Risk factors for infertility and barriers to treatment in Tanzania: a survey and medical records study

Emily A. Groene, Cyrialis Mutabuzi, Dickson Chinunje, Ester Shango, Mkhoi L. Mkhoi, Susan M. Mason, Shalini Kulasingam, Charles R. Majinge

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: The burden of infertility is serious for women in high-fertility countries. Objectives: We sought to identify demographic, behavioral/environmental, and reproductive risk factors for various infertility factors (i.e., ovarian, tubal, uterine/cervical, male/other) among women seeking infertility treatment in central Tanzania; to determine the association between pelvic inflammatory disease (PID) and tubal factor infertility (TFI); and to identify barriers to infertility treatment by women’s home regional zone. Methods: We conducted a cross-sectional survey of women seeking infertility treatment in Dodoma, Tanzania from January-March 2020. We surveyed 168 participants aged 18-49 years and reviewed their medical records to confirm infertility status and potential risk factors. We estimated prevalence ratios for factors associated with infertility using logistic regression. Treatment barriers were compared by women’s regional zone to see if barriers varied geographically. Results: The median age of participants was 32 years (range: 18-48). Infertility factors did not vary greatly by patient demographics, behavioral/environmental, or reproductive risk factors. Approximately 31.48% of women had PID diagnoses. Those with PID had 1.94 (95% CI: 1.30, 2.90) times the prevalence of TFI diagnosis as those with other infertility factors, after adjusting for age, pesticide use, alcohol use, age at sexual debut, prior obstetric events, and family history of infertility. Logistical barriers to treatment, such as time and cost, were more frequently reported than emotional, stigma, or other barriers, regardless of regional zone. Conclusions: PID was strongly associated with TFI after adjustment for confounders. Infertility treatment access due to cost remains a challenge in Tanzania.

Original languageEnglish (US)
Pages (from-to)462-471
Number of pages10
JournalAfrican Health Sciences
Issue number4
StatePublished - Dec 27 2023

Bibliographical note

Publisher Copyright:
© 2023 Groene EA et al. Licensee African Health Sciences.


  • Infection
  • Infertility
  • Tanzania


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