Zanzibaris overcome cultural barriers to seek family planning services

More people are turning to family planning in Tanzania's semi-autonomous island of Zanzibar as the government seeks to improve access to reproductive healthcare. Funding, however, remains a challenge.

“We have been moving on well in the recent months as the turn-up for family planning by both men and women is impressive. Acquiring enough contraceptives for our clients remains the biggest challenge,” Hanuni Ibrahim Sogora, the director for family planning in Zanzibar’s Ministry of Health and Social Welfare, told IRIN.

Health officials say a culture of polygamy and low male contraceptive use has limited the number of women accessing reproductive healthcare services.

"The major problem is a lack of male involvement in family planning. For example, if a mother comes to the clinic with her baby, there is no harm if the husband can escort her because whatever information is given is important for both,” Kassim Issa Kirobo of the Zanzibar reproductive health programme, told IRIN. “The men say we are busy looking for a livelihood.”

Kirobo, the programme's behaviour change officer in charge of communication and information, said: "The women may also want to use the [family planning] services but the men have the last word."

Regarding low male contraceptive use, Kirobo said: "People say, why do I need to use a condom with my wife?

“There is a view that condoms are just for STI [sexually transmitted infections] control, not for preventing pregnancies,” he said. “If there was a contraceptive for men, besides condoms, maybe that would work.”

Shortages

However, in the past three years, there has been a positive uptake of the services, according to Sogora.

"The number of women and men going for family planning has been growing. We now frequently have implants and Depo-Provera out of stock because of the growing demand,” she said.

Implants are tiny rods containing hormones that are inserted under the skin to prevent pregnancy. Depo-Provera is a form of birth control whereby a synthetic form of the hormone progesterone is injected every three months.

Sogora said over-reliance on donor funding was a problem, with the government only providing a small amount of funds.

Population growth

The population growth rate on the islands is 3.1 percent, says the chief government statistician, with 1.2 million people in 2008 from 981,750 in 2002, according to a demographic survey citing Zanzibar's 2002 census. Immigration is also a factor.

Mzee K. Juma of the municipal council said the average household size in the Zanzibar municipality was 5.6 persons, with the population growth rate higher there at 4.5 percent.

Modern contraceptive use in Tanzania increased from 17 percent in 1999 to 20 percent in 2004-2005 among married women. Unmet family planning needs remain, however, especially in rural areas.

Attitude change

Across Zanzibar, health officials are involved in awareness-raising to enhance the use of reproductive health services and religious leaders are being trained to reach the men.

Some men are changing their attitude. Ahmed Mussa, 41, said: “Previously, I was anti-family planning, but last year [2009] I accepted the idea after having four children in a short period of six years.

“[When] my wife decided to go for family planning, I supported her and [I ] think we can now decide to either remain with the four children or have two more with the required gaps."

Sabah Salum, a mother of two, said: “I think it is good to help mothers plan their family. It is tiresome to have children almost every year.”

Islam is the main religion in Zanzibar.

Issa Zidy, an Islamic scholar and lecturer at the State University of Zanzibar, said: "Islam encourages family planning because it promotes having another baby after two to three years."

But even for those who plan their families, challenges remain.

According to 2009 health estimates, the maternal mortality rate in Zanzibar was 377 per 100,000 live births. The deaths were mainly due to severe bleeding and eclampsia, exacerbated by inadequately skilled attendants and lack of facilities in primary healthcare units.

Challenges

Kirobo noted that rural primary healthcare centres often lacked comprehensive delivery facilities, with women needing caesarian services being transferred to towns.

Delivery costs are a barrier. "People say if I go to the TBA [traditional birth attendant] I do not have to pay anything," Kirobo said.

He said the government was training TBAs and providing life-saving skills to maternity ward attendants.

Asha Aboud Mzee, secretary of the Catalyst Organization for Women’s Progress in Zanzibar, said other challenges facing women included HIV/AIDS, domestic violence and poor representation in decision-making.

"Sometimes at the Shehia [lowest administration] level, we find few of the committee members are women; there is no one to talk about women’s and children’s issues."

Zanzibar recently passed a law seeking to increase female representation in parliament.

"We don’t just want numbers; we want to send [women] to parliament who will actually represent us. [They] should understand women’s problems, not just sit [in parliament] and listen. Women have many needs,” Mzee said.

Chwaka Bay

Chwaka Bay is a large indentation in the central east coast of the Tanzanian island of Unguja - the largest island of the Zanzibar Archipelago. The bay contains several small islands, and the towns of Chwaka and Kae are situated on its coast. The southwest corner of the bay forms part of the Jozani-Chwaka Bay National Park

Source: Trek Earth.

Zanzibar president backs unity government

The President of Tanzania's semi-autonomous Zanzibar islands backed a power-sharing deal with the opposition to end years of political turmoil.

"We cannot continue in crisis because we have gained nothing out of it in the past years," Amani Karume said on Thursday as he opened a renovated stadium.

"Britain recently had elections and had to form a coalition government. We must also learn from others to have smooth and stable democracy," added Amani of the ruling Chama Cha Mapinduzi (CCM - Revolutionary Party).

Zanzibar -- made up of Unguja and Pemba isles -- united with mainland Tanganyika in 1964 to form Tanzania.

It has been dogged by political crises ever since and these worsened with the restoration of multi-party politics in 1992.

Election disputes between CCM and the main opposition group, Civic United Front (CUF), have often resulted in bloody violence.

Last year Karume and CUF leader Seif Sharif Hamad opened talks to resolve the crisis and have agreed to hold a referendum on power-sharing on July 31.

Under the agreement, Zanzibar will have a president and two vice-presidents: A first deputy president from the party which comes second in the polls and the second from the winning party.

Ministries will be allocated on a proportional basis.

Tanzania is to hold general elections on October 31.

Geographically, Zanzibar archipelago comprises three isles, but the third, Mafia, falls under the mainland administratively.

The Indian Ocean archipelago, with palm-fringed beaches and historic sites, is a famous travel destination and tourism is its mainstay.


Source: LIVE

The Westminster model failed Africa

When Britain granted independence to the majority of its African colonies in the 1950s and 1960s, it attempted to hand down Westminster's parliamentary system as an institutional legacy. Today, the Westminster model in most of these colonies has all but disappeared. As Britain haggles over the prospect of reforms to its political system, there is room for dialogue with former African colonies about how to improve government models.

One of Britain's justifications for colonialism in Africa was that it sought to "civilise the natives" by preparing them for democratic government based on the Westminster model. At independence Ghana, Somalia, Cameroon, Sierra Leone, Tanzania, Uganda, Kenya, Zanzibar, Zambia, Malawi, Gambia, Lesotho, Botswana, Swaziland and Zimbabwe had as one of their institutional legacies this model.

However, institutionalising our parliamentary system among the "natives" had not been a dominant pursuit throughout colonialism. British colonial government had been undemocratic. As Barry Munslow writes, "from 1910 to 1948 Sir Roger Furse controlled all applications to civil service posts. He went to Eton and Balliol College (Oxford) but confessed that he owed his success more to his training as a cavalry officer. After the first world war, new recruits to the colonial service tended to be ex-officers and later were drawn from the public schools and Oxbridge. The result was that the ethos of a ruling class, that in Britain was fast losing its exclusive claim, became the ethos of the colonial service".

The Westminster model was, with the exception of Ghana, belatedly transplanted during rapid decolonisation processes in Africa. Britain did not consider that it could not be handed down to African colonies regardless of historical, cultural and education contexts. Transplanting the Westminster model also meant that there was no real ownership of the system in African colonies. There was no emphasis on the necessity of having a significant transition period during which it might have taken root in Africa.

In view of this, it is unsurprising that the imported political system collapsed in the vast majority of former British colonies in Africa. Single-party rule and military coup d'états became the norm. The blame was often directed at the Africans. The British model was not the problem: Africans were not ready for democracy. It is, however, more accurate to say that the system of the colonisers was unworkable in many former African colonies for the reasons outlined above. And despite ongoing problems, parts of Africa have democratised considerably since decolonisation.

Most former British colonies in Africa now have presidential systems of government. The presidential system has its merits: presidents are elected directly by the people and it offers stable and decisive government. Nonetheless, concentration of excessive powers in the presidency has caused dictatorship, and is a hindrance to leadership change. Democracy activists have worked hard for the introduction of presidential term limits. They continue to work towards the reduction of presidential powers.

When Britain promotes government models in Africa, it is prone to assuming that its system is better. This is not to say African systems are of a higher standard. However, the flawed nature of the British political system, which became most evident in the 2010 elections, behoves us to be less paternalistic. It is fitting that we seek dialogue on political system reforms – as equals – with former African colonies. There is much we may learn from their experiences, just as they can learn from the British system's current problems.

Source:Guardian