households, to 41% in children from the poorest households. The introduction of Insecticide Treated bad Nets (ITN) is one of the primary health care interventions toward reducing the Transmission of malaria. About 62 percent of the under fives in Unguja slept under a Mosquito net, compared to 44% in Pemba Overall, for Zanzibar, 55% of children under five years of age slept under a net. Table No 5: % of children under five years of Age sleeping Under a Mosquito Net 2004/05 Children who slept under a ever treated Children who slept under Amy type of mosquito net mosquito net 28.4 Zanzibar 54.7 34.2 Unguja 61.6 19.0 Pemba 43.6 15.8 Zanzibar North 35.7 32.4 Zanzibar South 51.8 41.7 Zanzibar West 74.0 16.2 Pemba North 36.9 22.0 Pemba South 50.6 Source: NBS, Macro International TDHS, 2006 Maternal mortality and morbidity - High maternal mortality ratios (MMR) have persisted over the past decade with the current estimate at 580/100,000. High MMR is related to the prevalence of early childbearing (52 per cent of young women are pregnant or have a child by the age of 19)34, low levels of institutional deliveries (47 per cent) and low attendance at birth by skilled attendants (46 per cent). Adolescent girls are disproportionately affected by pregnancy and delivery complications and are also at higher risk of death, as are their children. UMATI (Family Planning Association) and Marie Stopes are two key NGO partners of the Ministry of Health and Social Welfare on sexual and reproductive health issues. One 34 TDHS, 2004/5 38