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Tanzania

Articles by Tanzania

UK parliament visit to Tanzania
04 March 2024

UK Lawmakers Assess Progress of Sexual Health Programs in Tanzania

A delegation of UK parliamentarians recently completed a six-day study tour in Tanzania to review the progress of sexual and reproductive health programs funded by the UK government and implemented by local partners like UMATI Tanzania, IPPF’s Member Association in country. The delegation was comprised of five lawmakers from the UK House of Commons and House of Lords representing the All-Party Parliamentary Group (APPG) on Population, Development and Reproductive Health. Throughout their visit, they met with representatives from UMATI, the International Planned Parenthood Federation affiliate in Tanzania, to learn about the  youth center that was established since 1983 to provide sexual health resources and services to both in-school and out-of-school youth. UMATI operates a youth center in Temeke, Dar es Salaam, that offers a range of adolescent sexual and reproductive health (ASRH) services including education on HIV/AIDS and sexually transmitted infections, access to contraceptives, and support for gender-based violence survivors. Additionally, the center provides skills training in areas like cooking and sewing to teenage mothers while also housing a daycare for their children. The APPG delegation toured the Temeke facility and met with youth beneficiaries as well as UMATI staff members overseeing operations. The lawmakers praised UMATI's efforts to reach Tanzanian adolescents, who face high rates of early pregnancy and maternal mortality, with critical health services and economic empowerment programs. The visit to UMATI was part of a broader APPG objective to evaluate UK-funded family planning and reproductive health initiatives in Tanzania. Since 2015, the UK has dedicated significant resources to expanding access to voluntary, high-quality family planning services across the country's disadvantaged regions. Host organizations like UMATI and UNFPA have received British aid support to advance reproductive healthcare access and education for vulnerable Tanzanians in line with the UK's commitment to the ICPD Programme of Action. Throughout their trip, the parliamentarians met with additional UK implementing partners such as Marie Stopes, Engender Health, and UNFPA to review programming and progress data. The delegation left Tanzania better equipped to advocate future British investments to improve reproductive health outcomes, reduce maternal deaths from unintended pregnancies and unsafe abortions, and empower women economically. APPG members called on the UK government to maintain support for local organizations like UMATI working to realize these goals at the conclusion of their study tour.

Women’s Integrated Sexual Health (WISH)
12 August 2022

Leaving no youth behind: WISH2ACTION’s youth weekend clinics in Tanzania

By Renee Sewe and Richard Ryaganda 12 August 2022: International Youth Day is a day designated by the United Nations to recognize the importance of the youth and draw attention to issues affecting the youth. This year it is being observed under the theme ‘Intergenerational solidarity: Creating a World for All Ages. The theme aims to emphasize that action is needed across all generations to address global issues. This theme is in line with the WISH strategy of ‘Leave No One Behind’. WISH2ACTION is a Foreign, Commonwealth & Development Office (FCDO) flagship programme to promote integrated sexual and reproductive health services to marginalized and hard-to-reach populations, including youth and people living with a disability. Through various approaches, WISH2ACTION has strived to create awareness for sexual and reproductive health and rights (SRHR) for youth, incorporating older generations such as parents, guardians, and community leaders in outreach pre-mobilization activities such as dialogues to address social norms and negative attitudes and support to youth. James Kiduo is a 24-year-old young man with a physical disability who lives in Mpanda municipal council in the Katavi region of Tanzania. James was born with a physical impairment that has limited his mobility and ability to participate in physical activities. He moves around on his pedal cycle. James has been determined to not let his disability hold him back. He lives with his nuclear family and works as a freelance cobbler to make a living. Like most young people, James is social and enjoys spending time with his peers. Unfortunately, due to his disability, he is not always enabled to physically participate in all the same activities as his friends, such as sports and other community festivities. On such occasions, he feels excluded and lonely. Youth weekend clinics In early June 2022, James noticed that one of his close friends would leave on Saturday and come back much later in the day. After a few weekends of this unusual behavior, James approached his friend and asked him where he had been going. His friend revealed that he had been attending Youth Weekend Clinics hosted by IPPF Member association in Tanzania, UMATI, and invited James to attend the following weekend. UMATI hosts Special Youth Weekend Clinics for the youth in Tanzania. The clinics are a blend of education and entertainment for adolescents and youth with a focus on sexual and reproductive health and rights. The clinics are scheduled over several weekends with a weekly focus on various subjects such as an overview of reproductive health, life skills, STIs, HIV, teenage pregnancy and early marriages, contraceptives and Gender Based Violence (GBV). The sessions are facilitated by peer educators and youth trained service providers who create an accommodating and welcoming environment for the youth. James discussed his friend’s invitation with his family and decided to attend the following weekend. He was curious to see what it was all about, as well as spend time with his friend and other young people. His friends assisted him in pushing his cycle to the facility where the clinic was being held.  At the clinic, James participated in the sessions and enjoyed the entertainment, games, and socializing. “The learning environment is very conducive here at the clinic. I particularly like the use of audio-visual cards which make learning easier as we can repeat several times until we understand the sexual and reproductive message portrayed during the sessions. I enjoy the lessons taught through the audio-visual cards.” Becoming an ambassador James enjoyed the first clinic he attended, so much so that he proceeded to attend for the next three weekends. Encouraged by his peers, he began participating in edutainment activities as he is a talented singer. James and his friends had not been exposed to sexual and reproductive health (SRH) information and services, as it not taught in school and rarely discussed at home. “I am now happy and confident as I have learned a lot of new things, gained lots of information, received services during sessions and was served equally like my peers. I can even be an ambassador by inviting other youth with disabilities to attend the good sessions like I have received without discrimination and with a high level of dignity and privacy,” he said. In July 2022, James was appointed an ambassador of the Special Youth Weekend Clinics and has been actively recruiting other youth with disability to the clinic. Some of them are now training to become peer educators. Richard Ryaganda of UMATI says “The Youth Weekend Clinics have positively impacted the youth with SRH information and have been able to integrate it with access to services, including counselling for youth. The peer-driven program encourages the attendance of other youth.” Through the WISH2ACTION project, with FCDO funding, UMATI has to date conducted 2,463 Youth Clinics and reached 47,809 youth. This has worked towards improving the sexual and reproductive lives of those who attend, building the foundation of positive sexual health for the future. UMATI plans to scale up implementation of the youth weekend clinics across the areas of implementation, to reach more youth. Also read: Disability and Access to Sexual and Reproductive Health Services in Mozambique Renee Sewe is the Communications Advisor - WISH2ACTION, IPPF Africa Region. Richard Ryaganda is the Social Behaviour Change Communications Manager, UMATI, Tanzania Featured image: James Kiduo reading SRH educational material with his peers. Photo by Mussa Mdemle, UMATI Field Officer. For more updates on our work, follow IPPF Africa Region on Facebook, Twitter, Instagram and You Tube.

PREGNANT WOMAN
27 June 2017

Statement In Support Of Pregnant School Girls In Tanzania

IPPF Africa Region is concerned about the alleged statement by Tanzanian President HE John Pombe Magufuli. The warning that schoolgirls who have given birth should not be allowed to return to school is contrary to Regional and Global policy commitments that seek to protect Africa’s Youth, to which the United Republic of Tanzania is a signatory. The Republic of Tanzania has ratified several protocols at the continental level – and these include the Banjul Protocol, the Maputo Protocol and most recently the Maputo Plan of Action 2016-2030. The Banjul Protocol specifically states in article 17 that ‘Every individual shall have the right to education” and part of article 18 declares that “The State shall ensure the elimination of every discrimination against women; and also ensure the protection of the rights of women and the child as stipulated in international declarations and conventions.” Education is not only a human right in itself, but also enables access to almost all other human rights (UNESCO, 2016). The right to education is enshrined in Article 26 of the Universal Declaration of Human Rights (United Nations, 1948). Equal access to quality education is also an objective of Africa’s Agenda 2063 and the United Nations 2030 Agenda for Sustainable Development. When a girl is not enrolled, or is pulled out of school for any reason whatsoever, her rights are violated, her opportunities are lost and her future options are limited. In light of the above, we would like to appeal to the government of the United Republic of Tanzania to review its overall position on the status of the girl child in the context of the Demographic Dividend, Maputo Plan of Action, Maputo Protocol and the African Youth Charter. We firmly believe that Africa can harness the Demographic Dividend through investing in youth, particularly young girls if their rights are preserved.

Service providers discussing the CA Cervical screening strategy at the health facility
30 October 2018

Cervical Cancer in Sexual and Reproductive Health

Cervical cancer is the fourth most common cancer among women worldwide. However, the problem disproportionately affects women in developing countries and ranks as either the first or second most common cancer. (Pimple S,2016) Human papillomavirus (HPV), especially type 16 and 18 a sexually transmitted infection (STI), is a causal factor for virtually all cases of invasive cervical cancer (ICC). Overall, women that engage in sex at an early age can subsequently become pregnant at an early age, and have a large number of children, which are factors that have been associated with an increased risk of HPV infection and ICC. (J. Ferlay 2013) Evidence suggests that these early sexual and reproductive health (SRH) factors, low social economic status and immune deficiency is associated with a greater risk of HPV infection and cervical cancer development because of the biological predisposition of the immature cervix and cervical trauma experienced during delivery of birth. In addition, a women's risk may also be heavily dependent on the "high-risk" sexual behaviour of the male partner rather than their own sexual behaviour. This is particular among lifetime sexually monogamous women, since men in general, report more lifetime numbers of sexual partners than women. (A.N. Burchell, and K. Wellings 2006) Therefore, to achieve the primary objective of cancer prevention reproductive health issues including HPV vaccination, regular cervical cancer screening and contraception use should not be overlooked.Cervical cancer risk is associated with increased sexual activity. Initiatives to encourage later commencement of sex and limiting the number of sexual partners would have a favourable impact on risk of cancer of the cervix and other sexually transmitted infections (Diane Cooper, 2007). There has been overwhelming evidence that connects cervical cancer to early sexual debut. It is important to have young people educated and have access to Social Behavioural Change and Communication (SBCC) and sexual and reproductive health rights (SRHR). This will ensure that they know how to go about STI prevention and use of contraception.  Cervical cancer remains a major cause of morbidity and mortality among women in resource constrained settings due to low access to cancer screening and vaccination (Bingham A, 2003). Studies show that those who come from low social economic status have high risk acquisition of HPV earlier and more frequent than those who are from high social economic status.  Citing the Tanzania Demographic Health Survey (TDHS) of 2015-16, the survey states that: Both women and men in rural areas are more likely to marry earlier than their urban counterparts. This is because the latter has more access to SRHR at such a young age, more opportunities to engage fellow young people and other youth friendly services as well as peer educators and make informed choice. Early diagnosis consists of 3 steps that must be integrated and provided in a timely fashion of which awareness and accessing care, clinical evaluation, diagnosis and staging and access to treatment that is saying in other words access to SRHR. Ivony Issack Kamala, Nurse and Midwife who is the Manager - Medical and Technical Service at Uzazi na Malezi Bora Tanzania (UMATI) – a Member Association of IPPF Africa Region shares with us about the UMATI Cervical Screening project in Tanzania: Question 1: Tell us about the recent Cervical Screening Project in Tango, Tanzania Answer:The cervical cancer screening project in Tanga is incorporated as integrated health services provided during outreach in Tanga city under the Cluster model/Cluster Plus; it being a Public – Private - People - Partnership (4Ps) for demand creation and integrated service delivery. In this model, we aim at providing services integrated service delivery to 5 multisectoral facilities identified within 20km radius engaged in formal agreement to provide outreach and subsidized facility-based services.  Question 2: What do you consider as the successes/achievement of the project? Answer: The successes/ achievements of the project have been: Reaching 1,626 women with Cervical Cancer screening services in just one month. Educating the population has been a great achievement too. We have had women come from great distances referring their peers and sharing stories of how well we have helped them. We share information with the community through community healthcare workers (CHW) and community-based distributors (CBD). They have been sensitizing our people and referring them to health facilities. After this, our field officer follows up the clients with easy.  By use of informative tools, they capture an extensive amount of data that is linked to a great feedback system. One thing we learnt from this is that, women need better access to family planning services and more men need easier access to education on family planning. Health providers and the great outreach team have strategies to incorporate integrated health services i.e. voluntary counseling and testing (VCT), visual inspection using acetic acid (VIA), sexually transmitted infections (STI) and FP services all in one service provision outreach basket. On job training/mentorship to the service providers during outreaches at Static facilities. We had two teams in the project headed by UMATI service providers of which one happens to a certified National Trainers on FP and another competent in VIA. These two teams each had a preceptor, a trainee and 1 or 2 CHW depending on their availabilities. The team leaders (UMATI Service providers were constant), preceptors were interchanging as well as trainees who were service providers at host outreach facility. After this leg of outreach, we are looking into certifying the service providers who were competent in their service provision. So, the ongoing on job mentorship ensures sustainable health service provision even long after UMATI moves on from Tanga outreach cluster model. Question 3: What challenges that you experienced during the implementation period? Answer: The challenges were mostly lack of education, sometimes women being reluctant to attend these services due to fear of the unknown. They have not experienced VIA before they do not know what it is but after they were educated, and they experience we got more clients. Another challenge was the culture and tradition of Tanga area in Tanzania. Most of our clients were communities that culture and religion tend to keep a woman at home and has to follow her man. This is so serious that men themselves go shopping for women to the market.  This robs the woman of the opportunity to get our services. Even getting counselling is a challenge. The service providers sometimes have to follow these women to their homes to counsel them. Eventually when the women come to the health facility they would spend less time accessing the cancer screening services.  Also, the issue of distance in which clients would travel a long distance to the facility hence the service providers were to be efficient in-service integration. The biggest challenge yet was the controversial political statements which had vague translation to the communities in Tanzania. The early days after the statements went out, there was a decline in uptake of FP services but after incorporation of VIA then we saw the slow but steady increase of demand for the integrated services.  HOW TO PREVENT CERVICAL CANCER It is not easy to avoid HPV in low-income setting due to the prevalence of risk factors such as early marriage, poor access to VIA services, inability to access HPV vaccination and et cetera. Hence, it is advisable to adhere to the following:  Have at least one faithful partner or use condom/barrier method of FP.  Cervical screening – for women of reproductive age around 35 years of age and should be done at least every 3 years. And women between 50-64 should have at least a check 5 yearly. Avoid use of cigarettes which increase susceptibility to HPV Do not douche with substances such as honey, cotton, perfumes and other cologne scents, chocolate or peanut butter.  Avoid basic douching agents because the vagina is naturally acidic in nature, basic douching agents neutralize the vaginal condition hence, leave the area susceptible to infections and lower the immunity. Gardasil vaccine started to be used in Tanzania, to prevent HPV infection which causes cervical cancer for young girls aged 14-26 years and services.      

Uzazi na Malezi Bora Tanzania

Chama cha Uzazi na Malezi Bora Tanzania (UMATI)

UMATI (Chama cha Uzazi na Malezi Bora Tanzania (UMATI) was established in 1959 and became a full IPPF Member Association in 1973. Since then, it has developed a comprehensive range of sexual and reproductive health (SRH) services for the Tanzanian people.

UMATI operates 33 services points which include 13 permanent clinics and 19 community-based distributors/community-based services (CBDs/CBSs). UMATI’s services are maintained and delivered by 120 permanent staff, 120 peer educators and a youth action movement membership of 250. 

UMATI also runs an extensive programme of home-based care and support for people living with HIV and AIDS (PLWHA). Voluntary counselling and testing (VCT) is a central part of UMATI’s HIV and AIDS prevention and treatment work. The organization is also highly active in promoting screening services and providing infertility diagnosis and counselling.

UMATI collaborates closely with and/or receives funding from the Ministry of Health and non-governmental organizations (NGOs) such as Youth Incentives, AMREF, the Japanese Organization for International Cooperation in Family Planning (JOICFP), GTZ, SIDA, Youth Incentives and AMREF.

Website: www.umati.or.tz

 

UK parliament visit to Tanzania
04 March 2024

UK Lawmakers Assess Progress of Sexual Health Programs in Tanzania

A delegation of UK parliamentarians recently completed a six-day study tour in Tanzania to review the progress of sexual and reproductive health programs funded by the UK government and implemented by local partners like UMATI Tanzania, IPPF’s Member Association in country. The delegation was comprised of five lawmakers from the UK House of Commons and House of Lords representing the All-Party Parliamentary Group (APPG) on Population, Development and Reproductive Health. Throughout their visit, they met with representatives from UMATI, the International Planned Parenthood Federation affiliate in Tanzania, to learn about the  youth center that was established since 1983 to provide sexual health resources and services to both in-school and out-of-school youth. UMATI operates a youth center in Temeke, Dar es Salaam, that offers a range of adolescent sexual and reproductive health (ASRH) services including education on HIV/AIDS and sexually transmitted infections, access to contraceptives, and support for gender-based violence survivors. Additionally, the center provides skills training in areas like cooking and sewing to teenage mothers while also housing a daycare for their children. The APPG delegation toured the Temeke facility and met with youth beneficiaries as well as UMATI staff members overseeing operations. The lawmakers praised UMATI's efforts to reach Tanzanian adolescents, who face high rates of early pregnancy and maternal mortality, with critical health services and economic empowerment programs. The visit to UMATI was part of a broader APPG objective to evaluate UK-funded family planning and reproductive health initiatives in Tanzania. Since 2015, the UK has dedicated significant resources to expanding access to voluntary, high-quality family planning services across the country's disadvantaged regions. Host organizations like UMATI and UNFPA have received British aid support to advance reproductive healthcare access and education for vulnerable Tanzanians in line with the UK's commitment to the ICPD Programme of Action. Throughout their trip, the parliamentarians met with additional UK implementing partners such as Marie Stopes, Engender Health, and UNFPA to review programming and progress data. The delegation left Tanzania better equipped to advocate future British investments to improve reproductive health outcomes, reduce maternal deaths from unintended pregnancies and unsafe abortions, and empower women economically. APPG members called on the UK government to maintain support for local organizations like UMATI working to realize these goals at the conclusion of their study tour.

Women’s Integrated Sexual Health (WISH)
12 August 2022

Leaving no youth behind: WISH2ACTION’s youth weekend clinics in Tanzania

By Renee Sewe and Richard Ryaganda 12 August 2022: International Youth Day is a day designated by the United Nations to recognize the importance of the youth and draw attention to issues affecting the youth. This year it is being observed under the theme ‘Intergenerational solidarity: Creating a World for All Ages. The theme aims to emphasize that action is needed across all generations to address global issues. This theme is in line with the WISH strategy of ‘Leave No One Behind’. WISH2ACTION is a Foreign, Commonwealth & Development Office (FCDO) flagship programme to promote integrated sexual and reproductive health services to marginalized and hard-to-reach populations, including youth and people living with a disability. Through various approaches, WISH2ACTION has strived to create awareness for sexual and reproductive health and rights (SRHR) for youth, incorporating older generations such as parents, guardians, and community leaders in outreach pre-mobilization activities such as dialogues to address social norms and negative attitudes and support to youth. James Kiduo is a 24-year-old young man with a physical disability who lives in Mpanda municipal council in the Katavi region of Tanzania. James was born with a physical impairment that has limited his mobility and ability to participate in physical activities. He moves around on his pedal cycle. James has been determined to not let his disability hold him back. He lives with his nuclear family and works as a freelance cobbler to make a living. Like most young people, James is social and enjoys spending time with his peers. Unfortunately, due to his disability, he is not always enabled to physically participate in all the same activities as his friends, such as sports and other community festivities. On such occasions, he feels excluded and lonely. Youth weekend clinics In early June 2022, James noticed that one of his close friends would leave on Saturday and come back much later in the day. After a few weekends of this unusual behavior, James approached his friend and asked him where he had been going. His friend revealed that he had been attending Youth Weekend Clinics hosted by IPPF Member association in Tanzania, UMATI, and invited James to attend the following weekend. UMATI hosts Special Youth Weekend Clinics for the youth in Tanzania. The clinics are a blend of education and entertainment for adolescents and youth with a focus on sexual and reproductive health and rights. The clinics are scheduled over several weekends with a weekly focus on various subjects such as an overview of reproductive health, life skills, STIs, HIV, teenage pregnancy and early marriages, contraceptives and Gender Based Violence (GBV). The sessions are facilitated by peer educators and youth trained service providers who create an accommodating and welcoming environment for the youth. James discussed his friend’s invitation with his family and decided to attend the following weekend. He was curious to see what it was all about, as well as spend time with his friend and other young people. His friends assisted him in pushing his cycle to the facility where the clinic was being held.  At the clinic, James participated in the sessions and enjoyed the entertainment, games, and socializing. “The learning environment is very conducive here at the clinic. I particularly like the use of audio-visual cards which make learning easier as we can repeat several times until we understand the sexual and reproductive message portrayed during the sessions. I enjoy the lessons taught through the audio-visual cards.” Becoming an ambassador James enjoyed the first clinic he attended, so much so that he proceeded to attend for the next three weekends. Encouraged by his peers, he began participating in edutainment activities as he is a talented singer. James and his friends had not been exposed to sexual and reproductive health (SRH) information and services, as it not taught in school and rarely discussed at home. “I am now happy and confident as I have learned a lot of new things, gained lots of information, received services during sessions and was served equally like my peers. I can even be an ambassador by inviting other youth with disabilities to attend the good sessions like I have received without discrimination and with a high level of dignity and privacy,” he said. In July 2022, James was appointed an ambassador of the Special Youth Weekend Clinics and has been actively recruiting other youth with disability to the clinic. Some of them are now training to become peer educators. Richard Ryaganda of UMATI says “The Youth Weekend Clinics have positively impacted the youth with SRH information and have been able to integrate it with access to services, including counselling for youth. The peer-driven program encourages the attendance of other youth.” Through the WISH2ACTION project, with FCDO funding, UMATI has to date conducted 2,463 Youth Clinics and reached 47,809 youth. This has worked towards improving the sexual and reproductive lives of those who attend, building the foundation of positive sexual health for the future. UMATI plans to scale up implementation of the youth weekend clinics across the areas of implementation, to reach more youth. Also read: Disability and Access to Sexual and Reproductive Health Services in Mozambique Renee Sewe is the Communications Advisor - WISH2ACTION, IPPF Africa Region. Richard Ryaganda is the Social Behaviour Change Communications Manager, UMATI, Tanzania Featured image: James Kiduo reading SRH educational material with his peers. Photo by Mussa Mdemle, UMATI Field Officer. For more updates on our work, follow IPPF Africa Region on Facebook, Twitter, Instagram and You Tube.

PREGNANT WOMAN
27 June 2017

Statement In Support Of Pregnant School Girls In Tanzania

IPPF Africa Region is concerned about the alleged statement by Tanzanian President HE John Pombe Magufuli. The warning that schoolgirls who have given birth should not be allowed to return to school is contrary to Regional and Global policy commitments that seek to protect Africa’s Youth, to which the United Republic of Tanzania is a signatory. The Republic of Tanzania has ratified several protocols at the continental level – and these include the Banjul Protocol, the Maputo Protocol and most recently the Maputo Plan of Action 2016-2030. The Banjul Protocol specifically states in article 17 that ‘Every individual shall have the right to education” and part of article 18 declares that “The State shall ensure the elimination of every discrimination against women; and also ensure the protection of the rights of women and the child as stipulated in international declarations and conventions.” Education is not only a human right in itself, but also enables access to almost all other human rights (UNESCO, 2016). The right to education is enshrined in Article 26 of the Universal Declaration of Human Rights (United Nations, 1948). Equal access to quality education is also an objective of Africa’s Agenda 2063 and the United Nations 2030 Agenda for Sustainable Development. When a girl is not enrolled, or is pulled out of school for any reason whatsoever, her rights are violated, her opportunities are lost and her future options are limited. In light of the above, we would like to appeal to the government of the United Republic of Tanzania to review its overall position on the status of the girl child in the context of the Demographic Dividend, Maputo Plan of Action, Maputo Protocol and the African Youth Charter. We firmly believe that Africa can harness the Demographic Dividend through investing in youth, particularly young girls if their rights are preserved.

Service providers discussing the CA Cervical screening strategy at the health facility
30 October 2018

Cervical Cancer in Sexual and Reproductive Health

Cervical cancer is the fourth most common cancer among women worldwide. However, the problem disproportionately affects women in developing countries and ranks as either the first or second most common cancer. (Pimple S,2016) Human papillomavirus (HPV), especially type 16 and 18 a sexually transmitted infection (STI), is a causal factor for virtually all cases of invasive cervical cancer (ICC). Overall, women that engage in sex at an early age can subsequently become pregnant at an early age, and have a large number of children, which are factors that have been associated with an increased risk of HPV infection and ICC. (J. Ferlay 2013) Evidence suggests that these early sexual and reproductive health (SRH) factors, low social economic status and immune deficiency is associated with a greater risk of HPV infection and cervical cancer development because of the biological predisposition of the immature cervix and cervical trauma experienced during delivery of birth. In addition, a women's risk may also be heavily dependent on the "high-risk" sexual behaviour of the male partner rather than their own sexual behaviour. This is particular among lifetime sexually monogamous women, since men in general, report more lifetime numbers of sexual partners than women. (A.N. Burchell, and K. Wellings 2006) Therefore, to achieve the primary objective of cancer prevention reproductive health issues including HPV vaccination, regular cervical cancer screening and contraception use should not be overlooked.Cervical cancer risk is associated with increased sexual activity. Initiatives to encourage later commencement of sex and limiting the number of sexual partners would have a favourable impact on risk of cancer of the cervix and other sexually transmitted infections (Diane Cooper, 2007). There has been overwhelming evidence that connects cervical cancer to early sexual debut. It is important to have young people educated and have access to Social Behavioural Change and Communication (SBCC) and sexual and reproductive health rights (SRHR). This will ensure that they know how to go about STI prevention and use of contraception.  Cervical cancer remains a major cause of morbidity and mortality among women in resource constrained settings due to low access to cancer screening and vaccination (Bingham A, 2003). Studies show that those who come from low social economic status have high risk acquisition of HPV earlier and more frequent than those who are from high social economic status.  Citing the Tanzania Demographic Health Survey (TDHS) of 2015-16, the survey states that: Both women and men in rural areas are more likely to marry earlier than their urban counterparts. This is because the latter has more access to SRHR at such a young age, more opportunities to engage fellow young people and other youth friendly services as well as peer educators and make informed choice. Early diagnosis consists of 3 steps that must be integrated and provided in a timely fashion of which awareness and accessing care, clinical evaluation, diagnosis and staging and access to treatment that is saying in other words access to SRHR. Ivony Issack Kamala, Nurse and Midwife who is the Manager - Medical and Technical Service at Uzazi na Malezi Bora Tanzania (UMATI) – a Member Association of IPPF Africa Region shares with us about the UMATI Cervical Screening project in Tanzania: Question 1: Tell us about the recent Cervical Screening Project in Tango, Tanzania Answer:The cervical cancer screening project in Tanga is incorporated as integrated health services provided during outreach in Tanga city under the Cluster model/Cluster Plus; it being a Public – Private - People - Partnership (4Ps) for demand creation and integrated service delivery. In this model, we aim at providing services integrated service delivery to 5 multisectoral facilities identified within 20km radius engaged in formal agreement to provide outreach and subsidized facility-based services.  Question 2: What do you consider as the successes/achievement of the project? Answer: The successes/ achievements of the project have been: Reaching 1,626 women with Cervical Cancer screening services in just one month. Educating the population has been a great achievement too. We have had women come from great distances referring their peers and sharing stories of how well we have helped them. We share information with the community through community healthcare workers (CHW) and community-based distributors (CBD). They have been sensitizing our people and referring them to health facilities. After this, our field officer follows up the clients with easy.  By use of informative tools, they capture an extensive amount of data that is linked to a great feedback system. One thing we learnt from this is that, women need better access to family planning services and more men need easier access to education on family planning. Health providers and the great outreach team have strategies to incorporate integrated health services i.e. voluntary counseling and testing (VCT), visual inspection using acetic acid (VIA), sexually transmitted infections (STI) and FP services all in one service provision outreach basket. On job training/mentorship to the service providers during outreaches at Static facilities. We had two teams in the project headed by UMATI service providers of which one happens to a certified National Trainers on FP and another competent in VIA. These two teams each had a preceptor, a trainee and 1 or 2 CHW depending on their availabilities. The team leaders (UMATI Service providers were constant), preceptors were interchanging as well as trainees who were service providers at host outreach facility. After this leg of outreach, we are looking into certifying the service providers who were competent in their service provision. So, the ongoing on job mentorship ensures sustainable health service provision even long after UMATI moves on from Tanga outreach cluster model. Question 3: What challenges that you experienced during the implementation period? Answer: The challenges were mostly lack of education, sometimes women being reluctant to attend these services due to fear of the unknown. They have not experienced VIA before they do not know what it is but after they were educated, and they experience we got more clients. Another challenge was the culture and tradition of Tanga area in Tanzania. Most of our clients were communities that culture and religion tend to keep a woman at home and has to follow her man. This is so serious that men themselves go shopping for women to the market.  This robs the woman of the opportunity to get our services. Even getting counselling is a challenge. The service providers sometimes have to follow these women to their homes to counsel them. Eventually when the women come to the health facility they would spend less time accessing the cancer screening services.  Also, the issue of distance in which clients would travel a long distance to the facility hence the service providers were to be efficient in-service integration. The biggest challenge yet was the controversial political statements which had vague translation to the communities in Tanzania. The early days after the statements went out, there was a decline in uptake of FP services but after incorporation of VIA then we saw the slow but steady increase of demand for the integrated services.  HOW TO PREVENT CERVICAL CANCER It is not easy to avoid HPV in low-income setting due to the prevalence of risk factors such as early marriage, poor access to VIA services, inability to access HPV vaccination and et cetera. Hence, it is advisable to adhere to the following:  Have at least one faithful partner or use condom/barrier method of FP.  Cervical screening – for women of reproductive age around 35 years of age and should be done at least every 3 years. And women between 50-64 should have at least a check 5 yearly. Avoid use of cigarettes which increase susceptibility to HPV Do not douche with substances such as honey, cotton, perfumes and other cologne scents, chocolate or peanut butter.  Avoid basic douching agents because the vagina is naturally acidic in nature, basic douching agents neutralize the vaginal condition hence, leave the area susceptible to infections and lower the immunity. Gardasil vaccine started to be used in Tanzania, to prevent HPV infection which causes cervical cancer for young girls aged 14-26 years and services.      

Uzazi na Malezi Bora Tanzania

Chama cha Uzazi na Malezi Bora Tanzania (UMATI)

UMATI (Chama cha Uzazi na Malezi Bora Tanzania (UMATI) was established in 1959 and became a full IPPF Member Association in 1973. Since then, it has developed a comprehensive range of sexual and reproductive health (SRH) services for the Tanzanian people.

UMATI operates 33 services points which include 13 permanent clinics and 19 community-based distributors/community-based services (CBDs/CBSs). UMATI’s services are maintained and delivered by 120 permanent staff, 120 peer educators and a youth action movement membership of 250. 

UMATI also runs an extensive programme of home-based care and support for people living with HIV and AIDS (PLWHA). Voluntary counselling and testing (VCT) is a central part of UMATI’s HIV and AIDS prevention and treatment work. The organization is also highly active in promoting screening services and providing infertility diagnosis and counselling.

UMATI collaborates closely with and/or receives funding from the Ministry of Health and non-governmental organizations (NGOs) such as Youth Incentives, AMREF, the Japanese Organization for International Cooperation in Family Planning (JOICFP), GTZ, SIDA, Youth Incentives and AMREF.

Website: www.umati.or.tz