Advocacy for Family Planning funding in Zanzibar
Tanzania is one of Sub-Saharan Africa countries that have committed to achieving Maternal, Newborn, Child, and Adolescent Health (RMNCAH) targets. Family Planning constitutes a core preventive intervention that has the potential to improve maternal, infant, and child health through spacing births, therefore averting unplanned pregnancies and preventable birth-related complications.
As it is in the Mainland, Zanzibar records a high fertility rate at 5.1 children per woman of reproductive age, high maternal deaths recorded at 556 deaths for every 100,000 live births. Infant mortality is at 45 per 1,000 for live births with under-five mortality being at 67 per 1,000 live births. Studies show that family planning services can avert 44% of maternal deaths and 35% of children under-five.
Ending preventable Maternal Mortality (EPMM) targets beyond 2015 set a goal that by 2030, no country should have more than 140 MMR per 100,000 live births and countries should have less than 100 maternal deaths per100,000 live births by 2035 to achieve the MMR recommended for 2035. Tanzania decided that it will make from the current rate of 4.8% to the recommended rate of 5.5% from 2016 to 2020. From 2021 – 2025 the country will accelerate to 6.5%, and from 2026 to 2030 the country would like to reach more than 7% in order to achieve the 2035 goal of having less than 100 MMR per 100,000 live births (One Plan II).
FP services in Zanzibar were launched in 1985 under Zanzibar Family Planning Project (ZFPP) that aimed to reduce maternal morbidity and mortality.
In 1995 there were 104 maternal – child health centers providing FP services. However, despite the acceptance by women contraceptive prevalence has remained low i.e.14% (TDHS, 2015/16) among married women.
At the same point, unmet needs for FP amongst married women in the Island is high i.e. 37% in north Pemba; 35% in South Pemba; 31% in North Unguja; 23% Urban west and 20% in South Unguja.
The Zanzibar Nurses Association (ZANA) and AWLN coalition recently conducted a rapid assessment on the availability of reproductive and child health commodities and services with a focus on outreach services in four sites of North Unguja and North Pemba. The assessment revealed a notable increase in new users of family planning methods especially of those older than 25 years in North A and B Unguja, Micheweni, and Wete in North Pemba, and the utilization of contraceptives still being low. The availability of commodities and other logistics interims of increasing contraceptives prevalence was weak and almost inexistence in some areas or sites visited.
Challenges arising from low funds allocation of family planning initiatives:
Over the past four financial years, the Zanzibar government has continued to keep its promise in making incremental allocations for family planning, with a record allocation of 1 billion Tanzanian shillings, an increase of 200 million shillings for FP commodity in 2017/18. However, funds are often not disbursed timely and consequently. This situation calls for action in holding service providers and leaders accountable to their communities towards attaining the 45% national modern contraceptive prevalence rate (mCPR) by 2020 set by the United Republican of Tanzania.
For services to be running smoothly family planning commodities have to be available at all health facilities. Nevertheless, while there have been adequate stocks of commodities at the Central Medical Stores Department’s warehouses, there have been frequent and persistent stock-outs at facilities. Supply chain issues such as inaccurate ordering and late deliveries of the orders to the facilities have greatly contributed to this and one of the root causes of the situation. Over the past couple of years, contraceptive use has been increasing with inflation rates providing pressure on procurement and transportation costs for the commodities from central to the last mile.
What Parliamentarians can do:
- Approve budget increase for FP commodity supply to match with unmet needs; forecasts in utilization; procurement and distribution to the last mile.
- Strengthen Accountability Mechanisms for Family Planning financing at all levels,
- Monitor the supply chain of contraceptives commodities from the Medical Stores Department (MSD) to facilities,
- Promote transparency in family planning commodities and services related information.
Sources of information:
- Tanzania Demographic and Health Survey and Malaria Indicator Survey 2015-16;
- National Family Planning Costed Implementation Plan (NFPCIP) 2010-15;
- One Plan II 2016/17-2020/21
For more information please contact:
Ms. Halima Shariff,
Advance Family Planning (AFP),
Johns Hopkins Center for Communication Programs, P.O.Box 105303 Dar es Salaam.
Office Tel: +255 222600784;
Cell/Mobile: +255 788 249091;
Project Coordinator ZANA Office
Benjamin Mkapa Road, Mwanakwerekwe Street
P O BOX 2325,
TEL: +255 24 2234785/0778713721
 EVERY WOMAN’s RIGHT, how family planning saves children’s lives (2012); Save The Children, UK