Women Lead in Reproductive Health

Sept. 22, 2009 – Sadly, giving birth in Tanzania is one of the most dangerous things a woman can do. Surveys show that one out of every 24 women in the country will die because of pregnancy complications, according to UNICEF.

The reasons are varied, but among them are high levels of fertility—leading to high-risk pregnancies that occur at too young of an age or that are too closely spaced together—and the lack of access to skilled care during pregnancy and childbirth.

According to the country’s local reproductive health champions, there is one critical intervention that is often overlooked in the fight to reduce maternal mortality and improve reproductive health: women’s empowerment.

“Most of our women, they are not the decision makers in their families,” says Grace Elias Magembe (pictured above), who leads health programs for the Ilala Municipal Council of Tanzania. “That is why you have stories in my country of women hiding contraceptives in the kitchen, under the mattresses or digging a hole and hiding the pills there,” she says, especially if their husbands are not supportive.

In fact, almost 40 percent of women in Tanzania said in a recent health survey that their husbands alone made the sole decisions about their healthcare. This is why outreach to husbands and males is so critical, according to Grace. “We want men to believe that taking care of a pregnant woman and a child are the responsibility of the husband as well as the wife.”

Grace’s story is a familiar refrain in many other countries around the world, especially in sub-Saharan Africa and South Asia. Studies show that when women have access to quality reproductive health and family planning services and information, the quality of their lives and that of their families and communities improves. Yet, increasing access to quality reproductive health information and services remains a stubborn challenge in Tanzania and in many developing countries.

Participants learn not only from the facilitators, but also from the successes and failures they have each experienced in their own countries.

Grace Magembe is one of 26 women leaders who are in Washington, DC this month for the WomenLead in Repositioning Family Planning and Reproductive Health workshop, which is designed to reinvigorate family planning and reproductive health programs, funding and policies. The workshop is sponsored by the USAID | Health Policy Initiative, Task Order 1, which is led by the Futures Group International and includes CEDPA, the White Ribbon Alliance for Safe Motherhood, and the Futures Institute.

Participants in the three-week WomenLead training represent reproductive health and family planning programs at the community and national levels in Ethiopia, India, Kenya, Malawi, Nigeria, Pakistan, Tanzania and Uganda. These countries have some of the highest rates of maternal mortality in the world, and some of the lowest usage rates of modern family planning methods.

The WomenLead program provides these women leaders with a forum for exchange of best practices and lessons learned, as well as technical updates and skill-building sessions. As a result, participants are expected to gain the skills and tools to assume greater leadership in advocating for effective reproductive health policies, programs, and increased funding streams in their countries. The program also will allow them to reinvigorate their health sectors with effective reproductive health services, and design and implement integrated service delivery models that reflect best practices.

As for Grace, she looks forward to implementing a number of lessons that she learned during the workshop. “The training will help me integrate family planning and reproductive health care into other services such as HIV/AIDS care and treatment…to better answer the needs of people living with HIV/AIDS,” she says.

The cross-cultural learning has also been invaluable, she says. “I’ve learned a lot from other country’s experiences,” she says. In particular, “Pakistan and India have a very strong community family planning program and I’m learning from them about the kind of training they provided to local health volunteers and how they were able to scale it up.”

Participants will leave the workshop with a plan of action steps that will allow them to implement the tools that they learned about during the workshop.

With her newfound skills, she plans to work harder to ensure that budget allocations within her country reflect the health needs of the population. “The people who actually negotiate the budgets, they do not have enough information to understand what the real needs are at the community level.”

“If we would be able to address the real needs [in the budget process], that’s when we would be able to improve the services and see improved outcome in terms of maternal and child health,” she says.

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The USAID | Health Policy Initiative, Task Order 1, is funded by the U.S. Agency for International Development (USAID) under Contract No. GPO-I-01-05-00040-00, beginning September 30, 2005. Task Order 1 is implemented by the Futures Group International, in collaboration with the Centre for Development and Population Activities (CEDPA),White Ribbon Alliance for Safe Motherhood (WRA), and Futures Institute.

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