Volume 123, Issue 1 p. 37-41
Clinical articles

Women's ability to self-screen for contraindications to combined oral contraceptive pills in Tanzanian drug shops

Dawn Chin-Quee

Corresponding Author

Dawn Chin-Quee

Division of Health Services Research, FHI 360, Research Triangle Park, Durham, USA

Corresponding author at: Health Services Research, FHI 360, 2224 E. NC Highway 54, Durham, NC 27713, USA. Tel.: + 1 919 544 7040; fax: + 1 919 544 7261.Search for more papers by this author
Esther Ngadaya

Esther Ngadaya

National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania

Search for more papers by this author
Amos Kahwa

Amos Kahwa

National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania

Search for more papers by this author
Thomas Mwinyiheri

Thomas Mwinyiheri

National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania

Search for more papers by this author
Conrad Otterness

Conrad Otterness

Division of Health Services Research, FHI 360, Research Triangle Park, Durham, USA

Search for more papers by this author
Sayoki Mfinanga

Sayoki Mfinanga

National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania

Search for more papers by this author
Kavita Nanda

Kavita Nanda

Department of Integrated Health Sciences, FHI 360, Research Triangle Park, Durham, USA

Search for more papers by this author
First published: 13 July 2013
Citations: 9
Results published in part as a research brief: “Women's ability to self-screen for COCs compared to a nurse's assessment: Drug shops in rural and peri-urban Tanzania” (http://www.fhi360.org/sites/default/files/media/documents/tanzania-addo-coc-selfscreen.pdf).

Abstract

Objective

To estimate the accuracy of self-screening for contraindications to combined oral contraceptive pills (COCs) and to estimate the proportion of women with contraindications to hormonal methods among those using drug shops in Tanzania.

Methods

Trained nurses interviewed 1651 women aged 18–39 years who self-screened for contraindications to COCs with the help of a poster at drug shops in Tanzania. Nurse assessment of the women served as the gold standard for comparison with self-assessment. Blood pressure was also measured onsite.

Results

Nurses reported that 437 (26.5%) women were not eligible to use COCs, compared with 485 (29.4%) according to self-report. Overall, 133 (8.1%) women who said that they were eligible were deemed ineligible by nurses. The rate of ineligibility was artificially high owing to participant and nurse assessments that were incorrectly based on adverse effects of pill use and cultural reasons, and because of the sampling procedure, which intercepted women regardless of their reasons for visiting the drug shop. Adjusted rates of ineligibility were 8.6% and 12.7%, respectively, according to nurse and participant assessment. Both nurses and women underestimated the prevalence of hypertension in the present group.

Conclusion

Self-screening among women in rural and peri-urban Tanzania with regard to contraindications to COC use was comparable to assessment by trained nurses.