Dar es Salaam. Reproductive health experts in Tanzania have urged the Government to exercise caution before signing a proposed Memorandum of Understanding (MoU) with the United States, currently under discussion in several African countries.
Although the document has not been made public, regional experts warn it could impose conditions restricting access to essential reproductive health information and services.
The MoU forms part of a broader international health strategy, including agreements with several African countries under the recently launched US “America First Global Health Strategy”. Instead of channelling aid through NGOs or international agencies, the US intends to establish direct bilateral agreements with beneficiary governments.
Experts caution that the agreement could limit reproductive health services, reduce access to legally sanctioned post-abortion care, and undermine progress in family planning.
“In countries where similar agreements have been implemented, confusion among service providers, reductions in public health education, and fear among doctors to provide full services have been reported,” said Resident Director of Engender Health Tanzania, Dr Moke Makoma.
He warned that signing the MoU could reduce access to family planning, increase unintended pregnancies, unsafe abortions, and maternal deaths, placing additional strain on the health system.
“Tanzania receives substantial support for reproductive health through family planning programmes, but the current approach risks undermining scientific and medical priorities. Restrictive conditions could reverse our achievements and increase maternal deaths,” Dr Makoma said.
He added that limitations on health data access and long-term MoU agreements could shift public health priorities, diverting resources previously dedicated to family planning.
UNFPA Resident Representative in Tanzania, Jacqueline Mahon, emphasised that every dollar invested in family planning can save up to six dollars in emergency healthcare costs and reduce social and economic impacts.
Treating complications from unsafe abortion is costly, with each patient requiring between $45 and $100 depending on severity. Over 66,000 women are treated annually, while thousands more cannot reach hospitals due to distance, cost, or stigma.
Over the past decade, Tanzania has improved access to family planning services, strengthened community awareness, and enhanced health facilities’ capacity to provide emergency care. However, experts warn these gains remain fragile and require continued investment and autonomy for service providers.
“A policy restricting family planning or post-abortion care will directly increase maternal deaths, with rural women suffering most,” said a senior reproductive health specialist.
An informed Member of Parliament, who wished to remain anonymous, stressed: “Any international agreement must align with Tanzania’s priorities and not undermine progress achieved.”
Experts insist that reproductive health is not a political issue—it is central to national development, community wellbeing, and human dignity. WHO and the UN consider family planning among the most effective public health investments.
With Tanzania’s large youth population, access to accurate information and youth-friendly reproductive health services is essential for social and economic stability.
The experts urge the Government to ensure that any external agreement does not compromise Tanzanian laws, policies, or citizens’ rights. They call for transparency, broad stakeholder engagement, and impact assessments before decisions are taken.
They warn that signing a restrictive agreement could increase unintended pregnancies, maternal deaths, and health system costs. Tanzania must therefore stand firm and protect its reproductive health achievements, which are vital for the wellbeing of future generations.
Currently, the country faces persistent reproductive health challenges, including high rates of unintended pregnancies and deaths from unsafe abortions. Nearly one million women experience unintended pregnancies annually, with 40 per cent ending in abortion, often unsafe.
Between 16 and 19 per cent of maternal deaths are directly linked to unsafe abortion, meaning hundreds of women die each year due to a lack of access to safe reproductive health services.
A major contributor is the unmet demand for family planning: around one in four married women require modern contraception but cannot access it. For adolescents, unmet needs are even higher due to stigma, fear of judgment, and limited access to youth-friendly services.
Register to begin your journey to our premium contentSubscribe for full access to premium content
