PAI in Tanzania

The Policy Impact Project traveled to Tanzania in early October to assess the impact of U.S. family planning and reproductive health (FP/RH) and HIV/AIDS funding and policy. The PAI team interviewed a range of U.S.-based and local NGOs, as well as key government officials and USAID mission staff. We also explored the potential for supporting FP/RH advocacy by Tanzanian organizations. (PAI first documented the impact of the Global Gag Rule/Mexico City Policy in Tanzania back in 2004.)

U.S. family planning assistance to Tanzania has been very low for the past several years, averaging $5 million annually (since 1999), despite the country's persistently high rates of maternal death and unmet need for family planning. Last year USAID named Tanzania an "Intensive Focus" country for family planning; the country will receive at least $10 million annually over the next five years. By way of comparison, in fiscal year 2008,Tanzania received $32 million under the President's Malaria Initiative and a record $300 million for HIV/AIDS. This funding disparity has made it it extremely difficult to coordinate and integrate RH and HIV programming on the ground.

Overall, nearly all interviewees described family planning as missing from Tanzania's maternal health strategic plans, guidelines and initiatives. The Global Gag Rule continues to negatively impact access to family planning at the district level. Tanzania's indigenous providers—Marie Stopes Tanzania and UMATI, the IPPF member association—both refused the terms of the gag rule years ago, losing funding, technical assistance and contraceptives from USAID. Government support for family planning has waned and Tanzania will begin experiencing contraceptive stockouts later this year that will intensify in early 2009.

Two policy briefs will be developed—one for use with Congress to make the case for boosting FP/RH funding levels, and a second for local Tanzanian NGO partners to use with their policymakers that reconnects FP/RH to maternal health outcomes.