In Tanzania, 44% of women experience intimate partner violence (IPV) in their lifetime, but the majority never seeks help, and many never tell anyone about their experience. Even among the minority of women who seek support, only 10% access formal services. Our research explored the social and structural barriers that render Tanzanian women unable to exercise agency in this critical domain of their lives. We collected qualitative data in three regions of Tanzania through 104 key informant interviews with duty bearers and participatory focus groups with 96 male and female community members. The findings revealed numerous sociocultural barriers to help-seeking, including gendered social norms that accept IPV and impose stigma and shame upon survivors. Because IPV is highly normalised, survivors are silenced by their fear of social consequences, a fear reinforced by the belief that it is women's reporting of IPV that brings shame, rather than the perpetration of violence itself. Barriers to help-seeking curtail women's agency. Even women who reject IPV as a 'normal' practice are blocked from action by powerful social norms. These constraints deny survivors the support, services and justice they deserve and also perpetuate low reporting and inaccurate estimates of IPV prevalence.

BackgroundIntensive malaria control interventions in the United Republic of Tanzania have contributed to reductions in malaria prevalence. Given that malaria control remains reliant upon continued use of long-lasting insecticidal bed nets (LLINs) even when the threat of malaria has been reduced, this qualitative study sought to understand how changes in perceived risk influence LLIN usage, and to explore in more detail the benefits of net use that are unrelated to malaria.MethodsEleven focus group discussions were conducted in Bukoba Rural district and in Zanzibar Urban West district in late 2011. Participants were males aged 18 and over, females between the ages of 18 and 49, and females at least 50 years old.ResultsThe perceived risk of malaria had decreased among the respondents, and malaria control interventions were credited for the decline. Participants cited reductions in both the severity of malaria and in their perceived susceptibility to malaria. However, malaria was still considered a significant threat. Participants’ conceptualization of risk appeared to be an important consideration for net use. At the same time, comfort and aspects of comfort (getting a good night’s sleep, avoiding biting pests) appeared to play a large role in personal decisions to use nets consistently or not. Barriers to comfort (feeling uncomfortable or trapped; perceived difficulty breathing, or itching/rashes) were frequently cited as reasons not to use a net consistently. While it was apparent that participants acknowledged the malaria-prevention benefits of net use, the exploration of the risk and comfort determinants of net use provides a richer understanding of net use behaviours, particularly in a setting where transmission has fallen and yet consistent net use is still crucial to maintaining those gains.ConclusionFuture behaviour change communication campaigns should capitalize on the non-malaria benefits of net use that provide a long-term rationale for consistent use even when the immediate threat of malaria transmission has been reduced.

BackgroundThe objective of this study was to identify attitudes and misconceptions related to acceptance or refusal of indoor residual spraying (IRS) in Tanzania for both the general population and among certain groups (e.g., farmers, fishermen, community leaders, and women).MethodsThis study was a series of qualitative, semi-structured, in-depth interviews and focus group discussions conducted from October 2010 to March 2011 on Mainland Tanzania and Zanzibar. Three groups of participants were targeted: acceptors of IRS (those who have already had their homes sprayed), refusers (those whose communities have been sprayed, but refused to have their individual home sprayed), and those whose houses were about to be sprayed as part of IRS scale-up. Interviews were also conducted with farmers, fishermen, women, community leaders and members of non-government organizations responsible for community mobilization around IRS.ResultsResults showed refusers are a very small percentage of the population. They tend to be more knowledgeable people such as teachers, drivers, extension workers, and other civil servants who do not simply follow the orders of the local government or the sprayers, but are skeptical about the process until they see true results. Refusal took three forms: 1) refusing partially until thorough explanation is provided; 2) accepting spray to be done in a few rooms only; and 3) refusing outright. In most of the refusal interviews, refusers justified why their houses were not sprayed, often without admitting that they had refused. Reasons for refusal included initial ignorance about the reasons for IRS, uncertainty about its effectiveness, increased prevalence of other insects, potential physical side effects, odour, rumours about the chemical affecting fertility, embarrassment about moving poor quality possessions out of the house, and belief that the spray was politically motivated.ConclusionsTo increase IRS acceptance, participants recommended more emphasis on providing thorough public education, ensuring the sprayers themselves are more knowledgeable about IRS, and asking that community leaders encourage participation by their constituents rather than threatening punishment for noncompliance. While there are several rumours and misconceptions concerning IRS in Tanzania, acceptance is very high and continues to increase as positive results become apparent.Swahili AbstractUsuliMalengo mahususi ya utafiti huu ni kutambua tabia na imani potofu zinazopelekea kukubali au kutakaa upuliaziaji wa dawa ya kuua mbu majumbani (IRS) katika Tanzania kwa watu wote kwa ujumla na kwa makundi maalumu ya watu (kama wakulima, wavuvi, viongozi wa jamii na wanawake).NjiaUtafiti huu ni mfululizo wa tafiti stahilifu zenye sehemu ya muundo, tafiti za kina na majadilianao ya vikundi vya walengwa yaliyofanyika Tanzania bara na Zanzibar kuanzia mwezi Oktoba, 2010 hadi mwezi Machi, 2011. Yalikuwepo makundi matatu ya walengwa: wanaokubali IRS (wale ambao nyumba zao zilikwisha kupulizwa dawa ya kuua mbu) wasiokubali (hii ni jamii ili...

Among women in mainland Tanzania, Iringa region in the southern highlands has the highest HIV/AIDS prevalence rate while Arusha region in the north-east has the lowest prevalence rate. In a 2007/8 survey, Iringa's HIV rate for women was 18.6% versus 0.8% in Arusha. Using data from a survey of women aged 15-49 years conducted in 2009 by the Champion project of EngenderHealth, a comparison was made of HIV/AIDS knowledge, attitude and practice between women in Iringa and Arusha regions. It was found that women in Arusha region had more knowledge of HIV/AIDS than women in Iringa region, and that more than three-quarters of the women in each region were married and 12% of the women in Arusha region had never been married compared with 8% of the women in Iringa region. The majority of women in each region had at least primary school education and there was no significant difference between their educational levels. Women in Arusha region were economically less active than women in Iringa region, a statistically significant association. More women in Arusha region than in Iringa region had never had children (24% versus 12%). Similarly, women in Arusha region had significantly fewer children compared with women in Iringa.