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 the consequences of unwanted pregnancy. Globally, more than million women in developing countries have unmet need for contraception, leading to an estimated 76 million unintended pregnancies every year. Why are women in Zanzibar not using available, affordable, effective methods of contraception, and what are the consequences of unwanted pregnancy?
To answer these questions, I initiated a year-long social science research study to address contraceptive decision-making and the impact of recent unplanned pregnancies in a population of poor Muslim women. The study assessed community-held views on the barriers to contraceptive use through semi-structured group interviews with men and women in the community and in-depth interviews with health care providers and explored the particular circumstances of unmet need for contraception among women who have terminated pregnancies through in-depth interviews with 50 women recruited through participant driven sampling.
The final component of the research is a quantitative surveywith women who present to the main tertiary care facility in Zanzibar, Tanzania for post-abortion care. These survey data on the use, perceptions, and barriers to contraception use and the experiences and consequences of unwanted pregnancy in Zanzibar build on the formative, qualitative research done by my group. My research teamβtrained Zanzibari interviewersβis using an empathic interview method to interview women receiving post-abortion care.
Collaborations with the Zanzibar Ministry of Health and health care providers give these research findings unique leverage to improve programs for contraception and to provide policy-makers with information necessary to design interventions to reduce poor outcomes from unwanted pregnancy. In June and July , together former members of my research team, we carried out several dissemination activities with stakeholders and partner organizations in Zanzibar and Dar es Salaam.
Causes and consequences of induced abortion among a community-based snowball sample of Zanzibari women. Reproductive Health. February Partner approval and intention to use contraception among women presenting for post-abortion care at Mnazi Mmoja Hospital, Zanzibar.
