For more than 20 years, Maurice Hiza has been on the frontlines of family planning in Tanzania, first as a clinical practitioner, then as a trainer and ultimately as a policymaker. He is now the National Family Planning Coordinator for the Ministry of Health, responsible for all family planning services and activities in the country. His background as a service provider gives him insight into the real day-to-day issues in clinics and communities throughout Tanzania—and a strong sense of what needs to happen to make things better.
“When we started to work on awareness-raising, we started by encouraging women,” he says. Knowledge of contraception was minimal in most regions of Tanzania, so programs were designed to provide women with basic information about the methods and benefits of family planning. Outreach campaigns carried the message outside the clinic walls and directly into the communities. A particularly successful approach was the decision to offer contraceptives to women when they brought their children in for immunizations. This exposed the problem of husbands forbidding their wives to go to the family planning clinic.
The result has been a marked increase in demand for contraceptives—to the point that stock-outs are now a frequent problem. Mr. Hiza considers it an encouraging sign. “It means that women now are looking for contraceptives,” he says. “It was challenging for me to see commodities are moving at a very fast pace, but at the same time, it is a success.”
The male attitude to family planning has proven more intractable. Some men in Tanzania mistrust contraception and believe that women do not have the right to make such decisions. To confront these deeply entrenched cultural attitudes head-on, Mr. Hiza’s team at the Ministry of Health has launched a high-profile family planning champions initiative.
The champions initiative recruits respected leaders in each community and trains them to be advocates for family planning. “We use the WHO family planning advocacy kit to teach these champions,” explains Mr. Hiza. “After their training, they go to the community. These people play a very important role in raising awareness, and they really mobilize the community by telling of the advantages and benefits of family planning.”
Photo by Dominic Chavez/FP2020