Browsing by Author "Murewanhema, G."

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    Changes in causes of pregnancy‑related and maternal mortality in Zimbabwe 2007‑08 to 2018‑19: findings from two reproductive age mortality surveys
    (BMC Public Health, 2022) Musarandega, R.; Ngwenya, S.; Murewanhema, G.; Machekano, R.; Magwali, T.; Nystrom, L.; Pattinson, R.; Munjanja, S.
    Background Reducing maternal mortality is a priority of Sustainable Development Goal 3.1 which requires frequent epidemiological analysis of trends and patterns of the causes of maternal deaths. We conducted two reproductive age mortality surveys to analyse the epidemiology of maternal mortality in Zimbabwe and analysed the changes in the causes of deaths between 2007-08 and 2018-19. Methods We performed a before and after analysis of the causes of death among women of reproductive ages (WRAs) (12-49 years), and pregnant women from the two surveys implemented in 11 districts, selected using multi-stage cluster sampling from each province of Zimbabwe (n=10); an additional district selected from Harare. We calculated mortality incidence rates and incidence rate ratios per 10000 WRAs and pregnant women (with 95% confidence intervals), in international classification of disease groups, using negative binomial models, and compared them between the two surveys. We also calculated maternal mortality ratios, per 100 000 live births, for selected causes of pregnancy-related deaths. Results We identified 6188 deaths among WRAs and 325 PRDs in 2007-08, and 1856 and 137 respectively in 2018-19. Mortality in the WRAs decreased by 82% in diseases of the respiratory system and 81% in certain infectious or parasitic diseases' groups, which include HIV/AIDS and malaria. Pregnancy-related deaths decreased by 84% in the indirect causes group and by 61% in the direct causes group, and HIV/AIDS-related deaths decreased by 91% in pregnant women. Direct causes of death still had a three-fold MMR than indirect causes (151 vs. 51 deaths per 100 000) in 2018-19. Conclusion Zimbabwe experienced a decline in both direct and indirect causes of pregnancy-related deaths. Deaths from indirect causes declined mainly due to a reduction in HIV/AIDS-related and malaria mortality, while deaths from direct causes declined because of a reduction in obstetric haemorrhage and pregnancy-related infections. Ongoing interventions ought to improve the coverage and quality of maternal care in Zimbabwe, to further reduce deaths from direct causes.
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    HIV status and contraceptive use in Zimbabwe among sexually active adolescent girls and women: Secondary analysis of Zimbabwe Demographic Health survey data
    (SAMJ Research, 2024-06) Musuka, G.; Murewanhema, G.; Mukandavire, Z.; Chingombe, I.; Cuadros, D.; Mutenherwa, F.; Dzinamarira, T.; Eghtessadi, R.; Malunguza, N.; Mapingure, M.
    BACKGROUND. Understanding the pattern of contraceptive use among women living with HIV is critical for formulating relevant public health interventions to improve the uptake and use of reliable methods in this population. This helps to reduce the incidence of unintended pregnancies. OBJECTIVE. In this secondary data analysis, we aimed to describe contraceptive use by HIV-positive and HIV-negative sexually active adolescent girls and women, using data from the Zimbabwe Demographic and Health Survey (2015-16). METHOD. We used statistical analysis to determine the association between the use of various methods of contraception and HIV status using the Zimbabwe Demographic and Health Survey, 2015-16 data. RESULTS. Overall, the contraceptive use prevalence in this study was 60%. Sexually active adolescent girls and women on the Pill and injections were less likely to be HIV-positive compared with those not using any method of contraception (odds ratio (OR)= 0.54, 95% confidence interval (CI)(0.45-0.64), p= 0.001; and OR= 0.75, 95% CI (0.59-0.96), p= 0.020, respectively). Those using either a male or female condom were more likely to be HIV-positive, OR= 3.36, 95% CI (2.63-4.28), p= 0.001. CONCLUSIONS. This study revealed that there is still a considerable unmet need for contraception among the study population, highlighting the need to devise strategies to increase contraception uptake among women. Statistically significant differences were noted in the use of condoms, with those who are HIV-positive having a higher use of condoms compared with those who are HIV-negative. This may reflect that HIV-positive individuals have received appropriate counselling messages on the need to use barrier methods.