By Maryanne W. WAWERU

Mifepristone, one of the two medications used for abortion and post-abortion care (PAC) is now registered in Tanzania. Various organizations, including IPPF’s Member Association (MA) in the country, Chama cha Uzazi na Malezi Bora Tanzania (UMATI) played a key advocacy role towards its authorization in Tanzania. In this interview, we speak to Mr. Daniel Kirhima, UMATI’s Head of Programmes, about the role that the organization played towards this advocacy win, and what this now means for Tanzanian women and girls.

What role did UMATI play in advocating for the registration and authorization of mifepristone?

Through the Coalition to Address Maternal Morbidity and Mortality due to Abortion and its Complications (CAMMAC), UMATI continues to engage in different advocacy activities, more so those pertaining to sexual reproductive health and rights (SRHR). One of the key issues that the CAMMAC coalition advocated for was the approval of registration/authorization of mifepristone in the country with technical support from the Association of Gynaecologists and Obstetricians of Tanzania (AGOTA).

In its capacity as one of the leading SRHR advocates and service providers in the country, UMATI disseminated different studies on postabortion and abortion cases undertaken by the Guttmacher Institute to build the capacity of CAMMAC members[i], policymakers, media houses, and local civil society organizations (CSOs) to advocate for the full realization of the Maputo Protocol on safe abortion – which is in progress.

What was the process and how was UMATI involved?

As part of the process, the CAMMAC members, including UMATI, worked together towards the development of evidence-based advocacy tools including a fact sheet showing the magnitude of unsafe abortion in Tanzania, policy briefs on legal gaps and loopholes indicating the need for safe abortion, and recommendations for policymakers to embrace the proposed policy change. UMATI was involved in all the meetings with decision-makers at the Ministry of Health (MoH) and with different policymakers, including Members of Parliament.

Could you please share some statistics on maternal death linked to unsafe abortions in Tanzania?

Maternal Mortality rate in Tanzania is 104/100,000 live births (TDHS 2022) and roughly one-quarter of maternal deaths, indicating that one out of four maternal deaths is due to unsafe abortion (Guttmacher Institutes, 2016)

What is the current legal policy context on abortion in Tanzania, and how is UMATI navigating this context?

Currently, the abortion laws in Tanzania are restrictive, allowing the procedure only to save the life of the pregnant woman. The penal code allows abortion when the pregnancy threatens the life of the pregnant woman, and pre-independence jurisprudence has affirmed that this also includes when the pregnancy affects the physical or mental health of the pregnant woman, or when the pregnancy results from rape. This jurisprudence, however, is not reflected in any law or policy.

Through the support of IPPF and the Guttmacher Institute, UMATI currently supports SRHR partners through the CAMMAC coalition to advocate for abortion law to authorize abortions in cases of assault, rape, and incest, and when continuing with the pregnancy endangers the mental and physical health of the pregnant woman and life of the pregnant woman or fetus.

UMATI uses the Guttmacher abortion research findings and fact sheets in strengthening the capacities of partners including CAMMAC members, policymakers, media houses, and local CSOs to amplify voices in advocating for the Government to undertake a law reform process to localise the Maputo protocol on safe abortion in national laws and policies. This advocacy agenda is still ongoing.

What does the registration and authorization of mifepristone mean for Tanzanian girls and woman?

It will mean an increased ability to protect women and girls against unwanted/unintended pregnancies. Women and girls will now be able to avoid unsafe abortions they were previously exposed to.

The authorization of mifepristone could pave the way for the legalization of safe abortion in Tanzania. Women and girls will now enjoy the human right to life as maternal deaths due to unsafe abortion will be tremendously reduced.

Tell us about the importance of partnerships when achieving such successes?

Joint advocacy is vital, particularly in tough legal environments such as those that restrict abortion. In such cases, it requires joint efforts and partners to amplify voices for policy change. UMATI believes that “many voices are louder and carry more weight than individual voices”. While noting that advocacy work requires a lot of resources, UMATI’s involvement in such partnerships ensures the effective and efficient sharing of limited resources to achieve greater milestones.

What is UMATI’s commitment to Tanzanian women and girls?

UMATI is committed to continue advocating for their rights, especially their rights to access SRHR services and enjoy a better life as part of their human rights.

[i] The 12 coalition member organizations include TAWLA, Pathfinder, Marie stopes, UMATI, WGNRR Africa, ULINGO, Engender Health, PSI, WADADA Initiatives, WPC, KIVIDEA, TAHECAP and HAKI ZETU.

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