Note: World Lung Foundation united with The Union North America. From January 2016, the combined organization is known as “Vital Strategies.”
(16 June 2015, Dar es Salaam and New York) – A news conference in Kigoma today highlighted the vital role of community health workers in encouraging couples to use family planning. Attendees at the event, hosted by Kigoma’s Regional Medical Officer and World Lung Foundation, heard that 20 community health workers have been trained to raise awareness of the longer-term benefits of family planning within their communities. This initiative is part of a multi-channel communication campaign, developed and implemented by the Ministry of Health and Social Welfare, Engender Health and World Lung Foundation (WLF) under the Thamini Uhai (Value Life) brand. These community health workers will play an important role in reducing unmet family planning needs by connecting potential service users with health facilities in the region.
Commenting on the campaign, Kigoma Regional Medical Officer Dr Leonard Subi said, “Community health workers are a vital part of health campaigns like Thamini Uhai. They are able to link clients in the community who need to access health services, like family planning, with workers in health facilities who provide those services. Of course, the success of this campaign will also rely upon the quality of care delivered at health facilities, so the initiative engages with health care providers and undertakes facility- and community-level meetings to focus all our stakeholders on quality of care and community needs.”
The new campaign, which was launched on May 25, includes radio spots, a radio drama, social media, posters and a comic book in addition to community health worker outreach. Campaign messages target both men and women of reproductive age and highlight the benefits of spacing or limiting pregnancies, such as increased education and employment opportunities for women, better health for mothers and children, more effective use of family resources, and stronger communities.
Dr. Nguke Mwakatundu, Country Director – Tanzania, World Lung Foundation, said: “A lack of family planning, including birth spacing, contributes to high levels of maternal and neonatal mortality in Tanzania and limits the ability of women and families to make choices that can protect their health, their economic well-being and their life chances. The situation is particularly acute in Kigoma and the Western region, where women tend to give birth to more children than is the average for Tanzania and many start having children between the ages of 15 and 19. Well-trained and knowledgeable community health workers, who engage with potential service users on a daily basis, can help promote the benefits of family planning, help to break down misperceptions and encourage women and men, including youth, to access family planning services at health facilities. The resulting social, health and economic benefits could radically improve the life opportunities of current and future generations.”
The total fertility rate in 2010 was 7.1 for women in the Western zone, including Kigoma, which means that on average each woman has 7.1 children. The rate is notably higher than the Tanzania national average of 5.4 children and a global average of 2.5 children. In the Western zone 30% of women age 15-19 have begun childbearing, compared with just 16% in the Northern zone.
According to the Tanzania Demographic and Health Survey (DHS) 2010, 25% of married women in Tanzania and as many as 41% of married women in Kigoma have an unmet need for contraception — that is, they do not want to become pregnant (for childbirth spacing or limiting reasons) but are not using family planning methods. A further 34% of married women in Tanzania, but only 25% of married women in Kigoma, do not want to become pregnant and are using family planning methods to avoid unplanned pregnancy. These data show that there is scope to increase the use of family planning in Kigoma. Barriers include: social, religious and cultural attitudes and beliefs; a lack of knowledge about the benefits of contraception; misperceptions of side effects of contraceptive methods; and unmet need for modern contraceptives among adolescents, which contributes to high fertility, unintended pregnancies and complications at birth. Service delivery barriers include a lack of adequate resources to meet the requirements for contraceptive commodities, equipment and supplies.
Family planning is a key strategy to promote social and economic development and to improve the health of women and children in Tanzania. The National Road Map Strategic Plan to Accelerate Reduction of Maternal, Newborn and Child Deaths in Tanzania, 2008–2015 (Sharpened One Plan) had set a goal to increase the contraceptive prevalence rate (CPR) from 27%(1) to 60% by 2015. Increased use of family planning was recognized as having great potential to contribute to the Sharpened One Plan target of reducing the maternal mortality ratio (MMR) from 578 to 193 per 100,000 live births by 2015. This new phase of the Thamini Uhai campaign aims to support these objectives.
About Thamini Uhai
The Thamini Uhai campaign debuted in 2014, with a focus on the critical importance of facility delivery. This new campaign extends Thamini Uhai to encompass family planning and launched with an emotional narrative through hard-hitting radio spots and a radio drama series. Three radio spots began airing on Radio Kwizera, Tanzania Broadcasting Corporation (TBC), and Clouds FM, starting May 25 and will run for 15 weeks. The serial radio drama Jitofautishe (Be Different) is airing on TBC and Radio Kwizera. The radio drama in particular emphasizes the important role partners and families can play in supporting family planning for the benefit of women and families.
This comprehensive campaign also incorporates training of community health workers to provide community outreach to promote the benefits of family planning and help potential users access services. In addition to the radio spots and drama, a comic book, posters and community outreach program, the campaign will reach out to a wider audience on social media through the hashtag #ThaminiUhai.
About WLF’s Maternal Health Program
Recently published data from WHO, UNICEF, UNFPA, and The World Bank(2) estimate that Tanzania, which accounted for 3% of global maternal deaths in 2013, reduced its maternal mortality ratio (MMR) by 55% between 1990 and 2013. Since 2008, WLF has been working to help reduce maternal and neonatal mortality in Tanzania by implementing a state-of-the-art maternal health program.
The program, which has received financial support from Bloomberg Philanthropies, Fondation H&B Agerup, Merck for Mothers and Swedish International Development Cooperation Agency (Sida), aims to improve women’s access to good-quality, comprehensive emergency obstetric care, particularly in rural and isolated areas. World Lung Foundation can point to a number of accomplishments across geographically strategic health centers and hospitals in eight districts in the Kigoma, Morogoro and Pwani regions. Since 2008:
- WLF has actively upgraded, renovated or rebuilt 10 rural health centers and four district hospitals to ensure the provision of life-saving comprehensive emergency obstetric care. Prior to the program, patients had to travel three to four hours to the nearest hospital. Now, emergency obstetric care is available in the community
- More than 100 assistant medical officers, nurse-midwives, and clinical officers have been trained in comprehensive emergency obstetric care or anesthesia.
- Health center utilization for delivery care has increased substantially, from about 3,500 deliveries per year in nine health centers prior to the program to about 12,300 in 2014 after WLF’s intervention.
- More than 2,500 C-sections have been performed in supported health centers that could not have provided this service prior to WLF’s maternal health program.
More information about WLF’s Tanzania program can be found at http://var/www/html.worldlungfoundation.org/maternalhealth and http://worldlungfoundation.org/ht/d/sp/i/35469/pid/35469.
1. The CPR, which is the percentage of couples using contraception, was measured at 27% in 2010 (TDHS 2010).
2. http://var/www/html.who.int/reproductivehealth/publications/monitoring/maternal-mortality-2013/en/