ZANA SUCCESS STORY FOR BUBGET INCREASE 2017/2018

Situation/Background

The Tanzania Demographic and Health Survey (TDHS) 2015 have shown some improvement in contraceptive prevalence rate in Zanzibar rising from 12% to 14% between 2010 and 2015. Low performing regions of Unguja North and Pemba North have also succeeded in increasing the family planning uptake. The two regions have doubled their CPR to 14% over the past five years. A lot more has to be done given the fact that contraceptive use is still generally low the effect of which is partly high maternal and newborn mortality. The unmet need for family planning in Zanzibar is 34.7%.

The Zanzibar Nurses Association (ZANA) over the past three years has been coordinating a coalition of family planning (FP) partners [1](ZANGOC, ANGOZA, UNFPA-YAP, UMATI, ZANA, & ZAC). This coalition seeks to promote increased access and utilization of family planning services towards reducing maternal and child deaths in Zanzibar

In 2017 ZANA will continue to engage leaders and family planning stakeholders at the national and district levels with a view to strengthening access to family planning services through the improvement of processes and functionalities of various key bodies. It will also take into account and build on the work thus far, as well as pay attention to emerging advocacy opportunities. Currently, Zanzibar is developing its first National Family Planning Costed Implementation Plan (2016-2020) that would provide yet another avenue for improving FP utilization. This will also involve promoting choice, equity, quality and availability of FP commodities.  Development of FP CIP and its eventual launch also calls for intensified advocacy on increased funding. With respect to family planning, Zanzibar has over the years been totally supported by donors. The Ministry of Health’s allocation to family planning has not exceeded 15 million shillings per year and the budget is within the MCH budget that places a lot of emphasis on maternal and child health.

 Program Activities

The FP coalition has over the past three years addressed issues around availability and uptake of FP commodities and services in the selected sites, low FP services utilization, strengthening Family planning outreach services, and life-saving commodities.  Other areas that the coalition focused on included the availability of skilled manpower and resources for FP commodities. Along those initiatives specifically coalition targeted to achieve the budget increase across national and district resources leverage advocacy by working under the following activities:

• Meet with ZANA-coordinated NGO coalition on FP/RH to share data on FP and develop smart asks
• Engage a consultant to package data/information on FP funding and develop advocacy materials
• Engage stakeholders during CIP launch advocate commitment to increased FP budget
• Meeting with RCHS budget officers
• Develop policy briefs and one-page fact sheet to share with policymakers
• Lobbying meeting with key messengers in the Ministry of Health, Zanzibar
• Engage a few members (champions) of the Zanzibar House of Representatives to dialogue on FP budget
• Meeting with the Minister of Health Zanzibar
• Share outcomes with media

 Results/Impact

The Ministry of Health Zanzibar[2] increases the family planning budget for 2017/18 by 25% (200 million increase to one billion) of the previous year (2016/17) of 800 million for accelerating the implementation of FP Cost Implementation Program (CIP) to be launched in 2017. The following are some other observed outcomes:

• Central Medical Stores (CMS) management and district health management teams commit to improving commodity security and enhance supportive supervision in the selected sites, respectively.
• Increased number of outreach services from 8 to 12 per month in North Unguja
• Integrated Reproductive Health (IRH) commitment to direct UNFPA funds for FP outreach in North Unguja and North Pemba
• District Management Teams incorporate IRH activities in their plans
• FP commodity agenda integrated into district development plan; District Management Teams (DMTs) allocate funds for RH activities.
• Four districts in Unguja North and Pemba North have developed plans to enhance community health workers (CHWs) skills in long-acting methods and have committed to injecting resources in this financial year.

 Evaluation/Evidence

The achieved Impact of FP budget increase has been validated through a tracking system which is; Mid Term Expenditure Framework (MTEF)  and budget speech. This validation has the implication of direct disbursement to all relevant actors with their area of focuses.

[1] African Women Leadership Network (AWLN), Zanzibar Nurses Association (ZANA), Zanzibar NGO Cluster for HIV/AIDS (ZANGOC), Association of NGOs in Zanzibar (ANGOZA), UNFPA Youth Advisory Panel (YAP), Uzazi na Malezi Bora Tanzania (UMATI) and Zanzibar AIDS Commission (ZAC).

[2] Health Ministries (Zanzibar and Mainland) are separate entities within the United Republic of Tanzania.