Tanzania - Counting What Counts: Tracking Access to Emergency Contraception

Publication date: 2014

April 2014 Government policies support the use of EC in Tanzania and call for emergency contra- ceptive pills (ECPs) to be available at every level of the health system, but knowledge of and ever use of ECPs remain very low, with almost 90% of women unaware of EC. ABOUT TANZANIA Located in East Africa, Tanzania has a population of 48,261,942, with 26.7% living in urban areas.1 16.2% of women have completed the secondary level of education. 2 CONTRACEPTIVE & EC KNOWLEDGE AND USE POLICIES Essential Drug List: The 2007 Standard Treatment Guidelines and National Essential Medicines List does not include levonorgestrel (LNG) in the proper dose for EC, but provides information about the Yuzpe method of EC (using certain combined oral contraceptives).3 National norms and guidelines: Tanzania’s 2013 National Family Planning Guidelines and Standards indicates that ECPs should be provided at all public and private service- delivery points. It also includes ECPs on the list of contraceptive methods that health care providers should counsel clients on.4 The 2007 National Family Planning Procedure Manual includes a section on the effective- ness of emergency contraception pills, including safety, advantages, disadvantages and instructions on dosage.5 Prescription status and who is authorized to dispense: A prescription is required to access ECPs in Tanzania. National guidelines state that EC should be provided at all six levels of the formal health system; in government, NGO, and private-sector facilities; as well as pharmacies, drug shops, and in the community.4 Post-rape care: The 2011 National Manage- ment Guidelines for the Health Sector Response to and Prevention of Gender Based Violence states that all health facilities must have the supplies necessary to provide the minimum standard of care for GBV survivors, including EC, and recommends that it be offered to all women of reproductive age in cases of sexual violence.6 Ta nz an ia TANZANIA COUNTING WHAT COUNTS: TRACKING ACCESS TO EMERGENCY CONTRACEPTION IN TANZANIA • Total fertility rate: 5.4 children per woman (6.1 Rural, 3.7 Urban) • Unmet need for contraception (among all women): 18.3% • Current contraceptive modern method use (among all women): 23.6% Source: Demographic and Health Surveys, Tanzania 2010 KNOWLEDGE AND EVER USE OF MODERN CONTRACEPTION AND EC 0 20 40 60 80 100 ECAny Modern Method Knowledge (DHS 2010) Ever Use (DHS 2004-05) % o f A ll W om en Type of Contraception 97.9 37.1 35.1 0.211.8 Source: Demographic and Health Surveys, Tanzania Ta nz an ia 2 PRODUCT AVAILABLITY Registered products: There is one levonorgestrel EC pill product registered and distributed in Tanzania: P2 (FamyCare).7 Locally manufactured products: None available. Poor quality or counterfeit EC products: Although counterfeit and poor quality drugs have been a problem in Tanzania, the government has taken initiative on combating this problem.8 The current status of poor quality or counterfeit EC products in Tanzania is not known. WHERE WOMEN CAN ACCESS EC EC in the commercial sector: Private hospitals, health centers and pharmacies provide contra- ceptives for 13.6% of current contraceptive users.2 However, the proportion of women using EC who obtain it in the private sector is not known. EC in the public sector: The 2010 DHS indicates that the public sector is the major source of contraceptive methods in Tanzania, providing modern contraceptives to 65.2% of users.2 UNFPA recently donated 351,000 boxes of emergency contraceptive pills to be available in public health facilities.9 EC in the NGO, social marketing and social fran- chising sectors: Population Services International (PSI) started a social marketing contracep- tive program in Tanzania in 1993 and in 2009 launched Tanzania Familia,10 a clinical social franchising initiative, which provides ECPs at the pharmacy level and private dispensary, health center and hospital levels.4 In 2012, PSI sold 1,680 units of EC.11 Community-based distribution of EC: Tanzania policy allows for community-based distribution of ECPs.4 MEDIA COVERAGE OF EC Between 2010 and 2011, FHI 360 implemented the Mobile for Reproductive Health (m4RH) pilot program in Tanzania. The text message mobile service provided information about contracep- tives and health centers to users. Queries for eight contraceptive methods were tracked, and EC received the second highest number of que- ries, with 16% of all users of the text message service requesting information about EC.12 In the six months leading up to the 2010 DHS survey, three-quarters of women were exposed to a family planning message, with radio being the most common mass media source of infor- mation (49%). Billboards (35%) and posters (34%) were the next most common mass media sources for family planning messages.2 However, it is not known whether this coverage was ever specific to EC. DONOR SUPPORT Donors have purchased EC for Tanzania’s family planning programs. According to RHInterchange, between 2010 and 2013, three shipments, totaling 441,500 units, were made to Tanzania. Funding sources included IPPF, UNFPA and the Dutch government.13 This fact sheet has been prepared by the International Consortium for Emergency Contraception and represents the best information we have been able to gather. We welcome your input for future revisions. Please contact us at info@cecinfo.org. Visit our website at www.emergencycontraception.org for more information on EC. REFERENCES 1 CIA The World Factbook. Africa: Tanzania. Retrieved 9 October 2013, from https://www.cia.gov/library/publications/ the-world-factbook/geos/tz.html. 2 Demographic and Health Surveys, Tanzania, 2010. ICF Macro and National Bureau of Statistics, Tanzania, April 2011. (http://www.measuredhs.com/pubs/pdf/FR243/ FR243[24June2011].pdf). 3 The United Republic of Tanzania, Ministry of Health and Social Welfare. Standard Treatment Guidelines and The National Essential Medicines List for Mainland Tanzania, 3rd Edition. 2007. (http://www.who.int/selection_medicines/ country_lists/tza_stg_neml_2007.pdf). 4 The United Republic of Tanzania, Ministry of Health and Social Welfare. National Family Planning Guidelines and Standards. 2013. 5 The United Republic of Tanzania, Ministry of Health and Social Welfare. National Family Planning Procedure Manual. 2007. 6 The United Republic of Tanzania, Ministry of Health and Social Welfare. National Management Guidelines for the Health Sector Response to and Prevention of Gender-Based Violence (GBV). September 2011. (http://countryoffice. unfpa.org/tanzania/drive/1466_1_MANAGEMENT_ GDLINES_TO_MOHSW_SEPT_FINAL_acc.pdf). 7 ICEC Status and Availability Database. Retrieved 10 October 2013, from http://www.cecinfo.org/country-by-country-infor mation/status-availability-database/countries/tanzania/. 8 Nuhu A. For TFDA, the anti-fake drugs battle isn’t over. Daily News. 10 July 2013. Accessed 17 December 2013, from http://www.dailynews.co.tz/index.php/features/ popular-features/19694-for-tfda-the-anti-fake-drugs- battle-isn-t-over. 9 Tambwe M. Family Planning Bid Gets Support. 24 Tanzania News. 20 June 2013. Accessed 17 December 2013, from http://www.24tanzania.com/family-planning- bid-gets-support/. 10 Population Services International. Tanzania: Clinical Social Franchising Case Study Series. June 2012. (http://www.psi. org/sites/default/files/publication_files/tanzania-sf-cas estudy.pdf). 11 DKT 2012 Contraceptive Social Marketing Statistics. DKT International, Washington, DC, June 2013. 12 FHI 360. Assessing the Feasibility of Providing Family Planning Information via Mobile Phones in Kenya and Tanzania. March 2013. (http://m4rh.fhi360.org/wp- content/uploads/2013/07/Assessing-the-Feasibility-of- Providing-Family-Planning-Information-via-Mobile-Phones- in-Kenya-and-Tanzania.pdf). 13 RHInterchange. Tanzania-Summary of Shipments. Retrieved 30 October 2013, from http://www.myaccessrh. org/rhi-home?p_p_id=rhiuserportlet_WAR_rhiportlet&p_p_ lifecycle=1&p_p_state=normal&p_p_mode=view&p_p_col_ id=column-1&p_p_col_count=1&_rhiuserportlet_WAR_rhi portlet__spage=%2Fquantitysummary.do&_rhiuserportlet_ WAR_rhiportlet__sorig=%2Fquantitysummary.do. Tanzania 3

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