It is widely acknowledged that family planning saves lives by reducing the number of high-risk pregnancies and possibly abortion. Family planning is also a cost-effective intervention that not only promotes healthy families as a result of women spacing births, but also resources (time and money) needed for investing in other developmental opportunities. Featured author, Halima Shariff tells us more.
Featured author, Halima Shariff of Advance Family Planning Tanzania gives MamaYe Tanzania some insight into family planning.The wailings of relatives echo the corridors of a Maternity Ward in a reputable hospital in Dar es Salaam City; a husband is seen confused as doctors and nurses try to console him. He has just lost his wife, a loving mother of five who left behind a few hours old baby boy. Another death, another statistic adding up to the already high number of maternal deaths in Tanzania; 24 women die daily from pregnancy complications and child birth. With a maternal mortality rate (MMR) of 454 per every 100,000 live births, according to the Demographic and Health Survey (DHS, 2010), these sad stories of death and morbidity have become a common feature in the lives of Tanzanians. A number of factors are attributable to this disheartening situation. These include heavy bleeding, eclampsia, prolonged/obstructed labour, anemia, and blood pressure, all of which could be mitigated through close monitoring of the mother during pregnancy (ante-natal care), seeking timely medical attention, and making life-saving commodities such as Oxytocin, Misoprostol, and Magnesium Sulphate (MgSO4) available and accessible to all those in need. Hope for Tanzanian mothers and babiesThese tearful reports of women dying during child birth in most developing countries instigated the international community through the United Nations to launch the Global Strategy for Women’s and Children’s Health in 2010 to improve access to comprehensive, integrated package of essential interventions and services. This entailed addressing issues that impact on health such as safe drinking water, malnutrition, gender equality and women empowerment, and other related health systems strengthening efforts. The strategy was a critical addition to existing global initiatives to save women’s lives during pregnancies and childbirth in most African countries including Tanzania, which had since 2009 embarked on a Campaign for Accelerated Reduction of Maternal Mortality in Africa (CARMMA) with a target of 75% reduction in MMR by 2015. Many other global, regional and national initiatives including the recent one - United National Commission on Life-Saving Commodities (UNCoLSC) - aim at protecting women and children from these preventable deaths.It is encouraging to note that Tanzania has made notable progress in translating global initiatives into actionable national frameworks, strategies, and programs – the National Road Map Strategic Plan to Accelerate Reduction of Maternal, Newborn and Child Deaths in Tanzania 2008–2015 (known as the One Plan); the national launch of CARMMA in 2011; and recently, the UNCoLSC country costed plan. Although these endeavours are commendable to ensure continuum of care in reproductive maternal newborn and child health (RMNCH), they do not serve as immediate consolation to those who are left behind to endure life without their beloved mothers, wives, daughters or sisters. Indeed this immeasurable grief has no end in sight especially because the health infrastructure for RMNCH cannot adequately cater for the growing demand in a country where a woman of reproductive age bears an average of between five and six children. Tanzanian men and women need to take drastic measures in planning their families; in managing fertility so that they only have children when they are mentally, psychologically, physically, and financially ready and able to do so.Working together Inevitably, men and women ought to work as a team and use contraceptives of their choice to space pregnancies and childbirths. Contraception is a human right underscoring individuals and couples’ choice and decision on when, how many, and whether or not they want to have children. From the International Conference on Population and Development (ICPD 1994) in Egypt that set the tone to prioritization of reproductive health and rights, to the London Summit on Family Planning (FP2020) that set the target of 120 million women and girls reached with contraceptives, information and services by 2020 – the message cannot be more louder: strengthen access to voluntary family planning services to save lives, empower women and meet health and other development goals. Tanzania’s low contraceptive prevalence rate of 27% (2010 DHS) and a high unmet need of 25% of women needing family planning services, is indeed a concern despite on-going efforts to improve service uptake. The endless list of myths and misconceptions about family planning modern methods amidst cultural practices that deny women the power to decide on matters of their sexuality and fertility further complicates successful attainment of set goals.Family planning to save lives and boost economyYet, it is widely acknowledged that family planning saves lives by reducing the number of high-risk pregnancies and possibly abortion. Family planning is also a cost-effective intervention that not only promotes healthy families as a result of women spacing births but also resources (time and money) needed for investing in other developmental opportunities. Again, equally important is the fact that falling birth rates also bring the potential to increasing the ratio of working adults to dependants in poverty-stricken countries like Tanzania. The DHS shows a dependency ratio of 1:9, which means for every man or woman in the working age (15-64 years) there are nine (9) people of the dependant age group (below 15 and above 65 years) that he or she supports. This is overwhelming and evidently impacts on the quality of life. Therefore, the unquestionable linkage between family planning and maternal (and child) health calls for sustained investment in family planning services in terms of infrastructure, qualified manpower and commodity availability to strengthen efforts to reach the last mile. Parallel to this is the need to intensify demand creation initiatives, ensure method mix, and enhance public information and education on the various methods to promote informed choice. Every person has to play their part!Guest Blogger: Halima Shariff is the Country Director of Advance Family Planning Tanzania