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Spotlight on Tanzania

Kisa and Stanley, a couple in their 30s living in Arusha, Tanzania, are proud parents of five healthy children—and that was enough for them. Before EngenderHealth’s ACQUIRE Tanzania Project (ATP), with support from the American people through the U.S. Agency for International Development (USAID), partnered with their local health clinic to make a range of contraceptive options available, they were resigned to the possibility of Kisa’s becoming pregnant again—a prospect that caused her endless worry. But, according to Stanley, contraception has “helped us plan our life, and take care of our family.”

This sentiment is what ATP staff hear often from clients in hospitals and health centers across all 26 regions of mainland Tanzania and the Zanzibar archipelago. ATP works in partnership with health professionals to expand family planning options, including long-acting and permanent methods (LA/PMs) such as IUDs, implants, and surgical contraception for both men and women.

Since 2004, EngenderHealth’s ACQUIRE Project, now ATP, has been USAID/Tanzania’s flagship family planning program and, in partnership with the national Ministry of Health and Social Welfare (MOHSW), has not only succeeded in making contraceptive services more widely available, but also decentralized comprehensive postabortion care (cPAC) and has expanded services that prevent mother-to-child transmission of HIV.

These efforts are reflected in the results of the latest Tanzania Demographic and Health Survey, which shows an impressive gain in the use of modern family planning, from 20% among married women in 2004–2005 to 27% in 2009–2010. In addition, maternal mortality decreased from 578 maternal deaths per 100,000 live births in 2004–2005 to 454 per 100,000 in 2009–2010. Notably, the number of clients choosing LA/PMs has increased 20% annually since 2007.

Last year alone, more than 200,000 women and men opted for an LA/PM at a site supported through ATP. Many of these individuals surely share the sense of relief that Stanley says followed Kisa’s surgical contraception procedure. “The health of my wife changed,” Stanley, an electrician, reported. “Before, my wife worried about getting pregnant, but now she doesn’t worry.”

Meanwhile, with complications of unsafe abortion a leading cause of maternal death in Tanzania, there was an urgency to make cPAC more widely available, too. Prior to ATP, these lifesaving services were only offered at regional hospitals, most of which were too far from the villages where women needed the care most.

Through ATP’s decentralization efforts with the MOHSW, more than 200 local health facilities and dispensaries across 16 rural districts on the mainland, as well as five districts in Zanzibar, are now staffed with medical personnel trained to treat and save the lives of women who present with complications from unsafe abortion and miscarriage. An essential part of this training includes how to offer family planning counseling and services, so that postabortion clients are better able to prevent future unplanned pregnancies. In the past year, 84% of women receiving cPAC services were counseled for family planning, and 81% of those received the method of their choice—furthering the positive feedback loop of saving and transforming lives through increased access to family planning.

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