Proper family planning initiatives to promote country’s economy

Despite various government initiatives designed to boost the health sector in the country, there have been challenges affecting the supply of contraceptives at a few health centres, which offer family planning services, especially in rural areas. James Mlali, project implementation manager at the Tanzania Communication and Development Center (TCDC), shared these observations while addressing the media over the weekend.

Mlali said the challenges are due to insufficient budget allocated towards family planning initiatives, something which has contributed to many Tanzanians failing to use family planning adequately, particularly those residing in rural areas. Mlali added that TCDC, together with key family planning stakeholders, has been pushing for a budget increase for the health sector and specifically on family planning in order to push for increased use of modern family planning methods.

“Unless the government sees the importance of family planning, society will always be faced with countless challenges, such as poverty and lack of education for most who live in rural areas. When people lack family planning methods, then there is no proper control of birth. This, according to Mlali, increases the number of dependents within a family. “When you have many dependents in a family, most of the income is used to feed them meaning other areas will not be developed or pursued,” Mlali added.

Since Tanzania gained independence more than five decades ago, most people living in rural areas continue to be affected by poverty to this present day. This is mainly due to the fact that most people in households depend on one person, either the father or mother. In addition, most productive people in rural areas are women and when these women birth and raise children every now and then, without proper of family planning, the household remains trapped in a cycle of poverty. This is the unfortunate predicament facing many rural households that are faced with increasingly more mouths to feed and lower levels of income, which inevitably increases poverty levels of rural families, said Mlali.

He added that for the country to achieve the industrialization drive, it is important for the country to invest heavily on family planning. In addition, the government must also make sure that the increase in population go hand-in-hand with the available resources and economic situation of the country. Mlali further explained this scenario by adding that we can have a high population, but again as a country, are we producing enough to cater to the population? If we look at the example of post-secondary education, are graduates getting employment opportunities after completing school? Mlali asked. This is an important aspect to consider particularly given the close correlation between employment and economic growth.

‘When a country attains a middle economy, it is important for the people to depend on themselves economically.” This is very important and it is precisely where our country should focus on, Mlali concluded.


Commodity Availability: Focus on What Women Want

Most, if not all, reproductive health partners say: ”No commodity, no program,” as they ponder how best to reach women and girls with life-saving commodities including contraceptives. The focus has for many years remained on target number of those reached or to be reached with various services including contraceptives.

Yet ensuring access to family planning (FP) services is beyond setting target numbers only. But also, and increasingly important, is to ensure clients rights are upheld, which includes many more aspects beyond meeting clients’ needs for information, counseling and their method choice through informed decision-making. It also means empowering them to participate, provide feedback on services rendered and be involved in accountability issues.

Studies in a number of developing countries shows that ensuring method mix, choice and having adequate skilled service providers in place, have been a constant struggle and challenge. Coercion to using contraceptives methods or to pregnancy by service providers or intimate partners, respectively, continue to characterize a number of family planning programs worldwide.

A recent post-London FP Summit consultative meeting that brought CSOs from the North and the South, donors and researchers, explored the rights-based approach (RBA) and acknowledged the need for doing ‘business unusual’. This means apart from focusing on quality, voluntary, informed choice and decision making as well as addressing privacy and confidentiality, the FP movement (governments, CSOs, donors, private sector, etc) should be more intentional in ensuring that services are non-discriminatory and equitable.

They also ought to put in place clients’ empowerment, their autonomy, and participation, while engaging different structures, processes, and actors including youth, to promote and ensure accountability at all levels. It means applying a human rights lens in the family planning / reproductive health program.

Admittedly, the RBA move is complex because it interrogates socio-cultural practices, and political contexts and is subject to different interpretation, but based on evidence the good news is that once integrated in FP program, RBA contributes to increased reproductive outcomes, and reduced coercion and intimate partner violence.

There is already evidence that shows that increasingly countries and donors are thinking about how to incorporate human rights into the design and execution of family planning programs, because globally, respecting, protecting, and fulfilling rights of individuals is acknowledged as key to advancing family planning and the broader sexual and reproductive health and rights (SRHR) agenda.

Admittedly, “rights” is an unfinished agenda in FP and SRHR arena, however, given the existing Results-based family planning index, that adheres to human rights and empowerment principles for FP, and other protocols, there is great hope for progress.

As countries begin to implement their respective FP2020 commitments made in 2017, RBA will certainly feature in national consultations, as well as Costed Implementation Plans (CIPs). Contributing to global 120 million more users with family planning information, services and supplies by 2020, also means paying attention to women’s, girls’ and men’s human rights as they relate to family planning.

Reaching the Last Mile with Contraceptives: Parliamentarians Commit to Take Stock

On March 8th 2017, the Tanzania Parliamentary Association on Population and Development (TPAPD) made a number of commitments including;

  • Holding the government and its institutions accountable for allocating, disbursing, and utilizing resources for provision of reproductive health and family planning services; as well as
  • Engaging community leadership in promoting public demand, greater acceptance and use of the services so that the national contraceptive prevalence rate (CPR) target of 60% for all methods, (45% for modern methods) is attained by the year 2020.

Just three months later – on Thursday, June 22nd  2017 – TPAPD leadership and other members adopted an Action Plan to strengthen collaboration with key family planning partners such as the Advance Family Planning (AFP) project. The plan anchors on strengthening capacity in advocacy, and accountability to sustain efforts to catalyze community participation towards increased family planning uptake.

One critical issue that generated a lot of discussion was on how to monitor commodity stock levels in facilities in their respective constituencies. For some Members of Parliament (MPs) AFP’s Commodity Monitoring Tool introduced and validated last year was the option to facilitate their community work. TPAPD adopted the tool and demanded that it be used by its committed members beginning July this year.

TPAPD Chair Hon. Mary Mwanjelwa (Special Seat MP for Mbeya Region) and Secretary General, Hon Sebastian Kapufi (MP for Mpanda Urban in Katavi Region) made special appeals to parliamentarians to ensure that family planning remains at the centre of development planning, and see to it that sub-national level governments get serious with making contraceptives available everywhere all the time.

“This tool comes at the right time, as we see that maternal mortality and teenage pregnancies in the country are on the rise as a result of low coverage and use of family planning services. It will equip us with the ability to collect evidence and use it in decision making bodies in our respective constituencies” said a TPAPD member.

Rising rates of teenage pregnancy and maternal mortality have been mind-boggling issues that generated great concern given their impact on the status of girls and women, and especially on the overall movement to empower women – one of the key pillars in building a just and equitable society. About two-thirds (16) of Tanzania Mainland’s 26 regions have a teenage pregnancy rate that is above the national average of 27%, which in fact has risen from 23% in 2010.

Given the President’s directive recently on disallowing re-admission of girls who become pregnant while in school, efforts to ‘save’ this generation from poverty and deprivation as they become adult women become more complicated. This group of girls aged 15-19 comprises of a larger segment of society with more girls who are either married, divorced, or work as petty traders struggling to fend for themselves and their families after missing on education and other more decent opportunities.

Undoubtedly, at any one point, a generation of girls in this age group is lost because only a small percentage makes it to higher learning institutions including universities to enhance their knowledge and skills for presumably better paying jobs, or other opportunities for better lives.

Now as parliamentarians and other advocates take on this agenda to ‘save’ Tanzania’s girls, it is imperative to face this challenge head on: Equip girls and young women with information, knowledge, counseling on contraception, and provide contraceptives to those who are sexually active; invest in gender empowerment initiatives so that equal treatment and participation of girls and boys becomes a norm across all sectors; taking to task culprits who find comfort in preying on innocent girls.

This is called Prevention – it means taking responsibility of nurturing this future human resource, while remaining accountable to delivering on Tanzania’s Development Goal 2025 that states in part – “… to achieve a high quality of livelihood for its citizens; peace, stability, and unity; good governance; a well-educated society; and a competitive economy capable of producing sustainable growth and shared benefits”. It means girls will no longer be abandoned or condemned to figure out their own lives after pregnancy.



Mara regional leaders show ownership to family planning programs

After succeeding in raising its contraceptive prevalence rate (CPR) in the past five years, the Mara Regional leaders recently directed all its local government authorities (LGAs) to set aside 5% of its budget towards improving family planning services.

A letter dated February 28, 2017 containing the directive and signed on behalf of the Mara Regional Administrative Secretary, expressed concern over the slow pace in CPR growth at national and regional level, and underscored the need for intensifying efforts to improve family planning performance.

Mara’s move is exemplary and underscores leadership commitment to own and promote family planning. Mara is also one of the leading regions that have been successful in recording a major leap in CPR increase from 13% in 2010 to 29% in 2015-16, according to the Tanzania Health and Demographic Survey, Malaria Indicator Survey (TDHS-MIS 2015-16).

Located in the Lake Zone, Mara is among 12 regions that the Advance Family Planning (AFP) project has been working in since 2015. LGAs in the regions have strived to allocate between 2% and 5% of their district and health budgets, respectively to family planning. The directive therefore is meant to ensure sustained efforts to the family planning agenda.

AFP through its partners – Health Promotion Tanzania (HDT) and Tanzania Communication and Development Centre (TCDC) – has successfully engaged about 72 LGAs in phases with the majority of them heading to the call by making budget allocations and commitments from their own resources.

In 2017/18 financial year, fourty-four 44 LGAs in 6 Regions – Kigoma, Tabora, Dar es Salaam, Coast, Katavi and Manyara-  have allocated 2% of their ‘own’ funds for family planning services in the 2017/18. Investment in family planning is critical in reducing the high fertility of about six children per woman in reproductive age contributing to Tanzania’s rapid annual population growth rate of 2.7%.