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 4,771 sites, and encompass:

• Expanding contraceptive options
• Increasing access to postabortion care services
• Engaging Men As Partners
• Preventing 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:

1. Increasing availability of 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.
2. Implementing communications campaigns to increase awareness of LAPMs and to debunk myths surrounding these methods
   
3. Building the capacity of local health officials to advocate for family planning resources and programs
4. Introducing COPE® and facilitative supervision—two quality improvement tools that help health care staff identify and resolve problems on their own.
5. Integrating family planning into HIV and postabortion services
   

 
Increasing Access to Postabortion Care Services
To ensure that women have access to postabortion care, EngenderHealth trains doctors and midwives at 200 health facilities in mainland Tanzania and Zanzibar to provide comprehensive postabortion care services, including emergency treatment of complications from abortion and miscarriage, 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.

 
Engaging Men as Partners
EngenderHealth leads an innovative five-year initiative, called the CHAMPION Project, to increase men’s involvement in preventing the spread of HIV in Tanzania. CHAMPION, funded by USAID, takes a holistic approach to HIV prevention and addresses the underlying gender issues that drive HIV transmission.

EngenderHealth also addresses male gender norms and related behaviors that contribute to increased risk for HIV infection in Tanzania through an initiative funded by the President’s Emergency Plan for AIDS Relief (PEPFAR). EngenderHealth, through the ACQUIRE Project, advocates at the national level for greater attention to male gender norms and provides training and assistance to local PEPFAR partners to integrate male engagement approaches in their programs.

 
Prevention of Mother-to-Child Transmission of HIV
EngenderHealth and its partners work in Iringa and Manyara regions to reduce the transmission of HIV from pregnant women to their children. The project offers a continuum of integrated maternal and child health:


• 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.