Tanzania Moving Forward with FP2020 Commitments

Just a few months after Tanzania revitalized its FP2020 commitments in London in July this year, pace to broaden access to family planning services and ensure increase uptake is gaining momentum.

The government has recently launched a national campaign against teenage pregnancy demanding local government authorities to take charge in protecting young girls, and monitoring progress in reducing teenage pregnancy cases. The teenage pregnancy rate increased from 23% in 2010 to 27% in 2015, curtailing opportunities for young girls to complete their education.

Reports on one district of Mpwapwa in Dodoma Region show that 250 girls aged 15-19 failed to complete their secondary education due to pregnancy. And as a result, these girls, like others in such circumstances across the country, are barred from returning to school.

The government move, along with current efforts to finalize the Adolescent Health Strategy, is part of implementing its FP2020 commitments, which include scaling up the provision of adolescent reproductive health services to empower and enable young people make informed decisions.

Tanzania has also committed to increase domestic resources for family planning to 17 billion Tanzanian shillings by 2020, as well as reduce contraceptive stock outs from 70% to 40%.  In addition, the government and family planning stakeholders including development partners, are currently developing the second National Family Planning Costed Implementation Plan (2017-2022) to provide a framework for continuous investment in family planning with a focus on high impact interventions.

Other countries’ FP2020 commitments are found in this summary document here and the full Summit outcomes document here.

 

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.

Youth: The Pillar of Social Transformation

One of the biggest wins at the London Summit on Family Planning held on July 11th, 2017, is the engagement of young people in almost all panels and consultations, underscoring the reality that youth are both beneficiaries and key actors in sexual and reproductive health interventions across countries.

About 15 young people from a number of developing countries formed the Summit’s Youth Advisory Group that demonstrated the dynamism young people have, once empowered and given opportunities to act. And youthful countries have no choice but to open doors to these upcoming champions and youth networks in their respective societies.

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“I have listened and learnt a lot from the various sessions at the Summit, and I see a lot of opportunities to rally other young people around SRHR issues in my country,” said Qaisar Roonjha from Pakistan. Globally adolescent and youth constitute the largest group of over 1.2 billion people aged 10 – 19 years, the majority of whom (89%) live in developing countries.

Meaningful youth engagement through knowledge building, funding of youth-led programs, and sustained mentorship, is an opportunity for countries to harness youth potential in transforming their respective societies. And the SRHR focus, which includes family planning services, is an investment towards attaining socio-economic development.

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Today, a number of countries in sub-Sahara Africa, Tanzania included, are grappling with high fertility rates within a resource-stricken environment leading to high dependency ratios and poverty. Unfortunately, adolescents and youth are among those who contribute to and impacted by these conditions.

Therefore, with the right investment in engaging young people, building their knowledge, and granting them opportunities to access and make contraceptive choices, transformation in developing countries is inevitable.

The Summit’s Youth Advisory Group move to develop an Accountability Framework to guide the Group members in mobilizing fellow young people at country level to undertake youth-led social accountability and advocacy initiatives, is a solid step forward.

The framework will open doors for youth to participate in as well as monitor implementation of commitments made by their governments intended to scale up SRHR access. Success is more likely if this growing ‘army’ of knowledgeable youth across countries is tirelessly mentored to acquire greater heights in life while resources continue to be directed to youth-led initiatives.

It is indeed in this spirit that the Advance Family Planning (AFP) and partners – HDT and TCDC – embarked on a partnership journey November last year with the Tanzania Adolescent and Youth SRHR Coalition (TAYARH), also represented in the Youth Advisory Working Group, to push for youth meaningful engagement in SRHR especially family planning.

Global Family Planning movement re-energized

The London Summit on Family Planning ended on July 11th with at least 49 countries committing to improve family planning services, and many more are making commitments towards attaining the 120 million more users by 2020 – a goal set in 2012.

The family planning movement gained an impetus at the first London Summit five years ago, and today the landscape has changed; the global community has accumulated a number of lessons, substantive data and evidence, strengthened supply chains, and stronger partnerships.

Committing countries – 38 prior to the second London Summit – are not only committing domestic resources to family planning, but also mobilizing leadership at national, sub-national level, and enlisting cultural, religious and influential leaders to rally communities behind family planning.

“In 2012, the goal was purposefully set high: 120 million reached with family planning information, services, and supplies,” said Melinda Gates during a plenary session. And the Summit was a demonstration of collective accountability and a reflection of increased dedication to the cause.

The global community remains optimistic, and re-energized to accelerate progress to attaining voluntary, quality family planning services, despite reaching 30.4 million women thus far. The gathering witnessed a number of commitments made: a total of 64 new policy and financial commitments in developing countries, donors, civil society organizations, and private companies; USD1.5 billion in new financial commitments by countries in Africa and Asia, USD 660 million in new donor financing, and USD 19 million in new private sector commitments.

Reframing family planning within the sexual and reproductive health agenda would bring in a cross section of actors to work towards the goal, but most importantly, situate family planning as a tool to alleviate poverty. A number of speakers at the Summit reframed family planning as an anti-poverty intervention, a message likely to resonate with most governments especially in developing countries.

So as the dust settles after the Summit, all actors – donors, governments, private corporates, CSOs – are now challenged with putting the commitments to action, building on the work done so far, and more strongly, using the generated evidence towards implementing more effective interventions.

Photo caption: From left to right: Dr. Natalia Kanem, Acting Executive Director, UNFPA; Hon. Minister Marie-Claude Bibeau, Minister of International Development and La Francophonie for Canada; Hon. Dr. Jane Ruth Aceng (Achang), Minister of Health, Uganda; and Melinda Gates, Co-chair of the Bill & Melinda Gates Foundation

London Family Planning Summit, 11 July 2017: The Moment to Recommit for Progress

Family planning advocates around the world have been working tirelessly to accelerate the momentum towards attaining the July 11th 2012 family planning goal of reaching 120 million additional users with information, services and supplies. Progress recorded thus far is encouraging though falls short of meeting the set national and global targets.

This year’s Family Planning Summit, which takes place on July 11th 2017, is yet another opportunity for global and national actors to recommit to this noble goal when they convene in London. This time around, youth advocates from some of the 38 Family Planning committing countries will join global leaders – governments, private sector, multilateral organizations, and CSOs; to seek ways to transform key lessons into actionable interventions that countries would adapt within their contexts.

Special forums dubbed Spotlight Events will be interactive sessions to discuss how best to build on what has worked, as well as generate advocacy messages to promote and sustain change. These dialogues will further underline the role of family planning in promoting socio-economic development with a focus on six thematic areas namely, – i) Innovative financing; ii) Commodity financing; iii) Supply Chains; iv) Expanding method mix; v) Humanitarian approach – leaving no woman behind; and vi) Adolescents and youth.

The London Summit coincides with the World Population Day (WPD) marked globally every July 11th, with activities revolving around fertility, population growth, and development. World leaders make statements on #WorldPopulationDay #WPD to further rally different players around population-related issues.

While the global community gears up to the Family Planning Summit, country-level Satellite activities in committing countries will be running at various times during #WorldPopulationDay. These activities will take different forms and shape but all have family planning as one common agenda. Taking on board this year’s WPD theme (Family Planning: Empowering People, Developing Nations), family planning stakeholders in Tanzania plan on providing family planning services and conducting demand-creation activities. These will be held at the national level at Mwembeyanga grounds in Temeke Municipality in Dar es Salaam.

To cap it all, family planning partners will be hosting a breakfast meeting with the private corporates to deliberate on how best public-private partnership for family planning could be strengthened. This forum, to take place on #WorldPopulationDay, is expected to revitalize private sector commitment and broaden partnerships for change.

The private sector has played and continues to play a critical role in the country’s development efforts in all sectors, education and health in particular. A number of companies complimenting government efforts to fight malaria – The Malaria Safe Consortium – have acknowledged the benefits of supporting family planning initiatives towards increased productivity. Better-planned families reduce demands on man-hours for child rearing and absenteeism due to illness, among other things. In any production work this is considered ‘lost’ time.

By 2020, Tanzania should witness significant progress in ensuring that family planning services are universally available and that women and girls are better able to access contraceptives of their choice. This should be possible with the government’s continued budgetary commitments for family planning at both national and sub-national levels, as efforts to reach the ‘last mile’ are granted serious attention.