violence (IPV), as women undergo significant physical and emotional changes requiring support from their male partners. However, limited evidence exists on the determinants of emotional and controlling abuse during pregnancy, particularly in central Tanzania. This study aimed to determine the prevalence and determinants influencing the occurrence of these forms of IPV in the region.

Methods: An analytical cross-sectional study was conducted in the Central Zone of Tanzania, involving 360 postnatal women. A four-stage sampling technique was used to select participants, who were interviewed using a semi-structured questionnaire. Bivariate and multivariate logistic regression analyses were performed using SPSS version 25 to assess determinants of IPV during pregnancy.

Results: Emotional violence during pregnancy affected 42.8% of women, while 58.3% experienced male partner controlling behaviour. Civil marriage reduced the likelihood of emotional violence (aOR=0.16; 95%CI:0.03-0.76), whereas not cohabiting with a partner (aOR=3.23; 95%CI:1.43-7.29) and partner alcohol use (aOR = 3.94; 95%CI:1.97-7.88) increased the risk of emotional violence. Controlling behaviour was more likely when women independently chose their partners (aOR=3.20; 95%CI:1.39-7.68) and among partners employed in the private (aOR=2.14; 95%CI:1.03-4.48) and government sectors (aOR=3.43; 95%CI:1.21-9.70) compared to farmers.

Conclusion: The findings indicate that emotional violence and controlling behaviour during pregnancy are widespread and influenced by relationship dynamics, partner behaviours, and gender norms. The results highlight the need for integrated antenatal and community interventions focusing on early identification of IPV, male involvement, and addressing harmful social and behavioural norms to reduce violence during pregnancy.