In Tanzania, unmet need for
contraception is high, particularly in the postpartum period. Contraceptive
counseling during routine antenatal HIV testing could reach 97 percent of
pregnant women with much-needed information, but requires an understanding of
postpartum contraceptive use and its relationship to antenatal intentions.
We
conducted a baseline survey of reproductive behavior among 5,284 antenatal clients
in Northern Tanzania, followed by an intervention offering contraceptive
counseling to half the respondents. A follow-up survey at 6-15 months
postpartum examined patterns and determinants of postpartum contraceptive use,
assessed their correspondence with antenatal intentions, and evaluated the
impact of the intervention.
Despite high loss to follow-up, our findings
indicate that condoms and hormonal methods had particular and distinct roles in
the postpartum period, based on understandings of postpartum fertility.
Antenatal intentions were poor predictors of postpartum reproductive behavior.
Antenatal counseling had an effect on postpartum contraceptive intentions, but
not on use.
Different antenatal/contraceptive service integration models should
be tested to determine how and when antenatal counseling can be most effective.
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By:
- 1Postdoctoral Fellow, Department of Anthropology, University College London, Gower Street, London WC1E 6BT, United Kingdom.
- 2Senior Research Scientist, National Institute for Medical Research, Mwanza, Tanzania.
- 3Clinical Officer, National Institute for Medical Research, Mwanza, Tanzania.
- 4Samwel Kalongoji is District Medical Officer, Magu District Council, Tanzania.
- 5Daniel Kimaro is City Medical Officer, Mwanza City Council, Tanzania.
- 6Basia Zaba is Professor of Medical Demography, Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
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