Government Of Tanzania Allocates 2 Billion Shillings To Family Planning .

an evidence-based advocacy initiativeTANZANIAJanuary 2015Government of Tanzania Allocates 2 BillionShillings to Family Planning for 2014-2015CASE STUDYFor the 2014-2015 fiscal year, the Governmentof Tanzania allocated two billion shillings (Tsh)(US 1.15 million) to family planning—the largestallocation since the budget line for family planningwas created in 2010 and a 100% increase from the2013-2014 budget.Advance Family Planning (AFP) initiative’s localpartners: the Johns Hopkins Center for CommunicationPrograms Tanzania (CCP), Health Promotion Tanzania(HDT), and United Nations Association (UNA) ofTanzania applied strategic, evidence-based advocacywith the support of non-governmental organizations,parliamentarians, and other government leaders torequest the allocation.The budget increase followed unprecedented politicalcommitment by Tanzania’s President Jakaya Kikweteat the London Summit on Family Planning in July2012 and in the launch of the Sharpened One Plan2014-2015, a revised National Road Map StrategicPlan to Accelerate Reduction of Maternal, Newbornand Child Deaths.1President Kikwete shows the Score Card at the Sharpened OnePlan launch.The committed funds contribute to national goalsand policies aimed at: Increasing the number of skilled family planningproviders; Reducing the unmet need for family planning (25%in 2010)2 by strengthening public sector outreachservices, particularly in the regions and districtswith low contraceptive prevalence rates;advancefamilyplanning.org

ADVANCE FAMILY PLANNING I TanzaniaJanuary 2015 Enhancing community and leadership knowledgein the benefits of family planning in health anddevelopment; and Expanding access and utilization of family planningservices, which will contribute to reducing the highfertility rate of 5.4 as well as the high maternalmortality rate (454 deaths per 100,000 births),one of the highest in Africa.3Need for Sustainable Family Planning FundingIn 2010-2011, Tanzania introduced a budget line forfamily planning (mainly contraceptives), a move thatqualified success in advocacy efforts to repositionfamily planning. However, despite having a NationalFamily Planning Costed Implementation Program(NFCIP 2010-2015) and a budget line item, familyplanning was not among key priorities in governmentplans and budgets.In 2012-2013, despite continued advocacy efforts,the government did not make any allocation tofamily planning due to competing interests amongpolicymakers and the anticipation of donated fundsfrom the 2012 London Summit. Tanzania relies heavilyon donors in its provision of family planning andreproductive health services, especially with respectto procurement of contraceptives and other maternalhealth commodities. However, prevailing politicalcommitment following the Summit moved thegovernment to release 1.5 billion Tshs (US 864,315)that was not originally budgeted.Fluctuations in allocations (see Figure 1) are partlyattributed to the political sensitivity attached to familyplanning, generally associated with the perceptionthat contraceptives are intended to limit the numberof children that one could have. In a society thatplaces preference and value to having big families,5socio-cultural attitudes and practices generallydiscourage the use of modern contraceptives. Inaddition, inadequate understanding among somepolicymakers, political leaders, and the public on thebenefits of family planning in enhancing family welfareand socio-economic development also contributesto amplifying prevailing negative perceptions on theside effects of contraceptives.This funding environment has required sustainedadvocacy targeting key decisionmakers in thegovernment and parliament who can apply pressure toFIGURE 1: FAMILY PLANNING BUDGET ALLOCATIONS FROM GOVERNMENT FUNDS (2010-2015)2,000,000,0002,000,,000,,0002,tanzanian shillings1,501,5 001,5 3-142014-15fiscal year2advancefamilyplanning.org

January 2015ADVANCE FAMILY PLANNING I Tanzaniaensure budget allocation and increased prioritizationof family planning in development plans. For thisreason, AFP partners, in collaboration with otherpartners have continued to engage the ParliamentaryFamily Planning Club (PFPC) as a key mechanism forbudget advocacy.The PFPC is a family planning champions groupestablished in 2011 with support from AFP to dialoguewith the government for increased resources for familyplanning. Club members have used various strategiessuch as one-on-one meetings with national leadersincluding the Prime Minister, petitioning governmentofficials through signed letters, as well as makingbold and passionate statements during parliamentarysessions. Legislators and civil society organizationshave nurtured a growing political climate favorableto family planning, showing that it is a critical andcost-effective intervention to saving women’s livesand in promoting development.Increased Budget and Improved PolicyEnvironmentIn January 2014, the PFPC; AFP partners HDT, UNA,and CCP Tanzania; and other key stakeholders wantedto ensure that Tanzania’s commitments to familyplanning translated into an increased national familyplanning budget allocation from the government’sown sources by August 2014. AFP partners conducteda landscape analysis to determine funding and policyconstraints and opportunities, which informed thedevelopment of an advocacy strategy guided by theAFP SMART approach.HDT led efforts to meet one-on-one with keygovernment officials in the Ministry of Health andSocial Welfare (MoHSW), Ministry of Finance, andPrime Minister’s Office of Regional Administrationand Local Governments. UNA concurrently engagedthe PFPC to discuss their integral role in convincingthe government to increase the budget allocation forfamily planning. UNA also consulted the ParliamentarySocial Services Committee, which is responsible formaking policy and budgetary recommendations tothe MoHSW and other ministries.3advancefamilyplanning.org

January 2015As the budget decisions neared, in May 2014, PresidentDr. Jakaya Mrisho Kikwete launched the SharpenedOne Plan for the remaining 500 days of 2015 MillenniumDevelopment Goals. Family planning is first on thelist of four identified high impact interventions toaccelerate reduction of maternal, newborn, andchild deaths. The plan, developed by the MoHSWwith support from local and international healthpartners, is intended to strengthen accountability andtransparency through the Score Card, a tool used formonitoring progress of all interventions through a listof indicators. Local (district) government authoritiesand health teams report quarterly against a set ofperformance indicators. The launch provided anotheropportunity to demonstrate how investment fromhigh-level leaders to local government contributesto more sustainable family planning progress.By June 2014, four months after advocacy effortsbegan, the government (MoHSW) announced a 24ADVANCE FAMILY PLANNING I Tanzaniabillion Tshs allocation for family planning in the 20142015 fiscal year. Chief Medical Officer Dr. DonnanMbando, then the acting MoHSW Permanent Secretary,said, “The government has seen the importance ofsetting aside funds for reproductive health of youngpeople and it would continue to increase allocationsevery year” for this purpose. He also emphasized thatdistrict councils should begin to set aside funds forreproductive health and family planning as a way toimprove people’s health.Lessons LearnedStrengthened partner relations improve accessto data: Advocacy partners not only strategizedtogether, but also shared information criticalto building the necessary evidence. Some familyplanning partners work closely with donors, whileothers have more access to government officialsand budget information. Therefore, through theiradvancefamilyplanning.org

January 2015ADVANCE FAMILY PLANNING I Tanzanianetworks, there was less difficulty in accessing datato support advocacy asks.Sustained orientation of government officialsis critical for advocacy: Key officials at MoHSWand others at the district level changed positionsat different times—a challenge that advocatesovercame through quick and sustained orientationof incoming officials and decisionmakers throughone-on-one meetings, information-sharing meetings,and workshops.Simplifying data with policymakers facilitatesadvocacy: It was useful to package data in policybriefs using simple language, with specific asks inline with decisionmakers’ core concerns. Presentinginformation in the Kiswahili language has also beenkey and broadens decisionmakers’ understanding,commitment, and action to support family planning.Next StepsAFP partners CCP Tanzania, HDT, and UNA willengage key stakeholders in tracking the spending offunds from the current budget allocation, as well asgovernment commitments for increased allocationstoward meeting the unmet need for family planning.They will also work to strengthen local partners’ abilityto sustain advocacy efforts.References1United Republic of Tanzania - Ministry of Health and SocialWelfare (MOHSW): The National Road Map Strategic Plan toAccelerate Reduction of Maternal, Newborn and Child Deaths2008 - 2015 (Sharpened One Plan). In. Dar es salaam, Tanzania:MOHSW; 20142Tanzania Demographic and Health Survey (DHS) 20103DHS 20104Tanzania Medium Term Expenditure Framework5DHS 2010Cover photos by Emilia Tjernstrom, IAEA Image Bank, MaciejDakowicz, and Muhiddin Issa Michuzi (pg.1), Myjolnyr (pg.3),Compassion International (pg.4), Trond Viken (pg.5), andMuhiddin Issa Michuzi (pg.6).5advancefamilyplanning.org

January 2015ADVANCE FAMILY PLANNING I TanzaniaAcknowledgmentsThe AFP project and its local partners in Tanzania would like to acknowledge the technical support from keystakeholders in the National Family Planning Technical Working Group.Advance Family Planning (AFP) aims to increase the financial investment and political commitment neededto ensure access to quality family planning through evidence-based advocacy. An initiative of the Bill &Melinda Gates Institute for Population and Reproductive Health with the Johns Hopkins Bloomberg Schoolof Public Health, AFP works to achieve the goals of the FP2020 initiative: to enable women and girls in someof the world’s poorest countries to use contraceptive information, services and supplies, without coercionor discrimination.AFP is supported by the Bill & Melinda Gates Foundation, the David & Lucile Packard Foundation, andThe William and Flora Hewlett FoundationAdvance Family PlanningBill & Melinda Gates Institute for Population and Reproductive HealthJohns Hopkins Bloomberg School of Public Health615 N. Wolfe Street, Ste. W4503Baltimore, MD 21205Tel: 1 (410) 502 8715Email: afp@jhsph.eduwww.advancefamilyplanning.orgJohns Hopkins Center for Communication Programs – TanzaniaP.O. Box 105303Plot No 174/175 Msasani “B” BlockDar es Salaam, TanzaniaTel: 256 414 250 183Email: /countries/tanzania/6Health Promotion TanzaniaFirst Floor Josam House16 Mikocheni Coca Cola Rd.Dar es Salaam, TanzaniaEmail: nited Nations Association of TanzaniaP.O. Box 9182Dar es Salaam, TanzaniaTel: 255 773 257 121Email: nning.org

1 United Republic of Tanzania - Ministry of Health and Social Welfare (MOHSW): The National Road Map Strategic Plan to Accelerate Reduction of Maternal, Newborn and Child Deaths 2008 - 2015 (Sharpened One Plan). In. Dar es salaam, Tanzania: MOHSW; 2014 2 Tanzania Demographic and Health Survey (DHS) 2010 3 DHS 2010