Friday, February 9, 2018

How myth derails family planning in Kasulu

In rural Tanzania, family planning doesn't

In rural Tanzania, family planning doesn't exist 

In some Tanzanian tribes today, a number of out-dated myths still live on in the minds and hearts of many people, especially in rural settings.

 Some believe that having numerous children is a blessing that makes one gain respect in the community to the extent that parents derive soulful enrichment by the number of children they have. 

 Dotto Mahulo who resides at Mkunyika Ward in Kasulu District, Kigoma Region, still shares similar beliefs.

 This 26-year-old single mother has three children, and each one of them has a separate biological father.

 Neema Brayson, 9, Nasra Nelson, 7, and Abdalla Nassib, 1, live with their mother in a single-room makeshift clay soil shed with very poor ventilation.

 The two little sisters have not started school yet, and their mother doesn’t have the financial ability to take them even to elementary or kindergarten school.

 Although Dotto doesn’t have any idea how she’ll manage to raise them up and guarantee their welfare, she is willing to have more children even if it is with another man.

 “Although I am a single mother, I still need to have more children because I believe every child has their own luck; village people value those families that boast of many children,” she says.  Even though the current mother of three doesn’t know what the fate of her children holds, she’s adamant that adding more children will bring positive light. At the moment she neither has a decent job nor an assured daily casual work.

Family planning is an alien concept to this village dweller, who expresses no regard to family planning issues or the methods attached thereto. As a result, avoiding unplanned pregnancies is a far-fetched option at the moment.

34-year-old Rashid Hamad and his 39-year-old wife, Rehema Petro, are rolling on the same boat as Dotto. This village couple have no inclination as to what family planning entails. It is simply a concept that they know nothing about. However, as time goes by, the couple, who live at Kumsenga Village in Kasulu District, Kigoma Region, with their seven children, have begun contemplating what to do in order to avoid adding more family members to their already over-populated household.

 Rashid and his wife, who have lived together for about 20 years now, confessed that life has been so difficult for them considering the size of their family.

 “Life is very difficult for us. Sometimes we only take one meal a day,” said Rehema, adding that all the children depend on her as the family does not have a farm or a paying job.

 She says her husband moves around the streets daily, looking for casual work to do in order to feed his family.

 Medical experts agree in common that family planning involves using birth control techniques to decide how many children you have and when to have them.

 According to them, the methods allow couples to have their desired number of children, and control the spacing and timing of their births.  The Kasulu District Executive Director, Eng. Godfrey Kasekenya, expresses his concern over the increasing high birth rate in the district. 

“The birth rate in Kasulu is very high. It is very common to find a family with not less than eight children,” he says.

 For women living in rural areas, having many children is not viewed as an anomaly, and the 2015-16 Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS) showed that, despite the decrease in fertility from the average of 6.2 children per woman since the first TDSH survey in 1991-92 to 5.2 in 2015-16, still women in rural areas have an average of 6.0 children per woman.

 The survey also shows that Women living in the poorest households have an average of 7.5 children.

 The 2015-16 TDHS-MIS Key Findings correlates with the situation Rashid and Rehema are facing.  “If they would embrace family planning, they could have allowed spacing from one child to another, prevent unplanned pregnancies and plan the size of their families,” the Kasulu DED noted.

“Most families in Kasulu live in poverty. They have between 10 to15 children. Coupled with the large size of their families, guaranteeing the welfare of their children is almost impossible. It becomes very difficult to raise and provide their children with basic needs,” he added.

 Family planning has been widely recognized as a key strategy to improve health and overall well-being of women and families.

 The United Nations estimates that for “every dollar spent in family planning, between two and six dollars can be saved in interventions aimed at achieving other development goals.”

 The acting Kasulu District Chief Physician, Robert Rwebangira, says only 15 to 49 per cent of women in the district use at least one method of family planning.

 “Last year, only 34 per cent of women applied for family planning methods,” he says, adding that the rate is still low, making the district to lag behind compared to other areas,” adding, “Most women in Kasulu prefer injection method of family planning which is followed by filleted contraception, pills and Norplant. Not only that but also teenage pregnancies have dropped to 17 per cent, and this means that in every 100 pregnant women, 17 are expectant teenage mothers.”

Out-dated beliefs

 Outdated beliefs and misconception are among major reasons that scare most women from using family planning methods.

 A medical doctor with Marie Stopes Tanzania in Kigoma Region, Dr Salim Jaribu, agrees that there are still some misguided myths about family planning methods especially in rural areas. 

“There is a wrong notion among communities that when an implant is inserted when the time to remove it comes it will have moved away from its insertion site, something which isn’t true,” he says.

 “There are others who believe that the women will be haunted by the children that they have “tied or closed inside them, something which is not true either,” he said, adding,” “How could that have happened while there is no child for the woman is not pregnant?” Dr Salim, the outreach surgeon queried, saying they have been addressing such issues of misconception during their outreach visit programmes in more than 35 health facilities in Kasulu.

 Dr Salim, a surgeon with Marie Stopes Tanzania outreach team in Kibondo, Kasulu and Kakonko districts said men’s perception on family planning is still a problem as most men view family planning as an issue that concerns women only. 

However, he says, there is a positive response in the use of condoms than Vasectomies by men as a family planning method.

 “I attended very few cases for vasectomies not more than five in 2017,” he adds.

 “The situation is mostly due to misconception that a man who undergoes vasectomy would not be sexually active. Also community’s perception towards men who undergo vasectomy is negative. Through our health education we keep addressing the misconceptions and stigma,” says Dr Salim.

 Despite men’s perception that family planning is women’s business, most women have no say in deciding to use the birth control methods. Rehema said when it comes to family planning issues; it’s for the husband to decide. “This is a man’s decision. I am a woman and I don’t have any say when it comes to things like this. I do what he wants me to do,” she notes.

 Her husband seems to feel proud to have many children, despite difficulties in guaranteeing their welfare.   “A pride of a man in out tribe is to have many children. Otherwise, society will look at you as having infertility problems. This is how we were raised. A woman cannot decide without her husband’s consent,” says Rashid.