Updates from the field – spotlight on sexual & reproductive health

Putting the focus on Family Planning in Tanzania

By: Sophie Lauridsen

In 2013, 289,000 women died from pregnancy and childbirth related complications, a 45% reduction in levels since 1990. As we near the conclusion of the Millennium Development Goals, it can be safely acknowledged that the targets of reducing the maternal mortality ratio by three quarters between 1990-2015, as well as guaranteeing universal access to reproductive health for the improvement of maternal health (MDG 5) will not be achieved. In Tanzania as it is, maternal death and disability remains a leading contributor to healthy life years lost for women of reproductive age. According to the 2010 Global Burden of Disease study, for women 15-49 years of age, maternal disorders are the second major cause of deaths, just behind HIV/AIDS, and the fourth major contributor to disability-adjusted life-years.

Despite the acknowledgment that men play an essential role in maternal health and that recommendations exist to encourage male participation from the 1994 International Conference on Population and Development, many sexual and reproductive health interventions remain focused towards other challenges that revolve directly around the female counterpart.

One major component for the reduction of maternal deaths is the practice of Family Planning. Nevertheless, 222 million women in the world remain with unmet family planning needs. While there is a 60% demand for family planning among married women in Tanzania, 25% of them have an unmet need. Prenatal care is of major importance for the positive outcome of a pregnancy, especially in primagravida. Under normal circumstances, WHO recommends that a pregnant woman has at least four anti natal care (ANC) visits to provide sufficient care. Ninety six percent of pregnant women make at least one ANC visit in Tanzania, but only 43% have the recommended four ANC visits. During the ANC visits the woman will be presented to family planning. The utilisation of family planning services and methods is limited.

The levels of maternal mortality and morbidity have improved in the past decade and a half, but new strategies and evidence-based interventions need to be brought forward simultaneously. In Tanzania, the number of married women using family planning has remained relatively unchanged compared to the number of unmarried women, which has been seen to increase. Together with the figures of unmet need for family planning, it can be understood that cultural and gender related factors are strong barriers towards the utilisation of family planning.

Sex Education: Time for a change Poland?!

By: Cathrine SN, Elisa Odds and Nathalie S.

Addressing sexual education and issues surrounding this topic in a modern Central-European country was not as easy as one could have thought. The fact is that Poland has had a massive transformation the last years, going from a communist state to a modern “westernized” society. Poland has done a very good job in many areas, but there are still issues in need of improvement.

Sexual education in schools, or “Preparation for Family Life” as they like to call it here in Poland, must be said to be quite lacking. The NGO Ponton has stated in one of their reports that the level of adolescents’ knowledge on puberty, reproduction and contraception is “frighteningly low”.

As a student, quoted in the report, said: “In my school Preparation for Family Life was for girls only and the teacher made it look as if she was doing us a favour that she was teaching us. We were stunned when she said that a girl can have her period at the age of 16 at the earliest and if she had it sooner it means she’s sick. The classes were hopeless”.

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Another student said: “In secondary school there was a woman who came from nowhere and told us about the rhythm method and said that condoms are not effective because they may constrict the base of the penis cutting the blood flow, which may in turn cause permanent impotence (…)”.

Why is it like this in 2014? According to Ponton, the situation is a result of taboos concerning sex related topics as well as the religious influence in society.

The Catholic Church has a strong position in Poland and its influence can be seen in many ways. Abortion is not allowed, unless the foetus has some serious and life threatening malformations (and hence it is not viable), the woman’s life is at risk because of the pregnancy or if the pregnancy is a result of a criminal act. Estimates from a Polish NGO in the field, shown to us during class, placed the number of illegal abortions performed around 80.000-190.000 annually.

While staying here in Poland, we have had the chance to look into different perspectives and issues related to sexual education. We conclude that it is clear that young people in Poland still do not have proper access to information and knowledge regarding sexuality, reproduction, contraception use and STIs.

Thanks for reading. 

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