Transcript Document

Ministry of Health and Social Welfare
Reproductive and Child Health Section
Tanzania Provides
Over 900,000 Implants
in Last Six Years
International FP Conference
Addis Ababa, November 14, 2013
Presenter: Richard Killian, (EngenderHealth,
Tanzania [EHT]): Co-Authors: Mwanga, F
(EHT); Hiza, M, (Ministry of Health and Social
Welfare-Tanzania); Kanama, J (EHT)
Current FP situation in Tanzania
Total population: 44.9 million (2012)
Population growth rate: 2.7% (2012)
Three in four Tanzanians reside in rural areas
Total Fertility rate (TFR): 5.4
Modern CPR: 27% (20% in 2004-05)
LARC/PM CPR: 6%
Implants CPR: 2.3% (2010 DHS):
265% increase from 2004 (0.5%)
Unmet need for FP: 25%
Data Sources: Tanzania Census 2012; Tanzania DHS 2010
FP Programme Objectives and Action Areas
(from National FP Strategy)
Contraceptive Security
Capacity Building
Service Delivery
Advocacy and Demand
Generation
Management, Monitoring
and Evaluation
(2008 National FP goal: 60% total CPR by 2015)
USAID support to Tanzania’s public sector FP program
“Flagship” USAID projects, managed by EngenderHealth,
2007-present, for comprehensive technical assistance
to Tanzania’s public sector FP program
– Follows EngenderHealth’s holistic SEED Programming Model
– Country-wide coverage / national scale, district focus:
> All 30 regions;110 of 169 districts
> > 3,700 public sector health care facilities
> > 9,000 service providers trained
> ~2,200 service providers trained in implant insertion & removal
– Capacity-building / system strengthening approach, to build publicsector capacity and increase delivery of FP/RH services
– Direct support for public sector mobile outreach to serve hard-to-reach
and under-served individuals and communities
Tanzania’s LARC/PM service delivery achievements
Selected LARC/PM Results, 2007/08 to 2012/13
(70% in public sector; 50-60% of total via mobile services)
Annual LARC/PM clients Nearly tripled, from 157,107 to 424,761
Cumulative total of 1,671,067 clients in 2007-2013
IUD clients
Six-fold increase, 16,429 (2007-08) to 99,552
(2012-13), cumulative total of 350,242 IUDs
provided
Implants clients
More than tripled, with a 265% increase, from
78,687 (2007-08) to 247,620 (2012/13)
cumulative total of 900,045 implants provided
Minilap clients
(Female sterilization)
419,863 clients chose and received minilap
(female sterilization) from 2007-2013
Source: National HMIS (MTHUA), 2007/08-2012/13
Rising trends in total numbers of LARC/PM clients
being served, and rising number of implants users
300,000
250,000
Implants
247,620
207,089
200,000
Female Sterilization
166,768
150,000
Male Sterilization
IUD
100,000
100,360
78,687
61,752
67,430
16,429
239
2007-08
73,984
85,461
99,552
75,194
77,277
67,792
50,000
-
99,521
64,226
46,698
34,310
245
2008-09
347
2009-10
275
2010-11
260
2011-12
312
2012-13
Implant
Factors in the increase in implants acceptors
The clinical method most preferred by clients
and providers
More trained providers are available for
implants than other LARC/PMs
Less provider bias than for other LARCs/PMs
Mobile outreach services are bringing providers
to lower-level health facilities for services,
including implants
Good supplies of implants generally available
(except for 2009-2010)
Approval and stocking of Jadelle by the
MOHSW, so there are choices of two implants
Price reductions in 2012-2013 by
manufacturers of Jadelle and Implanon
A client receiving implant services at a public facility
Current use of implants in Tanzania (TDHS 2010)
1.5%
0.3%
2.1%
2.2.5%
3.6%
3.7
%
3.6%
Urban
Rural
percent implant use*
Education
3.3%
2.8%
2.1%
1.8%
1.1%
3.8%
2.8%
1.5%
1%
2.5% of urban women
2.2% of rural women
currently using implant for
FP
increased wealth/ education
A majority of married
women age 15-49
currently using implants
live in rural areas
*women 15-49 married
LARC/PM provision according to service modality
Total LARC/PM
OUTREACH
SERVICE DAY
ROUTINE
The increasing trend
of LARCs/PMs by
Routine services is
evidence of system
strengthening and
capacity building in
the public sector.
Conclusions: Good progress has been made in
Tanzania in increasing LARC/PM availability
FP service delivery and system strengthening
˗ Number of government hospitals, health centres and
dispensaries able to provide at least one LARC/PM has doubled
since 2007 and is continuing to rise
˗ The popularity and availability of implants continues to increase
˗ The public sector and its partners are reaching underserved
people and communities through mobile outreach
˗ Mobile services also are providing the opportunity for practical
skills development, with associated supervision and QA
The Way Forward: Further increase access and choice
by building on the strong foundation
Continue to build public sector
capacity
Enhance public-private
partnership and coordination
Fine tune approaches to reduce
unmet need, reach underserved
populations and increase equity,
and offer a full range of methods
Mobilize resources for FP,
including FP2020 commitments,
several of which specify implants
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