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March 3, 2018

Family Planning constitutes a core preventive intervention that has the potential to improve maternal, infant, and child health through spacing births, therefore averting unplanned pregnancies and preventable birth-related complications. Family planning saves costs that individuals, families and nations incur in providing health services especially to women in the reproductive age (15-49 yrs), and children. Generally, every dollar spent on family planning saves $4, and reduces overall health costs and re-investing the savings to improve other services.

Tanzania is one of Sub-Saharan Africa countries that have committed to achieve Maternal, Newborn, Child and Adolescent Health (RMNCAH) targets. The launch of RMNCAH Plan II (2016-2020) signifies the country’s resolve to continue investing in reproductive health to save the lives of women, girls, and children. Tanzania records high fertility rate at 5.2 children per woman of reproductive age, high maternal deaths recorded at 556 deaths for every 100,000 live births. Infant mortality is at 45 per 1,000 for live births with under-five mortality being at 67 per 1,000 live births. Studies show that family planning services can avert 44% of maternal deaths and 35% of children under-five .
Contraceptive Social accountability
For services to be provided, commodities have to be available at facilities. Nevertheless, while there have been adequate stocks of commodities at the Medical Stores Department’s warehouses, there have been frequent and persistent stock-outs at facilities. Recent data on stock levels shows that on average, only 40% of stocks were available in facilities. The target set for 2020 is to increase those levels to 70%. Supply chain issues such as inaccurate ordering and late deliveries of the orders to the facilities have greatly contributed to this situation. On top of those challenges, delays in the disbursements of funds for delivering the commodities have been one of the root causes of the situation. Over the past four financial years, Tanzanian government has continued to keep its promise in making incremental allocations for family planning, with a record allocation of 14 billion shillings for 2017/18. However, funds are often not disbursed timely and consequently; family planning supplies don’t reach clients at the last mile where most of the lower level facilities are. This situation calls for action in holding service providers and leaders accountable to their communities towards attaining the 45% national modern contraceptive prevalence rate (mCPR) by 2020.
TMEPiD has received one-year financial contribution from The CHAMPIONS OF GLOBAL REPRODUCTIVE HEALTH RIGHTS (PAI) to support advocacy efforts aimed to improve Family Planning (FP) commodities availability at last mile i.e. lowest level of health facilities (dispensaries), hence reducing significantly the long term challenge of contraceptive stock outs. The initiative will as well improve availability of method mix at the last mile hence contribute to the government’s target on increasing availability of contraceptives to 70% from the current 40% of stock levels.
TMEPiD is also advocating for formation of a functional oversight mechanism for tracking FP supplies funding, using power mapping of the supply chain. TMEPID aims to ensure community-led independent monitoring structures are established in two Local Government Authorities of Kinondoni (Dar es Salaam Region) and Kisarawe (Coast Region) for tracking family planning supplies at the last mile.
Landscape study to review existing bottlenecks in FP commodities procurement and distribution from central to last mile has been undertaken; key stakeholders consulted and fact sheet aimed at winning support of policy makers has as well been developed.
TMEPiD has met with members of Parliamentarian Association for Population and Development in September 2017 to discuss the challenge of availability of contraceptives and methods mix at last mile and roles the Parliamentarians could take towards the endeavor. The Parliamentarians have taken up the challenge and promised to share in their up-coming Parliament sessions and also for monitoring FP commodities budgets, supplies and use in their respective constituencies to start with.