Providing Quality Reproductive Health in Tanzania

With 35 million people in 2002, Tanzania has the largest population in East Africa. Furthermore, its population is growing at close to 3% per year, a rate that if maintained would double the country's population in one generation. Tanzania is also one of the poorest countries in Africa, with an average per capita Gross Domestic Product of just $478 per year. In other words, the majority of people subsist on less than two dollars per day.

The country registers 99infant deaths per 1,000 live births and maternal mortality rates remain high. Close to one quarter of all births are unplanned and 40% of women remain in dire need of reproductive health services. But the worst trend is the rising rate of HIV infections among young people. Although youth comprise one-fifth of the entire population, the age group 15-24 accounts for two-thirds of all new HIV infections.

The project has five main objectives:

  • To strengthen the national coalition of government agencies and NGOs and their commitment to providing quality sexual and reproductive health care.
  • To seek commitment and support from national and international organizations and identify sources of funding for phase II.
  • To assess existing knowledge regarding the quality of sexual and reproductive health (SRH) care, with a focus on demand issues influencing the provision of SRH care.
  • To establish community-based initiatives that empower clients, ensure their rights and enable them to work with providers in improving the quality of reproductive and sexual health care offered.
  • To support providers in their efforts at improving the quality of service delivery.

Pilot activities are being planned in both the Tanzania mainland and the semi-autonomous island of Zanzibar. The project's main activities include:

  • Disseminating information and building support for the project at national, district and community levels.
  • Developing a comprehensive fundraising strategy.
  • Reviewing and synthesizing programmes and policies regarding the quality of RSH care with a special focus on the health sector reform process.
  • Conducting an assessment of quality of care gaps at the national level and in pilot project sites.
  • Disseminating best practices and lessons learned from pilot projects
  • Identifying community-based groups or organizations to work as partners.
  • Planning and conducting training on SRH awareness.
  • Sensitizing local leaders and relevant stakeholders about sexual and reproductive health, rights and quality of care issues.
  • Identifying provider groups and assessing their willingness to participate in a quality of care initiative.
  • Undertaking a needs assessment of providers and determining gaps in service provision.
  • Conducting training sessions.

What's NEW

The Tanzania coalition has carried out a number of activities aimed to increase knowledge of effective approaches to empower communities and increase demand for improved quality of care.

In April 2003, the Tanzania team held a stakeholders workshop to define the project’s intervention strategies in mainland Tanzania and Zanzibar. One potential strategy is mobilizing and training organized community groups in advocacy skills so they can communicate their concerns and reproductive health needs to health care providers and district health councils. Another strategy will be to build the capacity of local health council systems and health boards/committees on addressing and prioritising sexual and reproductive health care in facility and council health plans. In Zanzibar, participatory approaches on gender, reproductive health, and rights will be initiated to link women’s credit groups with the safe motherhood programme.

As part of the health reform process, the government has set up community health funds in rural districts. Building on this local structure, the project will work with communities on reproductive health and rights issues so as to . strengthen their full involvement in and management of reproductive health services.

A process to support communities in determining and designing the pilot interventions is being planned. Concurrently, efforts to enhance existing linkages between this pilot project and programmes of the Ministry of Health are underway.

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