HTSP in Tanzania - Dr. Marina Njelekela ... - ESD Project

Advocacy For Healthy Timing
and Spacing of Pregnancy in
Tanzania
Marina Njelekela, MD, PhD
Chairperson, MEWATA
ESD AFRICA EXCHANGE MEETING
MAY 11th - 13th 2010
NAIROBI, KENYA

Medical Women Association of
Tanzania (MEWATA)
• A National NGO – PROFESSIONAL
• Registered in October, 1989
• Has more than 300 members
• Multi skilled professionals
• Membership :
– female medical doctors and dental practitioners
– assistant medical and dental officers (Associate)
– female medical students (Associate)

Main Goal:
Medical Women Association of
Tanzania (MEWATA)…
• To advance female medical professionals to be capable of addressing health
problems so as to improve health status and social well being of Tanzanians, with
particular focus on women, young people, children and men
Vision:
• Healthy Tanzanian population accessing quality health services that are
affordable and sustainable through efficient and effective support systems
Mission:
• Advocating for and facilitating provision of quality health services among women,
young people, children and men through existing social systems and capacity
building among health professionals

Medical Women Association of
Tanzania (MEWATA)...
• Reproductive Health & Rights
• HIV/AIDS
• Reproductive system cancers ( Breast & Cervical Cancer)
• Maternal & Newborn Health (Advocacy – UN Agencies)
• Family Planning (HTSP – ESD)
• Gender Based Violence (GBV Awareness and Training – UNIFEM)
• Adolescent Sexual Reproductive Health
• Prevention of Mother to Child of HIV Transmission
• Care, treatment and support
• Health professional development and institutional
advancement
• Advancement of female medical professionals
• Maintaining ethical standards of health professionals
• MEWATA Institutional development

Medical Women Association of
Tanzania (MEWATA)…

Tanzania FP Situation
Total Fertility Rate higher 5.7 children/woman
Contraceptive Prevalence Rate 26%
20% interviewed women use Modern Methods
Usage of Modern Methods ↑ in unmarried women
41%
Total demand for FP for married women 50%
22% of women have unmet need for FP

Tanzania ESD Project

Project Goal
Project Goal: To create awareness on HTSP and
to integrate HTSP messages into health policies,
guidelines, protocols and training
curricula/activities.
Time Line: June 1, 2009 – August 31, 2010 (15
months)

Key Objectives
Advocate for the integration of HTSP messages into
health policies, guidelines, protocols and training
curricula/activities
Improve Maternal Health - ↓MMR, ↑ CPR, ↑ Skills of HW and MDs
Increase awareness of the benefits of HTSP and the
key HTSP messages
Target – women, media, policy makers, nurses, doctors
Outcome – ↑ knowledge that will contribute to good
policies/guidelines and ↑ Usage of FP

Key Strategies and Approaches
Collaboration/ communication
ESD/Global Secretariat – for advice and planning
together the activities
Formation of HTSP network
Members Network dealing with FP issues and Media –
TANA, TAMA, AGOTA, HKMU, MUHAS, WDP,
UMATI, TAMWA, TAWLA, PRINMAT, MEDIA houses
Implement workshops
Create awareness of the concept and benefits and
request for wider dissemination to the communities
they work with

Key Strategies and Approaches
Presentations at conferences
Professional meetings – AGOTA, MEWATA, MWIA,
DMO, RMO, WRA, SOM Symposium
Media gatherings - AJAAT
Counsel clients in public RCH clinics in 23 regions
Involve media
HTSP Materials translated in Swahili and disseminated
in 23 regions including ZNZ and Pemba
radio, TV, Print media - newspapers

Key Activities Implemented…
Organized a public launch event to introduce
MEWATA as the HTSP Local Secretariat
Focused more on the media and FP stakeholders
Several articles in newspapers
Dissemination of HTSP benefits and messages to
public and private sector providers at the national,
regional, district and local level
Still in the implementation phase reports will be in by june/july 2010
Interest will be better spacing/use of modern methods effectively
Improved counseling and communication of HTSP benefits in clinics

Key Activities Implemented…
Plan to incorporate HTSP into pre and in-service
curricula and training guidelines
Nursing curriculum – FP Section MOHSW was reviewing their curriculum
incorporated HTSP concept and benefits in it
MD curriculum – OBGY Departments at MUHAS, HKMU, IMTU and
BUCHS to incorporate HTSP in FP sessions
Coordinate with public sector FP advocacy groups around
repositioning FP
Tanzania launched the FP Costed Implementation Plan 2010-2013 to
reposition FP in TZ
MEWATA is coordinating meetings with stakeholders to select areas to work
on in the plan

Key Activities Implemented…
Established and maintain a local HTSP network/coalition
For improving Maternal Health through HTSP
Developing a plan, have objectives
Held two meetings already
Promote HTSP to clients in 23 regions
Created a webpage on MEWATA’s website on HTSP –
www.mewata.org

Key Activities Implemented…
HTSP Public Service Announcement
Already translated in Swahili
Negotiating with Pathfinder and media houses to be aired free
Challenge is getting free air time - Experience from other countries
Translated the consumer and provider materials
and HTSP flier in Swahili, printed several copies
that has been distributed in our workshops and
meetings

Achievements to date…
Successful launching of MEWATA as local secretariat
Medical university (MUHAS): HTSP in Ob/Gyn
curriculum and included in seminars for postgraduate
students
Client and health worker brochures in Swahili

Achievements to date…
Formed a coalition of different organizations working on
family planning issues.
A three year Action Plan is being developed to advocate
for HTSP Nationwide by the coalition.
Curriculum from MOHSW incorporates HTSP in the inservice
training curriculum for nurses.
Website with HTSP developed at MEWATA website:
www.mewata.org.
Awareness and understanding among HW, MDs, Media
and Policy makers at MOHSW esp FP section increased

Lessons Learned
HTSP as a concept was not known by majority of health
care workers as well as by the clients.
Media is an important partner in advocacy.
Buy-in of the government is key to successful advocacy
strategy.
Partnership is of utmost importance in awareness creation
and advocacy.

Challenges
Conflicting activities of equal importance for the
association
Limited number of human resources –small secretariat
Short term project– sustainability issues, developing the
coalition important step
Scaling up – massive HTSP campaign as we prepare for
repositioning FP in TZ

Next Steps
To engage the Ministry of Health and Social Welfare to
promote HTSP as a way of repositioning family planning.
Scaling up the activities for sustainability purposes to
some other regions by extending network of stakeholders
to other regions.
Involving the media in a much larger scale for wider
dissemination of HTSP to the communities.

Planning/Advising

Launching ESD Secretariat

Meeting with Nurses Council

First Coalition Meeting

Second Coalition Meeting

Media Involvement

Thank You For Your
Attention

PICTURES