It Takes a Village: Results from the Expand Family Planning Project in Tanzania

Like so many around the globe, I have spent recent weeks cheering on athletes at the 2016 Olympics in Rio de Janeiro. These athletes are real-life superheroes. Take Simone Biles, who has won the most Olympic and world championship medals ever won by an American gymnast—simply amazing. Watching the Olympics, I am inspired by and in awe of the dedication and effort needed to succeed—not just by the athlete but also all the people who helped make that success happen, including family, coaches, doctors and therapists, fans, and so many more. It is that same collective commitment by many working toward a shared goal that achieves results, no matter what the industry or field.

It is in this spirit of collective effort by a village of actors that I am very pleased to share key results from the Expand Family Planning (ExpandFP) project in Tanzania. Led by EngenderHealth, the ExpandFP project ensures clients’ full, free, and informed choice of contraceptive method while expanding the availability and use of long-acting reversible contraceptives (LARCs)—i.e., hormonal implants and intrauterine devices (IUDs). Funded by the Bill & Melinda Gates Foundation, ExpandFP is part of the global FP2020 effort to provide contraception to an additional 120 million women and girls in the world’s poorest countries by 2020. The project focused on:

  • Training health care providers and managers in family planning (FP)
  • Improving service quality and supervision
  • Ensuring clients’ rights and choice, medical follow-up care, and access to implant and IUD removal services on demand
  • Using data for decision-making, particularly for contraceptive security
  • Reaching communities with FP information; supporting community health workers and volunteers; and engaging community leaders to support FP efforts

In addition to strengthening local capacity to expand the basket of choices/method mix (LARCs and permanent methods), ExpandFP also reached clients in diverse settings, including routine services at core facilities, mobile outreach services, and special days dedicated to FP.

Based on this comprehensive approach, ExpandFP significantly increased contraceptive uptake in its six participating districts during the project. Specifically, 160,378 clients voluntarily chose a contraceptive method between January 2014 and September 2015 (on average, approximately 23,000 clients per quarter), compared with 25,138 clients in the preintervention baseline period between January and December 2013 (on average, approximately 6,300 clients per quarter).

In terms of location, ExpandFP learned that mobile outreach services reached 57% of total clients, with the remaining 39% served via routine daily services and 4% during special FP days, which shows the value of offering diverse settings for women to access contraception.

Although a majority of clients received contraception at mobile outreach events, ExpandFP also worked to sustainably upgrade routine FP services at the static health care sites. Client loads for routine services at the 21 supported facilities increased from around 6,200 clients per quarter during the baseline period to just about 9,000 clients during the intervention, representing a 44% increase in clients served per quarter.

Improvements in method mix were also striking: The proportion of FP clients choosing LARCs increased more than six-fold, from 10% (implant, 8.4%; IUD, 1.6%) during the baseline period to 62% (implant, 49.5%; IUD, 12.9%) in the intervention period. A sizable increase in adoption of female sterilization was also seen, from fewer than 1% of clients to 12%.

In summary, ExpandFP dramatically improved the contraceptive options available and the ways in which they could be accessed, thereby increasing contraceptive uptake. The results in Tanzania demonstrate that there are many facets to ensuring that FP services are designed, implemented, and monitored in a way that protects women’s rights and puts their needs, desires, and preferences at the center. It truly does take a village to achieve success, and it is vital to ensure that these positive gains continue and expand across the country.

 

To download the full ExpandFP Tanzania brief please click here:

https://www.engenderhealth.org/files/pubs/project/expandfp/Expand-FP-Tanzania-Brief.pdf

 

For more information on the ExpandFP Project, visit:

https://www.engenderhealth.org/our-work/major-projects/gates-expand-fp.php

 

2 thoughts on “It Takes a Village: Results from the Expand Family Planning Project in Tanzania

  1. I have a small PHE project in a Maasai community of 2,000 in the Ngogoro Conservation area. We found Marie Stopes has a mobile clinic and 23 of the women in the community walked the 4 miles to nearby Nainokanoka to receive family planning methods. It is good that women can now get family planning, but it would be better that the small health clinic in Nainokanoka could be improved and family planning services provided year round. It would also help if the clinic were able to follow up on any side effects of the methods women are using. The second-closest health facility, and where the women go to give birth, is 70km away.

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