UNFPA at Work: Six Human Rights Case Studies

3.UNITED REPUBLICOF TANZANIAWhat I have appreciated most is accompanying my wife to the health centre for her antenatal clinic visits. That way,I will know if she has complications, and I can budget in advance to take her to a bigger hospital.I never went with my wife to the antenatal clinic when she was pregnant with our other children. I think I missed out.But in the past, men were not allowed. Now, if you go with your wife, the clinic staff treat you like someone important.— Joseph, age 42, a resident of northwestern Tanzania’s Geita DistrictJoseph’s experience reflects nothing less than the full floweringof the human rights-based approach in a project in theUnited Republic of Tanzania. This man and his wife, by visitingthe antenatal clinic together to prepare for the birth oftheir child, are actualizing the core principles of theStronger Voices for Reproductive Health Project, implementedin Tanzania and five other developing countries(India, Kyrgyzstan, Mauritania, Nepal and Peru).The right to quality reproductive health care is the cornerstoneof the project. The initiative aims to enable women tobetter articulate their reproductive needs and rightsthrough the establishment of community-based mechanismsthat give them a stronger voice in securing the informationand services they need to lead healthier, more productivelives. It is also intended to encourage more interactionbetween health-care providers and users. 4In Tanzania, one of Stronger Voices’ objectives was toestablish community-based initiatives that empowerclients, ensure their rights and enable them to work withproviders to improve the quality of reproductive and sexualhealth care. This case study discusses a successful StrongerVoices initiative in Geita District. The centrepiece of the initiativewas a seven-part community workshop series onreproductive health and rights. Workshop facilitators guidedparticipants through the seven modules of the StrongerVoices community manual, which Tanzanian implementers,using a cultural lens, adapted to meet local needs.The Stronger Voices project in Geita District also targetedtwo important groups of human rights duty-bearers – localgovernment representatives and local health-care providers– in order to create the essential enabling circumstances fornewly empowered rights-holders to claim their rights.COUNTRY CONTEXTThe United Republic of Tanzania has a population ofapproximately 36 million people, only 23 per cent of whomlive in urban areas. The average life expectancy at birth is51 years. According to the Tanzania Demographic andHealth Survey of 2004/2005, one in four women and onein eight men have had no education. One in three womenand one in five men cannot read.The survey indicated that almost all Tanzanians have heard ofAIDS. However, only about three quarters of men know thatthe risk of acquiring AIDS can be reduced by using condomsand by maintaining a monogamous relationship with an HIVnegativepartner. About half of men and one quarter ofwomen in the survey reported having sex with a non-marital,non-cohabiting partner in the past year. Among them, only28 per cent of women and 51 per cent of men used condoms.One in three young people were having premarital sex, andfewer than half of them were consistently using condoms.The survey found that the average number of children bornto a Tanzanian woman is 5.7. This is about the same fertilityrate found in surveys in 1999 and 1996. Fertility is much4 See the Stronger Voices for Reproductive Health website, http://www.unfpa.org/stronger_voices/. UNFPA has provided support for implementation of the project inpartnership with three other UN agencies: the International Labour Organization, the World Health Organization and the United Nations Children’s Fund.UNITED REPUBLIC OF TANZANIA19