Fenia is a primary school teacher in Uvinza district in western Tanzania. She’s not only a teacher, but a community activist. Fenia has taught in her school for the last five years and unfortunately, over that period she has seen at least five girls drop out of school annually thanks to pregnancy. This forced Fenia to take action and since January 2014 she has made it possible for girls to obtain contraceptives and has helped protect girls from pursuing unsafe abortions by providing them access to the drug Misoprostol. Misoprostol is drug that is used to induce early labour with the aim of terminating pregnancy. Furthermore, Fenia also gives sessions to the teachers within her school on sexual reproductive health (SRH).
Ever since they began conducting these sessions students from schools in neighbouring villages have been consulting Fenia’s school every month asking questions and seeking help on issues related to menstruation, pregnancy, sexuality, puberty, and contraception.
Maternal mortality is a general problem that affects poor women in Tanzania, with post partum haemorrhage and unsafe abortions being the main culprits of maternal death. The penal code in Tanzania states that termination of pregnancy is legally permitted if it is performed to save a woman’s life. However, safe abortion services are scarce and if available difficult to access, but receiving information on medical abortion with Misoprostol happens to be a great relief for women in some underserved rural areas.
In 2009, Women Promotion Centre (WPC) started a new challenge. It begun implementing community mobilization strategies to increase women and girls’ access to life saving sexual and reproductive information. They have gone on to promote access to quality and safe reproductive services, teach about motherhood, prevent unsafe abortions and advocate for policy change to achieve reproductive rights for women and youth.
When starting to work in new areas WPC contacts Community Based Organisations (CBOs), women groups, church choirs and farmers unions, etc. It uses these groups as change agents to mobilise groups. Each change agent is tasked with inviting individuals to meetings. WPC then steps in and informs these groups about preventing pregnancies and the use of Misoprostol as a method to prevent deaths due to unsafe abortion. Their strategy is to engage with both women and men, address fears and misconceptions, provide correct information and initiate discussion. Collaborating with the medical sector is another strategy that has been adopted by WPC.
“Society in Tanzania, as compared to Kenya and Uganda, is more conservative and more controlled when it comes to sexuality, contraceptives and abortion. Myths about contraceptives travel widely in communities and also among social workers and health care providers. For this reason, Hivos has partnered with WPC so as to provide information on access to contraceptives and safe abortion. WPC is the most progressive organisation and also run pharmacies that supply Misoprostol,” says Ruth Njambi, the Sexual Reproductive Health Rights Programme Officer in East Africa.
Unfortunately, few organisations are willing to talk about medicines like Misoprostol for fear of being labelled as promoters of abortion. WPC has taken on the challenge of making sure the right information is being disseminated. In spite of working in an environment that is conservative, members of staff of WPC have not encountered any hostility, but the accessibility to Misoprostol is a hurdle that still needs to be overcome. The cost of the drug to many school girls and women is still prohibitive. Commercial pharmacies can charge as much as US$ 18 for a dose. WPC partner pharmacies are able to charge US$ 8 for a prescription.
In East Africa, through the – Access to contraceptives and safe abortion’ programme, Hivos will increase its work on tackling taboos and on holding governments accountable to ensure access to life saving information and services for all citizens, in particular, the rural women and girls living in East Africa. Special attention is devoted to key populations who suffer most from stigma and have difficulty accessing SRHR services such as lesbians, bisexuals, HIV+ women and sex workers.
Fenia and her school can now boast of having received no cases of any pregnancies between December 2013 and July 2014. She strongly believes that thanks to attending WPC’s SRH training and being a SRH activist has empowered her to offer lessons that are not bound to the four corners of the classroom.