Elevate Access to Sexual and Reproductive Health and Rights in Tanzania
Program Overview
EngenderHealth’s Elevate Access to Sexual and Reproductive Health and Rights program, funded by the William and Flora Hewlett Foundation, is committed to ensuring that all individuals, particularly girls and women can fully exercise their bodily autonomy and sexual and reproductive health and rights (SRHR). The program expands equitable access to high-quality, gender-sensitive, and age-appropriate SRHR information and services, including postabortion care (PAC) and comprehensive abortion care (CAC).
Implemented across Mainland Tanzania and Zanzibar, the program works in close partnership with the Ministry of Health in Mainland Tanzania, the Zanzibar Ministry of Health (ZMoH), five local organizations, and a network of PAC/CAC champions.
Building on decades of expertise in sexual and reproductive health, EngenderHealth addresses the socio-cultural and systemic barriers that limit access to care. Through this work, we are strengthening Tanzania’s healthcare ecosystem to ensure safer, more inclusive access to abortion-related services.
Addressing Unmet Needs in Tanzania
The Government of Tanzania has made important progress in reproductive, maternal, newborn, child, and adolescent health (RMNCAH)—including declaring maternal health services, such as postabortion care (PAC), free and available in public facilities.
Yet many Tanzanians continue to face serious barriers to accessing high-quality PAC and comprehensive abortion care (CAC), such as:
- Weak service delivery infrastructure
- Shortages of skilled PAC and CAC providers
- Frequent stock-outs of essential medicines (e.g., misoprostol, mifepristone)
- Social stigma, harmful norms, and widespread misinformation
- Restrictive laws and policies
Unsafe abortion is a leading—but preventable—cause of maternal mortality worldwide. Tanzania reflects this global challenge, where too many people still lack access to safe, high-quality postabortion and comprehensive abortion care.
Key Program Activities:
To increase access to PAC and CAC in Mainland Tanzania and Zanzibar, this program takes a multi-pronged, locally led approach focused on four core strategies:
1. Strengthening the Legal and Policy Environment
- Partnering with government stakeholders to revise national guidelines and service delivery standards for PAC and CAC
- Facilitating cross-learning opportunities and policy dialogues to promote safe abortion as a public health priority
- Designing evidence-informed advocacy tools and materials
- Collaborating with like-minded partners in pursuing strategic litigation to challenge restrictive and punitive abortion laws
2. Addressing Stigma and Harmful Norms
- Conducting value clarification sessions with healthcare workers and community members
- Hosting intergenerational dialogues to challenge stigma, misinformation, and social taboos around abortion
- Empowering PAC and CAC champions
- Monitoring and responding to antichoice movement initiatives and oppositions
- Leverage social media platforms to disseminate behavior change (SBC) messages aimed at shifting attitudes toward PAC and CAC
3. Strengthening Health Systems
- Training health providers, pharmacists, and pharmacy attendants in rights-based PAC and CAC service delivery
- Supporting public facilities to improve planning, supply chains, and evaluation systems
- Improving health systems to deliver quality PAC and CAC services through supportive supervision and on-the-job (OJT) mentorship
- Support central coordination through Technical Working Group meetings for enhancing planning, service delivery and evaluation of PAC and CAC services
- Strengthening data capture, analysis and use for decision making
4. Empowering Local Advocacy
- Working with local organizations and champions to implement SMART (Specific, Measurable, Achievable, Relevant, Time-bound) advocacy strategies
- Building a resilient and adaptive abortion movement in Mainland Tanzania and Zanzibar
- Advocating for increased resource allocation and strengthened accountability mechanisms for PAC and CAC services
- Generating evidence to inform advocacy and PAC/CAC programming
Advancing SRHR and Safer Futures in Tanzania
EngenderHealth promotes essential sexual and reproductive health services and gender equity through strong, locally led advocacy rooted in Tanzanian realities.
By challenging harmful norms, myths, and misconceptions around PAC and CAC, we’re helping shape a more supportive social and policy environment—one where women and girls can access the care they need to protect their health, claim their rights, and shape their futures.
Together with our partners, we’re translating community-driven solutions into lasting change—making safe, respectful abortion care a reality in Tanzania.
