Data from the hospital shows an increase in acceptance rate whereas the number of women seeking family planning services at the facility is currently between 16 and 20 every day.
Buthaina Omary Khamis, In-charge of the hospital’s family planning department linked the successes with outreach services that have greatly helped to convince most of the rural women to use contraception.
“Women are now aware of family planning services and the importance of giving birth at hospitals. They are voluntarily seeking the services”, said Khamis who has been providing family planning services in Zanzibar since 1985.
She however acknowledged the educational training offered by Jhpiego through the UASID funded project—‘Boresha Afya’ that helped to sharpen her skills on family planning services. She said ten nurses from Kivunge, Makunduchi and Mnazi Mmoja hospital benefited with the trainings.
“We are thankful to our partners for the educative training on family planning and caring of the baby during and after birth”, she noted adding they were also equipped with skills on how to conduct advocacy to women on the importance of using contraception.
Interviewed, Miza Pandu Wadi (36) from Kaskazini ‘B’ district in Unguja said: “My ninth pregnancy was worse; I experienced a number of complications and illness. It is during the pregnancy period I started thinking of using contraceptives”.
Miza, a mother to nine children said that all her children were breastfeed for less than a year with exception of one child who was breastfed for two years. She linked the situation to poor knowledge on family planning services which led into her conceiving unknowingly.
According to her the low acceptance rate in rural areas is due to the fact that some of the peripheral health facilities do not offer family planning services. She said a nurse at Kitope dispensary in Kaskazini ‘B’ district advised her to go for antenatal services at Mnazi Mmoja hospital after ultrasound results showed she had twins.
“After giving birth in 2016, I told the doctor that I wanted to start using contraception since I was satisfied with the number of children I had. My husband backed the idea and he doesn’t want me to conceive again”, said Miza who has since then been using the Intra Uterine Device (IUD) method.
Meanwhile, the referral hospital has managed to reduce the number of maternal and newborn deaths with exception of few cases caused by various factors including delays to report to the hospital especially those coming from peripheral health centers.
Nurse Midwife at the maternity ward, Bimkubwa Suleiman Khalfan said nearly 100 women gave birth at the hospital during high season which is from April to August while during low season, the number decreases to 40 deliveries per day.
“Expectant mothers no longer lose their lives during delivery, we have the best knowledge and skills on management of postpartum hemorrhage (PPH) and pre and severe Eclampsia which are among leading factors contributing to women deaths during pregnancy and after delivery”, said Khalfan who also benefited with training offered by USAID ‘Boresha Afya’ project which is facilitated by Jphiego.
She added: “My skills have been improved. I am more confident with increased competence since I execute mu duties in accordance with the guidelines on how to treat pregnant women”.
Lailat Ramadhan Haji (28) who gave birth at the facility in August this year, hailed the services offered at the hospital insisting despite having complications during pregnancy and bleeding after birth, she was properly assisted to safely deliver her baby.
“The nurses saved my life because I had all the danger signs during and after pregnancy. I am advising my fellow women to ensure they give birth at hospitals to avoid deaths that can be caused by over breeding or Eclampsia”, she said.
Lucy Ikamba, Jhpiego Project Program Advisor in Zanzibar said they are working with religious and local leaders in advocating for family planning within the community.
“The number of people accepting to use contraceptives is increasing since we started to engage local and religious leaders in conducting advocacy. The leaders work closely with community health workers (CHW) where public meeting were conducted in both, Unguja and Pemba Islands”, said Ikamba noting with the support from religious leaders communities are changing their mindsets that using contraceptives is not a sin.
She insisted that more has to be done to empower women to make decisions on their own because currently they are required to seek permission from their husbands before using any of the contraception methods.
The government through Ministry of Health, Community Development, Gender, Elders and Children, plans to increase spending on family planning services from 32 per cent to 45 per cent by 2020 as the Tanzania Demographic and Health Survey (TDHS) 2015–2016 indicates that the country’s unmet need for contraceptives stands at 22 percent among married women aged between 15 and 49 years and 23.5 percent among young women aged between 20 and 24 years.