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  • Title: Perinatal mortality in rural Tanzania.
    Author: Kitange H, Swai AB, Masuki G, Kilima PM, Alberti KG, McLarty DG.
    Journal: World Health Forum; 1994; 15(1):82-4. PubMed ID: 8141988.
    Abstract:
    In 1987, as part of the World Health Organization's Inter-Health Programme, we carried out a noncommunicable diseases survey in six rural villages in Tanzania. Each women completed a questionnaire, part of which was concerned with obstetric history, and underwent a physical examination. Our findings of unacceptably high perinatal mortality and abortion rates are described below. Within the framework of the World Health Organization's [WHO] Inter- Health Program, a noncommunicable diseases survey was carried out in 6 villages located in 2 regions of Tanzania in 1987. A total of 3565 women were queried about their viable pregnancies, still-births, perinatal deaths (death within the first week of life), and abortions (loss of conceptus within 28 weeks of gestation). The overall abortion rate was 119/1000 pregnancies (range of 89/1000-170/1000 pregnancies). In the Kilimanjaro region, the abortion rate was 97/1000 compared to 145/1000 in the Morogoro region. The overall perinatal mortality rate was 73/1000 births (range of 49/1000-124/1000 births). In the Kilimanjaro region, the perinatal mortality rate was 58/1000 births vs. 91/1000 in the Morogoro region. The overall abortion rate for the 6 villages was 12% of pregnancies, while the range culled from the literature was 10-25%. The rate of miscarriage before 20 weeks of gestation has been estimated at 36-43%. In the Morogoro region, miscarriage rates were highest in the older age groups, which is indicative of improved health care. The difference in perinatal mortality rates between the 2 regions may be attributable to the relatively higher level of development of the Kilimanjaro region. This difference in socioeconomic development was also reflected in the infant mortality rate: 70/1000 births in the Kilimanjaro compared to 140/1000 in the Morogoro region. Other studies in east Africa showed perinatal mortality rates of 46/1000 births in Kenya's Machakos region during 1975-78, and a rate of 124/1000 births in Tanzania near the Morogoro region during 1984-85. Community-based studies focusing on women's health and care during pregnancy and childbirth are needed to investigate the causes of perinatal deaths, because hospital-based studies give a disjointed picture of both rates and the causes.
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