Senior Researcher and Social Scientist- areas of interests include family planning, nutritional behaviours, climate change, gender, maternal and newborn health and HIV and Aids Address: P.O BOX 65015 Dar es Salaam Tanzania
To explore the enabling factors, barriers, and strategies to improve retention in HIV care and ad... more To explore the enabling factors, barriers, and strategies to improve retention in HIV care and adherence to antiretroviral therapy (ART) among adults (18 years and above) living with HIV in Dar es Salaam, Tanzania. Methods: We conducted a descriptive qualitative study to better understand and explore enablers, barriers, and strategies to improve retention in HIV care and adherence to antiretroviral therapy (ART) among PLHIV in Dar es Salaam, Tanzania. Focus group discussions (FGD) were conducted with a semi-structured discussion guide between December 2021 and June 2022. A non-random purposive sampling technique was used to select PLHIV and people involved in provision of healthcare and socioeconomic support to PLHIV. Thematic analysis was used to identify and interpret the themes. Results: Three major themes with 10 sub-themes emerged. Participants indicated that family and partner support, peer-support group/ adherence clubs, and healthcare provider counselling on medication adherence facilitated retention and adherence to ART. In contrast, stigma and discrimination, financial constraints, disease outbreaks such as the COVID-19 pandemic, myths and misconceptions about HIV, and side effects of antiretrovirals were mentioned as barriers. Strengthening community and patient education about HIV and ART through peer support groups and financial support for poor PLHIV were the proposed mitigation. Conclusion: Addressing the challenges to ART adherence may require a more holistic approach. We recommend the implementation of peer support groups and financial support through small microfinance groups as interventions to increase retention in HIV care and adherence to ART in the study area.
Background Pre-Exposure Prophylaxis (PrEP) has demonstrated efficacy in preventing HIV infection.... more Background Pre-Exposure Prophylaxis (PrEP) has demonstrated efficacy in preventing HIV infection. Female Bar Workers (FBWs) often act as informal sex workers, placing them at risk of HIV infection. Despite expressing interest in PrEP, FBWs face barriers to accessing public-sector clinics where PrEP is delivered. We developed a study to compare the effectiveness of workplace-based PrEP provision to standard-of-care facility-based provision for PrEP initiation, retention and adherence among FBWs.
Introduction Mental disorders such as depression are prevalent among People Living with HIV, and ... more Introduction Mental disorders such as depression are prevalent among People Living with HIV, and therefore health care providers need to be trained well to manage depressive symptoms. This study aimed to assess healthcare providers' knowledge, attitude, and practices in screening and managing depressive symptoms among people living with HIV (PLWH) attending the Care and Treatment Clinics (CTCs) in Dar es Salaam, Tanzania. Methods This was a cross-section study that employed a questionnaire to collect data. Convenient sampling was used to recruit 34 healthcare providers providing services at 23 public CTCs in Ubungo, Dar es Salaam. Data were analyzed using the SPSS program. Frequencies and percentages were run between the variables. Furthermore, in bivariate analysis, Pearson's Chi
Background: Healthcare providers play an important role in the provision of health services in ca... more Background: Healthcare providers play an important role in the provision of health services in care and treatment clinics (CTCs), as they help clients cope with their HIV/AIDS diseases by providing health education and counseling. Little is known about the challenges that healthcare providers face when providing such services to people living with HIV (PLWH) in low-resource settings. This study aimed to explore and understand the challenges that healthcare providers face in delivering care to PLWH in Dar es Salaam, Tanzania. Materials and methods: We conducted a qualitative descriptive study to explore and understand the challenges that healthcare providers face when providing health services to PLWH. This study was carried out in the CTCs in the Ubungo District, Dar es Salaam, Tanzania. A total of 10 healthcare providers were recruited using a purposive sampling technique until information saturation was attained. Face-to-face interviews were conducted to obtain the data. We transcribed the interviews verbatim and analyzed them using reflexive thematic analysis to obtain the themes and subthemes. Findings: Client-related challenges included difficulty in managing antiretroviral (ARV) drug reactions of clients and their financial, follow-up, and index tracking problems; facility-related challenges included inadequate and limited space for CTC services, lack of integrated HIV services, and shortage of staff, which needed collaborative efforts to overcome; and healthcare provider-related challenges included a lack of up-to-date knowledge and limited access to health information. These challenges limit the provision of quality HIV care to the clients. Conclusion: This study highlights the important challenges that hinder the quality of HIV services at CTCs. The implementation of appropriate infrastructure to promote the privacy and confidentiality of clients is necessary as it alleviates the burden on the jobs of healthcare providers. The findings also suggest that healthcare providers improvise solutions to meet the needs of the clients in the study setting. Permanent resolution is required to overcome the challenges in CTCs. Further research on both providers and clients should be conducted to explore the challenges in CTCs in other similar settings.
Introduction: Adequate utilization of postnatal care services is associated with improved materna... more Introduction: Adequate utilization of postnatal care services is associated with improved maternal and neonatal health outcomes. The World Health Organization recommends postnatal women attend postnatal care as early as seven days after delivery because most maternal deaths occur within 7 days of the postnatal period. However, many postnatal women attend postnatal care very late during the 42 days and mainly for child immunization purposes. Little information is known on barriers to postnatal women who delay initiating postnatal care clinics for seven days post-delivery. This study explored barriers to attending early postnatal care among women attending early postnatal care services in Ubungo municipality, Dar es Salaam. Methods: A cross-sectional study design using a qualitative approach was used to explore factors associated with early postnatal care attendance among postnatal women in Ubungo Municipal, Dar es Salaam, Tanzania. Study participants were purposively selected. In-depth interviews were used to collect data. Audio-recorded interviews were transcribed verbatim and translated into English. Thematic analysis approach was used to excerpt barriers to delaying seeking early postnatal care services in Ubungo Municipality. Findings: The finding revealed a lack of awareness of the appropriate time to start early postnatal care visits and the recommended number of postnatal visits, the perception of postnatal women that the postnatal period is a normal condition that does not require health personnel’s attention, thus the perception that no need to initiate early postnatal care clinics if they were not sick. Similarly, long waiting times, transport costs, and healthcare providers’ attitudes were major reasons reported by postnatal women to contribute to late postnatal care attendance. Thus, healthcare providers should continue providing education to pregnant women on when and the importance of attending early postnatal care.
Intimate partner violence (IPV) is the most common form of violence faced by women globally. The ... more Intimate partner violence (IPV) is the most common form of violence faced by women globally. The prevalence of lifetime experiences of physical and sexual IPV is estimated to range from 15% to 71%. IPV where a perpetrator is a male current or ex-partner is an existing gender problem in many countries. Millions of women in Africa especially those living in informal settlements are affected by IPV. The most common form of IPV is physical, psychological and sexual abuse. Several studies conducted in Tanzania on IPV have not yet examined the characteristics of perpetrators of such violence acts in informal settlements. This cross-sectional study aimed to examine IPV perpetrators' characteristics and their association with IPV perpetration in informal settlements. Multi-stage sampling was applied. Random sampling was used to obtain a sample of 300 women living in informal settlements of Iringa Municipality. A survey was used to collect data and SPSS version 20 was used for analysis. A χ 2 test was used to assess the association between the outcome variable and a set of exposure variables. Ethical clearance was obtained from Muhimbili University Institutional Review Board. Written consent was sought before participation in the study. IPV perpetrators' socio-demographic characteristics were age, marital status, marriage type, occupation and level of education. Alcohol intake characteristics were alcohol intake status and intake frequency, where 62.7% were reported to take alcohol many times. Marital status, level of education, occupation, alcohol intake status and frequency of alcohol intake were linked to physical IPV (p < 0.005). Perpetrators' characteristics associated with both sexual and emotional IPV were marital status, alcohol intake and the frequency of alcohol intake (p < 0.005). IPV perpetrators' socio-demographic characteristics mainly marital status, level of education, alcohol abuse and alcohol intake frequency have a major contribution to the burden of IPV in Iringa municipality. Low level of education and occupation status as business persons are at higher risk of being violent physically, sexually and emotionally. Men aged between 31 and 50 years are more violent in all forms than others. Community IPV prevention interventions focusing on both men and women will be helpful since IPV perpetration may not only be initiated by men but also by women who may lack life and relationship coping skills. More research is important focusing on IPV perpetration attitude and perceptions from men and women perspectives to inform IPV prevention and management.
To curb HIV infection rate in Tanzania, antiretroviral therapy (ART) has been scaled up since 200... more To curb HIV infection rate in Tanzania, antiretroviral therapy (ART) has been scaled up since 2006, and in 2019, the country shifted to regimen including dolutegravir as a default first line. We assessed the success of ART and the contribution of HIV drug resistance (HIVDR) to unsuppressed viral loads. Between February and May 2023 a cross-sectional survey with random sampling was conducted in the six clinics in an urban cohort in Dar es Salaam. Patients with unsuppresed viral loads (local criteria viral load (VL) ≥ 1000 copies/mL) were tested for HIVDR mutations using the WHO adapted protocol for plasma samples. Mutations were interpreted using the Stanford HIVDR database. In total 600 individuals participated in this survey, the majority were female (76.83%), mean age (± standard deviation) was 44.0 (± 11.6) years. The median duration on ART (interquartile range) was 6.5 (3.9-10.2) years. Approximately 99% were receiving tenofovir + lamivudine + dolutegravir as a fixed dose combination. VL testing was successful in 99.67% (598/600) of survey patients and only 33 had VL ≥ 1000 copies/mL, resulting in a viral suppression level of 94.48% (565/598, 95% CI 92.34-96.17%). For 23 samples, protease and reverse transcriptase (RT) genotyping were successful, with 13 sequences containing RT inhibitor surveillance drug resistance mutations (SDRMs) (56.5%). No
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Background: Simultaneous heroin use among methadone-maintained clients is a recognized phenomenon... more Background: Simultaneous heroin use among methadone-maintained clients is a recognized phenomenon worldwide. Tanzania is the first sub-Saharan African country to offer methadone treatment. This study explored reasons for heroin use among clients on methadone treatment clinics in Dar es Salaam, Tanzania. Methods: This was exploratory cross-sectional study. Purposive sampling was used to select ten study participants. In in-depth interview guide was used to collect data. The interviews were conducted in Kiswahili and lasted for about sixty minutes. Audio-recordings of the interviews were transcribed verbatim and translated into English. Transcribed data was analysed and subjected to thematic analysis with the help of Nvivo 12 software. Results: Many reasons were mentioned for concurrent use of heroin and methadone among clients on methadone treatment. Some of the mentioned reasons were inadequate methadone dose, treatment, healthcare providers' attitudes, and healthcare provision environment, lack of family support, peer influence homeless and easy availability of heroin. Conclusions: Different measures should be taken by methadone programs and stakeholders to overcome concurrent use of heroin and methadone among clients receiving methadone treatment.
Adequate utilization of postnatal care services is associated with improved maternal and neonatal... more Adequate utilization of postnatal care services is associated with improved maternal and neonatal health outcomes.The World Health Organization recommends postnatal women to attend postnatal care as early as seven days after delivery because most maternal deaths occur within 7 days of the postnatal period. However, many postnatal women who deliver in health facilities attend postnatal care very late during 42 days for child immunization. Little information is known as to why postnatal women who deliver in health facilities delay initiating postnatal care clinics for seven days post-delivery. This study aimed at exploring reasons as to why women who deliver in health facilities delay attending early postnatal care services. Methods A cross-sectional design using a qualitative approach was used to explore factors associated with early postnatal care attendance among postnatal women in Ubungo Municipal, Dar es Salaam, Tanzania. Study participants were purposively selected. In-depth int...
To explore the enabling factors, barriers, and strategies to improve retention in HIV care and ad... more To explore the enabling factors, barriers, and strategies to improve retention in HIV care and adherence to antiretroviral therapy (ART) among adults (18 years and above) living with HIV in Dar es Salaam, Tanzania. Methods: We conducted a descriptive qualitative study to better understand and explore enablers, barriers, and strategies to improve retention in HIV care and adherence to antiretroviral therapy (ART) among PLHIV in Dar es Salaam, Tanzania. Focus group discussions (FGD) were conducted with a semi-structured discussion guide between December 2021 and June 2022. A non-random purposive sampling technique was used to select PLHIV and people involved in provision of healthcare and socioeconomic support to PLHIV. Thematic analysis was used to identify and interpret the themes. Results: Three major themes with 10 sub-themes emerged. Participants indicated that family and partner support, peer-support group/ adherence clubs, and healthcare provider counselling on medication adherence facilitated retention and adherence to ART. In contrast, stigma and discrimination, financial constraints, disease outbreaks such as the COVID-19 pandemic, myths and misconceptions about HIV, and side effects of antiretrovirals were mentioned as barriers. Strengthening community and patient education about HIV and ART through peer support groups and financial support for poor PLHIV were the proposed mitigation. Conclusion: Addressing the challenges to ART adherence may require a more holistic approach. We recommend the implementation of peer support groups and financial support through small microfinance groups as interventions to increase retention in HIV care and adherence to ART in the study area.
Background Pre-Exposure Prophylaxis (PrEP) has demonstrated efficacy in preventing HIV infection.... more Background Pre-Exposure Prophylaxis (PrEP) has demonstrated efficacy in preventing HIV infection. Female Bar Workers (FBWs) often act as informal sex workers, placing them at risk of HIV infection. Despite expressing interest in PrEP, FBWs face barriers to accessing public-sector clinics where PrEP is delivered. We developed a study to compare the effectiveness of workplace-based PrEP provision to standard-of-care facility-based provision for PrEP initiation, retention and adherence among FBWs.
Introduction Mental disorders such as depression are prevalent among People Living with HIV, and ... more Introduction Mental disorders such as depression are prevalent among People Living with HIV, and therefore health care providers need to be trained well to manage depressive symptoms. This study aimed to assess healthcare providers' knowledge, attitude, and practices in screening and managing depressive symptoms among people living with HIV (PLWH) attending the Care and Treatment Clinics (CTCs) in Dar es Salaam, Tanzania. Methods This was a cross-section study that employed a questionnaire to collect data. Convenient sampling was used to recruit 34 healthcare providers providing services at 23 public CTCs in Ubungo, Dar es Salaam. Data were analyzed using the SPSS program. Frequencies and percentages were run between the variables. Furthermore, in bivariate analysis, Pearson's Chi
Background: Healthcare providers play an important role in the provision of health services in ca... more Background: Healthcare providers play an important role in the provision of health services in care and treatment clinics (CTCs), as they help clients cope with their HIV/AIDS diseases by providing health education and counseling. Little is known about the challenges that healthcare providers face when providing such services to people living with HIV (PLWH) in low-resource settings. This study aimed to explore and understand the challenges that healthcare providers face in delivering care to PLWH in Dar es Salaam, Tanzania. Materials and methods: We conducted a qualitative descriptive study to explore and understand the challenges that healthcare providers face when providing health services to PLWH. This study was carried out in the CTCs in the Ubungo District, Dar es Salaam, Tanzania. A total of 10 healthcare providers were recruited using a purposive sampling technique until information saturation was attained. Face-to-face interviews were conducted to obtain the data. We transcribed the interviews verbatim and analyzed them using reflexive thematic analysis to obtain the themes and subthemes. Findings: Client-related challenges included difficulty in managing antiretroviral (ARV) drug reactions of clients and their financial, follow-up, and index tracking problems; facility-related challenges included inadequate and limited space for CTC services, lack of integrated HIV services, and shortage of staff, which needed collaborative efforts to overcome; and healthcare provider-related challenges included a lack of up-to-date knowledge and limited access to health information. These challenges limit the provision of quality HIV care to the clients. Conclusion: This study highlights the important challenges that hinder the quality of HIV services at CTCs. The implementation of appropriate infrastructure to promote the privacy and confidentiality of clients is necessary as it alleviates the burden on the jobs of healthcare providers. The findings also suggest that healthcare providers improvise solutions to meet the needs of the clients in the study setting. Permanent resolution is required to overcome the challenges in CTCs. Further research on both providers and clients should be conducted to explore the challenges in CTCs in other similar settings.
Introduction: Adequate utilization of postnatal care services is associated with improved materna... more Introduction: Adequate utilization of postnatal care services is associated with improved maternal and neonatal health outcomes. The World Health Organization recommends postnatal women attend postnatal care as early as seven days after delivery because most maternal deaths occur within 7 days of the postnatal period. However, many postnatal women attend postnatal care very late during the 42 days and mainly for child immunization purposes. Little information is known on barriers to postnatal women who delay initiating postnatal care clinics for seven days post-delivery. This study explored barriers to attending early postnatal care among women attending early postnatal care services in Ubungo municipality, Dar es Salaam. Methods: A cross-sectional study design using a qualitative approach was used to explore factors associated with early postnatal care attendance among postnatal women in Ubungo Municipal, Dar es Salaam, Tanzania. Study participants were purposively selected. In-depth interviews were used to collect data. Audio-recorded interviews were transcribed verbatim and translated into English. Thematic analysis approach was used to excerpt barriers to delaying seeking early postnatal care services in Ubungo Municipality. Findings: The finding revealed a lack of awareness of the appropriate time to start early postnatal care visits and the recommended number of postnatal visits, the perception of postnatal women that the postnatal period is a normal condition that does not require health personnel’s attention, thus the perception that no need to initiate early postnatal care clinics if they were not sick. Similarly, long waiting times, transport costs, and healthcare providers’ attitudes were major reasons reported by postnatal women to contribute to late postnatal care attendance. Thus, healthcare providers should continue providing education to pregnant women on when and the importance of attending early postnatal care.
Intimate partner violence (IPV) is the most common form of violence faced by women globally. The ... more Intimate partner violence (IPV) is the most common form of violence faced by women globally. The prevalence of lifetime experiences of physical and sexual IPV is estimated to range from 15% to 71%. IPV where a perpetrator is a male current or ex-partner is an existing gender problem in many countries. Millions of women in Africa especially those living in informal settlements are affected by IPV. The most common form of IPV is physical, psychological and sexual abuse. Several studies conducted in Tanzania on IPV have not yet examined the characteristics of perpetrators of such violence acts in informal settlements. This cross-sectional study aimed to examine IPV perpetrators' characteristics and their association with IPV perpetration in informal settlements. Multi-stage sampling was applied. Random sampling was used to obtain a sample of 300 women living in informal settlements of Iringa Municipality. A survey was used to collect data and SPSS version 20 was used for analysis. A χ 2 test was used to assess the association between the outcome variable and a set of exposure variables. Ethical clearance was obtained from Muhimbili University Institutional Review Board. Written consent was sought before participation in the study. IPV perpetrators' socio-demographic characteristics were age, marital status, marriage type, occupation and level of education. Alcohol intake characteristics were alcohol intake status and intake frequency, where 62.7% were reported to take alcohol many times. Marital status, level of education, occupation, alcohol intake status and frequency of alcohol intake were linked to physical IPV (p < 0.005). Perpetrators' characteristics associated with both sexual and emotional IPV were marital status, alcohol intake and the frequency of alcohol intake (p < 0.005). IPV perpetrators' socio-demographic characteristics mainly marital status, level of education, alcohol abuse and alcohol intake frequency have a major contribution to the burden of IPV in Iringa municipality. Low level of education and occupation status as business persons are at higher risk of being violent physically, sexually and emotionally. Men aged between 31 and 50 years are more violent in all forms than others. Community IPV prevention interventions focusing on both men and women will be helpful since IPV perpetration may not only be initiated by men but also by women who may lack life and relationship coping skills. More research is important focusing on IPV perpetration attitude and perceptions from men and women perspectives to inform IPV prevention and management.
To curb HIV infection rate in Tanzania, antiretroviral therapy (ART) has been scaled up since 200... more To curb HIV infection rate in Tanzania, antiretroviral therapy (ART) has been scaled up since 2006, and in 2019, the country shifted to regimen including dolutegravir as a default first line. We assessed the success of ART and the contribution of HIV drug resistance (HIVDR) to unsuppressed viral loads. Between February and May 2023 a cross-sectional survey with random sampling was conducted in the six clinics in an urban cohort in Dar es Salaam. Patients with unsuppresed viral loads (local criteria viral load (VL) ≥ 1000 copies/mL) were tested for HIVDR mutations using the WHO adapted protocol for plasma samples. Mutations were interpreted using the Stanford HIVDR database. In total 600 individuals participated in this survey, the majority were female (76.83%), mean age (± standard deviation) was 44.0 (± 11.6) years. The median duration on ART (interquartile range) was 6.5 (3.9-10.2) years. Approximately 99% were receiving tenofovir + lamivudine + dolutegravir as a fixed dose combination. VL testing was successful in 99.67% (598/600) of survey patients and only 33 had VL ≥ 1000 copies/mL, resulting in a viral suppression level of 94.48% (565/598, 95% CI 92.34-96.17%). For 23 samples, protease and reverse transcriptase (RT) genotyping were successful, with 13 sequences containing RT inhibitor surveillance drug resistance mutations (SDRMs) (56.5%). No
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Background: Simultaneous heroin use among methadone-maintained clients is a recognized phenomenon... more Background: Simultaneous heroin use among methadone-maintained clients is a recognized phenomenon worldwide. Tanzania is the first sub-Saharan African country to offer methadone treatment. This study explored reasons for heroin use among clients on methadone treatment clinics in Dar es Salaam, Tanzania. Methods: This was exploratory cross-sectional study. Purposive sampling was used to select ten study participants. In in-depth interview guide was used to collect data. The interviews were conducted in Kiswahili and lasted for about sixty minutes. Audio-recordings of the interviews were transcribed verbatim and translated into English. Transcribed data was analysed and subjected to thematic analysis with the help of Nvivo 12 software. Results: Many reasons were mentioned for concurrent use of heroin and methadone among clients on methadone treatment. Some of the mentioned reasons were inadequate methadone dose, treatment, healthcare providers' attitudes, and healthcare provision environment, lack of family support, peer influence homeless and easy availability of heroin. Conclusions: Different measures should be taken by methadone programs and stakeholders to overcome concurrent use of heroin and methadone among clients receiving methadone treatment.
Adequate utilization of postnatal care services is associated with improved maternal and neonatal... more Adequate utilization of postnatal care services is associated with improved maternal and neonatal health outcomes.The World Health Organization recommends postnatal women to attend postnatal care as early as seven days after delivery because most maternal deaths occur within 7 days of the postnatal period. However, many postnatal women who deliver in health facilities attend postnatal care very late during 42 days for child immunization. Little information is known as to why postnatal women who deliver in health facilities delay initiating postnatal care clinics for seven days post-delivery. This study aimed at exploring reasons as to why women who deliver in health facilities delay attending early postnatal care services. Methods A cross-sectional design using a qualitative approach was used to explore factors associated with early postnatal care attendance among postnatal women in Ubungo Municipal, Dar es Salaam, Tanzania. Study participants were purposively selected. In-depth int...
Uploads
and neonatal health outcomes. The World Health Organization recommends postnatal women
attend postnatal care as early as seven days after delivery because most maternal deaths occur
within 7 days of the postnatal period. However, many postnatal women attend postnatal care very
late during the 42 days and mainly for child immunization purposes. Little information is known on
barriers to postnatal women who delay initiating postnatal care clinics for seven days post-delivery.
This study explored barriers to attending early postnatal care among women attending early
postnatal care services in Ubungo municipality, Dar es Salaam.
Methods: A cross-sectional study design using a qualitative approach was used to explore factors
associated with early postnatal care attendance among postnatal women in Ubungo Municipal, Dar
es Salaam, Tanzania. Study participants were purposively selected. In-depth interviews were used
to collect data. Audio-recorded interviews were transcribed verbatim and translated into English.
Thematic analysis approach was used to excerpt barriers to delaying seeking early postnatal care
services in Ubungo Municipality.
Findings: The finding revealed a lack of awareness of the appropriate time to start early postnatal
care visits and the recommended number of postnatal visits, the perception of postnatal women
that the postnatal period is a normal condition that does not require health personnel’s attention,
thus the perception that no need to initiate early postnatal care clinics if they were not sick. Similarly,
long waiting times, transport costs, and healthcare providers’ attitudes were major reasons
reported by postnatal women to contribute to late postnatal care attendance. Thus, healthcare
providers should continue providing education to pregnant women on when and the importance of
attending early postnatal care.
and neonatal health outcomes. The World Health Organization recommends postnatal women
attend postnatal care as early as seven days after delivery because most maternal deaths occur
within 7 days of the postnatal period. However, many postnatal women attend postnatal care very
late during the 42 days and mainly for child immunization purposes. Little information is known on
barriers to postnatal women who delay initiating postnatal care clinics for seven days post-delivery.
This study explored barriers to attending early postnatal care among women attending early
postnatal care services in Ubungo municipality, Dar es Salaam.
Methods: A cross-sectional study design using a qualitative approach was used to explore factors
associated with early postnatal care attendance among postnatal women in Ubungo Municipal, Dar
es Salaam, Tanzania. Study participants were purposively selected. In-depth interviews were used
to collect data. Audio-recorded interviews were transcribed verbatim and translated into English.
Thematic analysis approach was used to excerpt barriers to delaying seeking early postnatal care
services in Ubungo Municipality.
Findings: The finding revealed a lack of awareness of the appropriate time to start early postnatal
care visits and the recommended number of postnatal visits, the perception of postnatal women
that the postnatal period is a normal condition that does not require health personnel’s attention,
thus the perception that no need to initiate early postnatal care clinics if they were not sick. Similarly,
long waiting times, transport costs, and healthcare providers’ attitudes were major reasons
reported by postnatal women to contribute to late postnatal care attendance. Thus, healthcare
providers should continue providing education to pregnant women on when and the importance of
attending early postnatal care.