Tanzania HIV/AIDS and Malaria Indicator Survey ... - Measure DHS

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The vision of the malaria medium term strategic plan is for Tanzania to become a society wheremalaria is no longer a threat to the health of its citizens, regardless of gender, religion or socioeconomicstatus.The recommended key malaria control strategies include:Improve early recognition of malaria and prompt treatment with effective antimalarial drugs;Prevent and control malaria in pregnancy, by increasing coverage with at least two doses ofIntermittent Preventive Treatment (IPT) among pregnant women attending public healthservices, and by promoting the regular and correct use of long-lasting insecticide-treated net(LLIN);Prevent infection with malaria by maintaining high coverage of LLITNs, with specificemphasis on vulnerable groups, complemented by other vector-control methods such asindoor residual spraying;Strengthen the Ministry of Health and Social Welfare (MoHSW) and key stakeholderssupport for malaria control through improved planning, management, partnership, andcoordination; andStrengthen monitoring and evaluation surveillance system to support localized control andenable early detection and response to malaria epidemics.Concerted effort, effective partnership, and coordination of all key players in malaria control at alllevels is critical to achievement of control and elimination of malaria in Tanzania.1.4 OBJECTIVES OF THE SURVEYThe 2007-08 Tanzania HIV/AIDS and Malaria Indicator Survey (THMIS) is the secondpopulation-based, comprehensive survey on HIV/AIDS carried out in Tanzania. The survey wascommissioned by the Tanzania Commission for AIDS (TACAIDS) and the Zanzibar AIDSCommission (ZAC).The 2007-08 THMIS was implemented by the National Bureau of Statistics (NBS) incollaboration with the Office of the Chief Government Statistician (OCGS), Zanzibar. MacroInternational provided technical assistance through MEASURE DHS, a USAID-funded projectproviding support and technical assistance in the implementation of population and health surveys incountries worldwide. Other agencies and organizations that facilitated the successful implementationof the survey, through technical or financial support, include the National AIDS Control Programme,the National Malaria Control Programme, the Ministry of Health and Social Welfare, the ZanzibarAIDS Control Programme, and Muhimbili University College of Health Sciences (MUCHS).The primary objectives of the 2007-08 THMIS survey were to provide up-to-date informationon the prevalence of HIV infection among Tanzanian adults, and the prevalence of malaria infectionand anaemia among children under age five years. The findings will be used to evaluate ongoingprogrammes and to develop new health strategies. Where appropriate, the findings from the 2007-08THMIS are compared with those from the 2003-04 Tanzania HIV/AIDS Indicator Survey (THIS).The findings of these two surveys are expected to complement the sentinel surveillance systemundertaken by the Ministry of Health and Social Welfare under its National AIDS Control Programme(NACP). The THMIS also provides updated estimates of selected basic demographic and healthindicators covered in previous surveys, including the 1991-92 Tanzania Demographic and HealthSurvey (TDHS), the 1996 TDHS, the 1999 Reproductive and Child Health Survey (RCHS), and the2004-05 TDHS.More specifically, the objectives of the 2007-08 THMIS were: To measure HIV prevalence among women and men age 15-49;Introduction | 3
To assess levels and trends in knowledge about HIV/AIDS, attitudes towards peopleinfected with the disease, and patterns of sexual behaviour; To collect information on the proportion of adults who are chronically sick, the extent oforphanhood, levels of and care and support; To gauge the extent to which these indicators vary by characteristics such as age, sex,region, education, marital status, and poverty status; and To measure the presence of malaria parasites and anaemia among children age 6-59months.The results of the 2007-08 THMIS are intended to provide information to assist policymakersand programme implementers to monitor and evaluate existing programmes and to design newstrategies for combating the HIV/AIDS epidemic in Tanzania. The survey data will also be used asinputs in population projections and to calculate indicators developed by the United Nations GeneralAssembly Special Session (UNGASS), the UNAIDS Programme, and the World Health Organization(WHO).1.5 SAMPLE SIZE AND DESIGNThe sampling frame used for the 2007-08 THMIS is the same as that used for the 2004-05TDHS, which was developed by NBS after the 2002 Population and Housing Census (PHC). Thesample excluded nomadic and institutional populations, such as persons staying in hotels, barracks,and prisons. The THMIS utilised a two-stage sample design. The first stage involved selecting samplepoints (clusters) consisting of enumeration areas delineated for the 2002 PHC. A total of 475 clusterswere selected. The sample was designed to allow estimates of key indicators for each of Tanzania’s26 regions. On the Mainland, 25 sample points were selected in Dar es Salaam and 18 in each of theother 20 regions. In Zanzibar, 18 sample points were selected in each of the five regions, for a total of90 sample points.A household listing operation was undertaken in all the selected areas prior to the fieldwork.From these lists, households to be included in the survey were selected. The second stage of selectioninvolved the systematic sampling of households from these lists. Approximately 16 households wereselected from each sampling point in Dar es Salaam, and 18 households per sampling point wereselected in other regions. In Zanzibar, approximately 18 households were selected from each samplingpoint in Unguja, and 36 households were selected in Pemba to allow reliable estimates of HIVprevalence for each island group.Because of the approximately equal sample sizes in each region, the sample is not selfweightingat the national level, and weighting factors have been added to the data file so that theresults will be proportional at the national level.In the selected households, interviews were conducted with all women and men age 15-49.The THMIS also collected blood samples for anaemia and malaria testing among children age 6-59months, and dried blood spot (DBS) samples for HIV testing among women and men age 15-49.1.6 QUESTIONNAIRESTwo questionnaires were used for the 2007-08 THMIS: the Household Questionnaire and theIndividual Questionnaire. The questionnaires are based on the standard AIDS Indicator Survey andMalaria Indicator Survey questionnaires, adapted for the population and health issues relevant toTanzania. Inputs were solicited from various stakeholders representing government ministries andagencies, nongovernmental organizations, and international partners. After the preparation of thedefinitive questionnaires in English, questionnaires were translated into Kiswahili.4 | Introduction
Page 1 and 2: TanzaniaHIV/AIDS and MalariaIndicat
Page 3 and 4: The 2007-08 Tanzania HIV/AIDS and M
Page 5 and 6: 3.5 Access to Mass Media ..........
Page 7 and 8: 12.2 Orphans and Vulnerable Childre
Page 9 and 10: Table 4.3Table 4.4Table 4.5Table 4.
Page 11 and 12: Figure 9.2 HIV Prevlence by Region/
Page 14: FOREWORDThis report presents the ma
Page 18 and 19: SUMMARY OF FINDINGSThe 2007-08 Tanz
Page 20 and 21: HIV prevalence among youth (women a
Page 23 and 24: xxii | Map of Tanzania
Page 25: 1.2 NATIONAL POLICY ON HIV/AIDSIn r
Page 29 and 30: 1.8 FIELDWORKData collection was ca
Page 31 and 32: Table 1.1 Results of the household
Page 33 and 34: Figure 2.1 presents a graphic pictu
Page 35 and 36: Table 2.3.1 Educational attainment
Page 37 and 38: Educational attainment is higher in
Page 39 and 40: 2.5.1 Energy SourcesTable 2.5 prese
Page 41 and 42: The most common items are agricultu
Page 43 and 44: The 2007-08 THMIS included aquestio
Page 45 and 46: Table 3.1—ContinuedBackgroundchar
Page 47 and 48: Education is positively related to
Page 49 and 50: Table 3.3.2 Employment status: MenP
Page 51 and 52: Table 3.4.1 Exposure to mass media:
Page 53 and 54: 3.6 CURRENT MARITAL STATUSMarriage
Page 55 and 56: Polygyny also varies by household w
Page 57 and 58: Four in ten women age 20-49 marry b
Page 59 and 60: There is a positive relationship be
Page 62 and 63: FERTILITY AND REPRODUCTIVE HEALTH 4
Page 64 and 65: Table 4.2 Fertility by background c
Page 66 and 67: infertility, 1 or the inability to
Page 68 and 69: 4.3 ADOLESCENT FERTILITYAdolescent
Page 70 and 71: Table 4.7 Antenatal carePercent dis
Page 72: Table 4.8 Place of antenatal carePe
Page 75 and 76: Table 5.1 Knowledge of AIDSPercenta
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The use of condoms as an effective
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Table 5.3.2 Comprehensive knowledge
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more education) and those in the fo
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Table 5.5.1 Exposure to HIV educati
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5.6 KNOWLEDGE AND ATTITUDE CONCERNI
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Table 5.6.2 Knowledge and attitudes
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Table 6.1.1 Accepting attitudes tow
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Stigma is also found to vary with l
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6.3 ATTITUDES OF ADULTS TOWARDS EDU
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HIV/AIDS-RELATED BEHAVIOUR 77.1 INT
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Table 7.2.1 Recent sexual activity:
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Figure 7.1 Recent Sexual Intercours
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Table 7.3.2 Multiple sexual partner
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Table 7.4 Payment for sexual interc
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Table 7.5.1 Coverage of prior HIV t
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Figure 7.2 Prior HIV Testing by Edu
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7.7 PREVALENCE OF SEXUALLY TRANSMIT
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Figure 7.3 Prevalence of STIs and S
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Table 7.8 Prevalence of medical inj
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Table 8.1 Comprehensive knowledge a
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Table 8.2 Age at first sexual inter
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Never-married women and men age 15-
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Figure 8.3 Condom Use at Premarital
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Table 8.5.2 Higher-risk sexual inte
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Table 8.6 Age-mixing in sexual rela
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8.9 HIV TESTING AMONG YOUNG PEOPLEK
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HIV PREVALENCE 99.1 INTRODUCTIONPri
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Table 9.1 Coverage of HIV testing b
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Table 9.1—ContinuedBackgroundchar
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Table 9.3 HIV prevalence by ageAmon
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There are large variations in HIV p
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Table 9.5 shows that men who are cu
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Women who said they had higher-risk
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Table 9.8 shows data on HIV prevale
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Table 9.11 HIV prevalence by male c
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INFANT AND CHILD MORTALITY 1010.1 I
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As expected, the level of infant an
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category (1.41) is 41 percent highe
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11.1 OWNERSHIP AND USE OF MOSQUITO
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carrying mosquitoes. Much of the fi
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11.2 USE OF ANTIMALARIAL DRUGS DURI
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11.3 TREATMENT OF CHILDREN WITH FEV
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11.4.1 Type and Timing of Antimalar
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11.4.2 Availability of Drug at Home
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11.6 SOURCE OF MOSQUITO NETSUntil l
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In spite of steady increases in ITN
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ORPHANS AND VULNERABLE CHILDREN 12P
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12.2 ORPHANS AND VULNERABLE CHILDRE
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12.3.1 School Attendance by Survivo
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While there are no differences in p
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Table 12.7 Widows dispossessed of p
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Table 12.9 External support for orp
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REFERENCESAgot, K.E., J.O. Ndinya-A
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SAMPLE IMPLEMENTATIONAPPENDIX AAppe
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Table A.2 Sample implementation: Me
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Table A.4 Coverage of HIV testing a
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Table A.6 Coverage of HIV testing a
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where h represents the stratum whic
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Table B.2 Sampling errors for Natio
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Table B.4 Sampling errors for Rural
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Table B.6 Sampling errors for Mainl
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Table B.8 Sampling errors for Mainl
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Table B.10 Sampling errors for Zanz
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Table B.12 Sampling errors for Nort
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Table B.14 Sampling errors for Sout
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Table B.16 Sampling errors for East
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Table B.18 Sampling errors for Dodo
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Table B.20 Sampling errors for Kili
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Table B.22 Sampling errors for Moro
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Table B.24 Sampling errors for Dar
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Table B.26 Sampling errors for Mtwa
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Table B.28 Sampling errors for Irin
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Table B.30 Sampling errors for Sing
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Table B.32 Sampling errors for Rukw
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Table B.34 Sampling errors for Shin
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Table B.36 Sampling errors for Mwan
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Table B.38 Sampling errors for Many
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Table B.40 Sampling errors for Pemb
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216 | Appendix B
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Joyce MbambaYulitha MwakasoleRemigi
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QUESTIONNAIRESAppendix DAppendix D
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HOUSEHOLD SCHEDULEIntroduction and
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IF AGE 0-17 YEARSIF AGE 5 YEARS OR
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IF AGE 0-17 YEARSLINE SICK CARE SUR
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HOUSEHOLD CHARACTERISTICSNO. QUESTI
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NO. QUESTIONS AND FILTERS CODING CA
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SUPPORT FOR SICK PEOPLENO. QUESTION
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NO.QUESTIONS AND FILTERSSUPPORT FOR
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NO.QUESTIONS AND FILTERSCODING CATE
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CHILD 4 CHILD 5 CHILD 6502 LINE NUM
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515 CHECK 509:NUMBER OF CHILDREN WI
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UNITED REPUBLIC OF TANZANIATANZANIA
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213 214 215 216217 218219 220221222
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LAST BIRTH NEXT-TO-LAST BIRTH SECON
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Page 282 and 283:
Page 284 and 285:
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LASTSEXUAL PARTNERSECOND-TO-LASTSEX
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Page 292 and 293:
Page 294 and 295:
Page 296 and 297:
SECTION 7 - HIV TESTTHIS PAGE TO BE
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