BMC Public Health 2006, 6:109 http://www.biomedcentral.com/1471-2458/6/109 Authors' contributions All authors contributed to the paper. All authors con- ceived the study. The first author conducted the study. B.E. Olsen and M. I. Matee supervised the research. K. I. Yahya- Malima and K Fylkesnes led the analysis. All authors helped to conceptualise ideas, interpret the findings and reviewed drafts of the manuscript. Acknowledgements We would like to acknowledge the Gender Generation and Communica- tion in these times of AIDS project (GeGCA), Bergen, Norway and the Centre for International Health, University of Bergen, Norway for funding this study. GeGCA is a collaborative project by the University of Bergen, and Faculty of Nursing, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania, funded by the Norwegian Council for Higher Edu- cation's Programme for Development Research (NUFU). Sincere apprecia- tion to Astrid Blystad of GeGCA, Bergen, and Carol Holm Hansen of the Institute of Public Health, Oslo, Norway for their initial efforts in this work. We thank the regional and district authorities of Manyara and Singida regions in Northern Tanzania, the local government reproductive and child health (RCH) co-ordinators and their staff in the antenatal clinics of Ndug- uti and Basotu. In addition, we thank the administration and staff of Mwanga Dispensary. We also thank the Haydom Lutheran Hospital, with its admin- istration, staff, RCH coordinator and RCH staff. Special acknowledgement is due to the former medical director of Haydom Lutheran Hospital, the Late Dr. Ole Halgrim Evjen Olsen and Mrs. Kari Olsen for their invaluable assistance. We are particularly thankful for the great assistance provided by the chairperson of the Haydom HIV prevention committee (HAVACOP), Mr Hosea Naman and the former secretary Ms Barbara Robertson and the rest of its staff. 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