World Contraception Day: Uncomfortable Conversations in Tanzania

We knew we wanted to highlight Women Deliver’s World Contraception Day post because Tanzania holds such a special place in our hearts.
The country made such an impression on Christy when she first visited in 1990 that she has visited many times and filmed a portion of NWNC there in 2009. Christy has returned twice since then. In fact she was there just last month with her family. Each visit leaves a greater impression that leads to a deeper commitment to make motherhood safe. Read this post, then log on to our Family Planning educational toolkit to learn more about how contraception can change and empower the lives of women around the world.

By: Florence B. Mwitwa, Women Deliver 100 Young Leader from Tanzania

This blog is part of a series, edited by Women Deliver, in partnership with Impatient Optimists, on youth perspectives to celebrate World Contraception Day. Share your thoughts in comments and join the conversation at #WCD2012. For more stories and to get involved further visit No Controversy.

For many young people in my community, talking about contraception is just not comfortable. This is not only true for young people, but also for adults, who might have trouble broaching the topic or supporting young people in their choices.

According to the 2010 Tanzania Demographic Health Survey, knowledge of contraception is almost universal in Tanzania. Current contraceptive use is higher among sexually active unmarried women than among married women (51 and 34 percent, respectively), primarily due to the use of male condomsand injectables (16 percent and 15 percent, respectively). Yet a report, entitled “Youth in Tanzania,” shows that 44 percent of young women are mothers or pregnant with their first child by the age of 19. This report also found that young people are poorly informed about family planning and, young women especially, are not empowered to make choices even when they have knowledge.

Young people face several barriers when it comes to consistent and correct contraceptive use, including negative perceptions, inadequate or incorrect information, conservative cultural or religious beliefs or lack of communication between partners.

Many people in the community, especially young people, feel uncomfortable when it comes to trying to access contraception because of stigma and discrimination. For example, when young people go to the shop to buy condoms, they are often met with judgment from store owners. It sometimes means that they buy condoms in secret because they are afraid that people will think they are a prostitute or have multiple sexual partners.

Inadequate knowledge or misinformation: Myths and misconceptions about contraceptives serve as another key obstacle for young people to access or use contraception correctly. Too often, young people receive partial or incorrect information, which makes it difficult for them to use contraceptives correctly. Also, many young people wrongly believe that hormonal contraceptives can lead to cancer, infertility, menstrual irregularity and obesity.

Cultural practices and religious beliefs: Some religions don’t encourage the use of contraception, and say that using it is going “against God’s will.” Some more conservative views regard it as a sin, and using contraception can make some young people feel guilty. There are some communities in Africa that only provide young people with abstinence-only sexuality education because the belief is that it leads to early sexual behavior, even though studies show that sex education delays sexual debut. Abstinence-only education prevents young people who are sexually active from obtaining information that would keep them safe.

Backlash from partner: It is common for young women to be worried about a negative reaction from their partner when they insist on using some form of contraception. Many young women have little or no power to negotiate condom use or make decisions about other methods of contraception. Young men are a central part of the decision to use contraception or not, and should pay attention to their partner’s expectations and limits. Young people need to be encouraged to have discussions with their partners about their sexual relationships to ensure that both are safe, healthy and protected.

We can tackle these barriers. We must provide young people with comprehensive sexuality education as a key intervention, which includes information about contraception, and it should be offered to young people starting from primary school to adolescent pupils. They are at risk for unintended pregnancy, STDs and HIV if we do not give them information to keep themselves safe.

We must empower women and men to be involved in conversations about their future, their needs and their health. If young men are taught to respect the needs of their partners, they are more likely to prioritize contraception. If women know that they have the right to decide on the use of contraception, this will allow them to be more comfortable with using it.

All of this will be possibile if we remove negative perceptions about contraception, and give young people the information they need.

My name is Florence B. Mwitwa, and I’m 26 years old. I’m a Fifth year Medical Student at Catholic University of Health and Allied Sciences — Bugando (CUHAS-BUGANDO), Mwanza Tanzania, studying for my degree in Medicine. I am also working as the supervising council member of Tanzania Medical Student Association (TAMSA), a professional organization that assembles all the medical students at national level under common umbrella with the purpose of promoting both excellent medical training as well as the medical students’ efforts in health education, promotion for betterment of our community.

TAMSA is working in six areas: Research Exchange, Reproductive health including HIV/AIDS, Medical Education, professional exchange, Public health and Human right and Peace.

I am the President of the Organizing Committee of International Federation of Medical Students Association Africa Regional Meeting (IFMSA ARM), which will be held in Arusha Tanzania from 14th — 22nd December 2012. The theme is “Health Crisis in Africa,” and will assemble medical student from all over Africa and various health stakeholders.