Factors affecting early identification of pregnant women by community health workers in Morogoro, Tanzania.

BACKGROUND: It is recommended that Antenatal Care (ANC) be initiated within the first trimester of pregnancy for essential interventions, such folic acid supplementation, to be effective. In Tanzania, only 24% of mothers attend their first ANC appointment during their first trimester. Studies have shown that women who have had contact with a health worker are more likely to attend their first antenatal care appointment earlier in pregnancy. Community health workers (CHWs) are in an opportune position to be this contact. This study explored CHW experiences with identifying women early in gestation to refer them to facility-based antenatal care services in Morogoro, Tanzania. METHODS: This qualitative study employed 10 semi-structured focus group discussions, 5 with 34 CHWs and 5 with 34 recently delivered women in three districts in Morogoro, Tanzania. A thematic analytical approach was used to identify emerging themes among the CHW and RDW responses. RESULTS: Study findings show CHWs play a major role in identifying pregnant women in their communities and linking them with health facilities. Lack of trust and other factors, however, affect early pregnancy identification by the CHWs. They utilize several methods to identify pregnant women, including: asking direct questions to households when collecting information on the national census, conducting frequent household visits and getting information about pregnant women from health facilities. CONCLUSIONS: We present a framework for the interaction of factors that affect CHWs' ability to identify pregnant women early in gestation. Further studies need to be conducted investigating optimal workload for CHWs, as well as reasons pregnant women might conceal their pregnancies.

Self-medication with antimalarial drugs in Dar es Salaam, Tanzania.

A hospital-based cross-sectional study was conducted in Dar es Salaam, Tanzania, using a questionnaire to assess the extent of self-medication with antimalarial drugs and malaria treatment-seeking behaviour among patients attending out-patient treatment at Mnazi mmoja dispensary. It was found that 15.3% of respondents admitted to having ever used malaria chemoprophylaxis while 8.0% reported to be current users of chemoprophylaxis. Among the current users of malaria chemoprophylaxis, some reported having used quinine and Fansidar. While 71.7% reported having treated themselves with home-kept antimalarial drugs for a suspected malaria fever, 14.7% consulted traditional healers. The data suggest the need for increasing public awareness on malaria and appropriate use of antimalarial drugs.