Tanzania is home to roughly 37 million people, most of who live in rural areas with limited health care options.  In some parts of the country, a single hospital serves as many as 350,000 people, and the ratio of doctors to inhabitants is 1:20,000.  Even among those who can afford it, health care can be seen as a luxury.  Since 1982, EngenderHealth has been a partner with Tanzania’s Ministry of Health and other local groups to make lasting improvements in the quality and availability of reproductive health care services.  Initially, EngenderHealth’s efforts focused specifically on increasing access to family planning at 35 sites.  Today, our programs reach more than 120 sites, and encompass:

• Expanding contraceptive options
• Increasing access to postabortion care services
• Involving Men As Partners®
• Fistula prevention and treatment
• Prevention of mother-to-child transmission of HIV

 
Expanding Contraceptive Options
Through the ACQUIRE Project, funded by USAID, EngenderHealth works to advance the availability, quality, and use of reproductive health and family planning services throughout the country. Efforts include:

• Providing long-term and permanent methods of contraception—such as sterilization, Norplant®, and intrauterine devices (IUDs)—as well as a range of other contraceptive methods, such as pills, condoms, and injectables.
• Introducing COPE® and facilitative supervision—two quality improvement tools that help health care staff identify and resolve problems on their own.
• Implementing a communications campaign throughout the country to increase awareness of vasectomy and other long-acting and permanent contraceptive methods.

 
Increasing Access to Postabortion Care Services
To ensure that women have access to postabortion care, EngenderHealth trains doctors and midwives at local clinics to provide comprehensive postabortion care services, including counseling, referral, and infection prevention. This includes decentralizing postabortion care services so that women can receive treatment at health centers and local dispensaries, not just at regional hospitals. 

In addition, EngenderHealth advocates for the integration of postabortion care into routine maternal care services.

 
Involving Men As Partners® 
EngenderHealth's Men As Partners® program educates men and involves them in supporting reproductive health access and decision-making. The program, which includes a series of workshops, peer-education initiatives, and media outreach, aims to:

• Challenge men’s attitudes and behaviors that compromise their own health and safety, as well as the health and safety of women and children;
• Provide men with access to services that prevent pregnancy, including vasectomy.

 
Fistula Prevention and Treatment
EngenderHealth works with the Women's Dignity Project, a Tanzanian nongovernmental organization, to identify and address the factors that put girls and women at risk for obstetric fistula. EngenderHealth and Women’s Dignity Project collaborated on Risk and Resilience: Obstetric Fistula in Tanzania, a study that explores the multidimensional impact of fistula on women and provides a vision for preventing and treating the condition.

 
Prevention of Mother-to-Child Transmission of HIV
EngenderHealth and its partners work in nine health facilities in the Arusha region’s Arumeru District to reduce the transmission of HIV from pregnant women to their children. The project, which is funded by the Elizabeth Glaser Pediatric AIDS Foundation, addresses both medical and social barriers. The project includes:

• Promoting voluntary counseling and testing;
• Providing peripartum antiretrovirals (ARVs);
• Encouraging safer obstetric practices;
• Educating new mothers about safe infant-feeding practices;
• Engaging male partners and mobilizing communities to reduce the stigma and discrimination surrounding HIV.