SOCIAL DETERMINANTS OF HEALTH

Angela Kimweri

Overview

• Introduction to SDH

• Core SDH issues in Tanzania

• SDH policies and strategies

• Results from INTREC research

• Recommendations

Objectives of the workshop

• Workshop outcome

Understanding about SDH

Research that link social Determinants of Health and healthcare outcomes;

Social determinants of health conceptual framework

“Social Determinants of Health in

Tanzania” • Social-Physical-Economic-Services Determinants Gender Age Geographical location Malnutrition Poor budget allocation for health care Lack of human resource for health Social inequality Lack of social protection and specialized care for

elderly Unequal distribution of income and resources Education for children Poor link between policy and practices

(Source: By Rose Kalage, INTREC student 2012: Mapping SDH)

Relevant SDH polices and strategies

• National strategy for Growth and Poverty Reduction (II)

• National Health Policy

• National Aging Policy

• Tanzania Development vision 2025

• Multisectoral approach to SDH

Results

Research Title: Assessing the association between gender of the household head and adolescent pregnancy in Tanzania.

Methods: A cross section survey, using DHS 2010 , conducted with 2019 currently pregnant adolescents.

Data analysis: we applied bi-variate and multi-variate logistic regression technique to find out how gender of the household head and other social determinants factors associated with teenage pregnancy.

Results Table 2. Percent distribution of adolescent by background

characteristics in Tanzania

Variable % of adolescents who are currently pregnant

P-values

Marital Status Single Married Ever married

3.4 10.8 11.8

<0.001

Education No education Primary Secondary

11.3 8.6 1.4

0.015

Place of residence Urban Rural

4.6 10.2

<0.001

Religion Muslim Catholic Protestant None

6.4 8.7 11.8 10.7

0.021

Sex of the household head Male Female

9.7 6.2

0.035

Results cont…..

Multivariate logistic regression of factors associated with adolescent pregnancy in Tanzania

Variable Odds ratio (OR) 95% confidence interval (CI)

P-value

Sex of the household head Male (ref) Female

1 0.71

0.44-1.44

0.165

Marital status Single (ref) Married Ever married

1.00 2.88 3.68

1.71-4.86 1.82-7.46

<0.001 <0.001

Education No education (ref) Primary Secondary

1.00 0.90 0.18

0.63-1.25 0.02-1.38

<0.001

Place of residence Rural (ref) Urban

1.00 1.93

1.18-3.20

0.009

Survey year 1991 (ref) 1996 1999 2004 2009

1.00 0.76 0.79 1.54 1.39

0.50-1.35 0.42-150 1.03-2.33 0.89.219

0.038

Conclusion

• Various factors are interconnected • Adolescent are both affected by marital status,

Education, religion, and place of residence. • Early marriage as one significant factor for

adolescent pregnant • No significant effect between head of household

and adolescent pregnant however need further analysis

Recommendation

• Government

• • Incorporate SDH in all its major programmes and in the programmes of other ministries/sectors

• • Commitment/political will