HEALTH
SEXUAL REPRODUCTIVE HEALTH & RIGHT
In Zanzibar the HIV prevalence has remained at 1% among general population, but is more concentrated among groups of Key Populations (KPs) according to Tanzania Malaria and HIV Indicator Survey (THMIS) 2011/12 . Although the HIV prevalence among the general population is low, the prevalence of HIV infections among the KPs are relatively high; 11.3% among People Who Inject Drugs (PWID), 2.6% among Men who Have Sex with Men (MSM) and 19.3% among Female Sex Workers (FSWs) . It estimated that there are: 3,000 PWID in Unguja and about 50-200 in Pemba; 2,157 MSM in Unguja and 30-60 in Pemba, and; 3,900 FSW Unguja and about 300-800 in Pemba.
Sexual and reproductive health (SRH) is a human right, essential to human development and the achievement of the Millennium Development Goals. SRH issues include death and disability related to pregnancy, abortion and childbirth, sexually transmitted infections, HIV and AIDS, and reproductive tract cancers. SRH accounts for at least 20 per cent of the burden of global ill health for women of reproductive age, and 14 per cent for men.
Sexual and reproductive rights are essential for a variety of reasons. Access to safe, affordable and effective methods of contraception provides women with the opportunity to make informed decisions about their lives. Family planning information and services can contribute to improvements in maternal and infant health by helping prevent unintended or closely spaced pregnancies among women. Adolescent girls are particularly at risk of complications during pregnancies. Sexual and reproductive rights can also help prevent HIV and AIDS.
Tanzania as developing country in east Africa continent with high fertility rates, early age at birth of first child, and high birth rates among adolescents are closely associated with the risk of HIV infection and cervical cancer. It is also estimated that close to 70,000 maternal deaths annually (13 per cent) are due to unsafe abortions.
To maintain one’s sexual and reproductive health, society needs access to accurate information and the safe, effective, affordable and acceptable contraception method of their choice. They must be informed and empowered to protect themselves from sexually transmitted infections. And when they decide to have children, women must have access to services that can help them have a fit pregnancy, safe delivery and healthy baby.
Every individual has the right to make their own choices about their sexual and reproductive health. CACS, works toward the goal of universal access to sexual and reproductive health and rights, including family planning
TUBERCULOSES (TB)
TB is a chronic infectious disease caused mainly by Mycobacterium tuberculosis (M. tuberculosis) and occasionally by Mycobacterium bovis or Mycobacterium africanum. These micro-organisms are also known as acid-fast bacilli (AFB) because of their staining characteristics
TB is transmitted from one person to another through inhalation of droplets during coughing, laughing, talking, sneezing, and singing; however, coughing remains the most common means of transmission. Factors that contribute to an individual acquiring TB infection includes Concentration and size of infectious droplets, Extent of exposure (length of time the individual is exposed to the infectious droplets), Prevalence of TB in the community: the higher the prevalence of TB in the community, the higher the risk of exposure and infection, and Overcrowding and prolonged stay with an infectious person in a poorly ventilated and lighted environment.
The risk of progression from infection to active disease depends on the status of the individual’s immune system. Only 10% of HIV-negative people infected with TB will eventually develop active disease in their lifetime because their immune system is strong enough to suppress multiplication of bacilli. Their TB infection therefore remains in the “dormant state”. Other groups of people have an increased risk of developing active TB disease following infection. These include: people with TB/HIV co-infection have an annual risk of 5-10% and a lifetime risk 20-30 times higher for developing TB disease, People with diabetes have a 1.5 times higher risk of developing TB disease than people without diabetes mellitus. Other risk factors for developing TB disease include: Malnutrition, recurrent infections of any kind, Substance abuse (alcoholism, drugs), Silicosis), Silicosis, Smoking, Age (very young or advanced), Long-term use of steroids and other immunosuppressive therapies, Poverty and Cancers.
Objectives:
The following objectives have been developed to address current and future challenges of TB and leprosy control in Tanzania in line with the new Stop TB strategy and WHO leprosy elimination targets.
- To increase case detection by 30% by 2024 by strengthening routine case notifications and addressing vulnerable groups of the elderly and diabetics.
- To Create TB/HIV collaborative activities by ensuring that all TB patients are tested for HIV and those who test HIV positive are put on ART promptly and managed accordingly.
- Supporting implementation of good quality, accessible and equitable TB and leprosy services in the country by 2024 through health and community systems strengthening and good programme management.
Key Activities
- Developing community-based strategies to identify potential TB cases and ensure early referrals for screening and treatment
- Assisting provincial health departments to integrate TB treatment with HIV and other health care services
- Conducting public education and social mobilization strategies, using mass and local media as well as the participation of patients and people with HIV/AIDS to reduce stigma, encourage early treatment-seeking, and promote a supportive environment for people affected by TB
- Providing assistance to integrate TB and HIV services by expanding the World Health Organization-funded ProTest model countrywide to ensure that TB suspects and cases are tested for HIV and that HIV-positive clients are screened for TB and other opportunistic infections
- Training providers to manage multi-drug and extensively drug resistant TB and to support patients’ drug adherence
HIV/AIDS
Women account for half of all people living with HIV worldwide. In sub-Saharan Africa, nearly 60 per cent of people living with HIV are women, and three out of four infected young people are female (UNFPA, 2009). Gender inequalities and norms relating to masculinity are a key driver of the HIV/AIDS epidemic, for example contributing to higher infection rates among young women by encouraging men to have more sexual partners and older men to have sexual relations with much younger women. Masculinity norms may also discourage men from using contraception and from seeking HIV services due to a fear of being perceived as ‘unmanly’.
Gender-based violence also increases vulnerability to HIV transmission in several ways. Women (and men) who fear violence may be less able to refuse unprotected sex. Forced sex involving tears and lacerations can also increase the risk of HIV transmission. In addition, fear of experiencing gender-based violence in response to being found HIV positive can be a deterrent to testing. Confidentiality of results can be essential.
Transactional sexual relationships, involving exchanges of material gifts or services for sex, have also been linked with an increased risk of HIV infection. Transactional sex typically involves multiple partners and large age differences (usually between older men and younger women or girls). Younger women (and men) generally have lower negotiating power to insist on condom use.
CACS’s work
CACS's as an organization seeking to fundamentally transform the landscape of reproductive health and rights in Tanzania. We have defined the course of reproductive rights in facilitates on improving sexual and reproductive health as the key effort towards achieving Sustainable Development Goal 3, which calls for good health and well-being. It also advances Goal 5, which calls for gender equality, as well as many of the other goals included in the 2030 Agenda.
CACS works with community to develop comprehensive efforts to ensure universal access to sexual and reproductive health care. In addition, CACS organization advocates for integrating the delivery of these services into primary health care, so it is as accessible as possible. This means, for instance, that a woman could address her family planning, antenatal care, HIV testing and general health needs all in one place.
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