In 2018, E2A joined Pathfinder International to launch a first-time parent initiative as a family planning component of its groundbreaking population, health, and environment program in a remote corner of Western Tanzania—where the teen pregnancy rates are the highest in the country. How did the Tuungane project reach this uniquely vulnerable youth population with critical information and health services? And what difference did it make? We asked Chaus Emmanuel, who leads first-time parents activities on the ground in Tanzania to weigh in and share his latest insights with you:
It’s exciting. Through our work, we’ve seen 145% increase in contraceptive uptake among first-time mothers aged 15–19. Here are three factors that I have seen—from my firsthand experience in these communities—play a key role in making it possible:
1. The path to building support for first-time mothers begins with involving male partners, mothers, mothers-in-law, and village leaders.
These young first-time mothers are still children of the community. And during such a challenging new phase of their lives, they need support, not judgment. That’s why we invited mothers-in-law and male partners to participate in their own bi-weekly meetings—to create a safe environment for everyone to learn about and share thoughts on family planning, healthy timing and spacing of pregnancy, gender norms, and healthy intimate relationships. Now, older women are even comfortable talking to their daughters and sisters-in-law about contraceptive use. Woman to woman. Family member to family member.
2. Investing in first-time mother peer leaders is essential to reach young women.
Often, young women in our communities do not feel comfortable seeking out community health workers, which is why peer leaders have become an invaluable resource for first-time mothers. We’ve seen how first-time mothers find it easier to talk to their fellow young women—they understand one another’s challenges and aspirations, and they share common interests within the community.
Thanks in large part to peer leaders’ ability to connect with young mothers, we saw voluntary contraceptive use almost double among first-time mothers aged 15-24 years over the course of the intervention—from 35% to 66%.
“I have spoken with people and some of them have started to understand me about what we learn in the peer group. Others come and ask you. You explain it to them and they understand and start to use those methods. Although we also have received a little education, they say, ‘if you get information, don’t withhold it from your peers.'”
—MARRIED FIRST-TIME MOTHER
In fact, given peer leaders’ knowledge of family planning and reproductive health and experience educating first-time parents, the next step for them might be to become community health workers themselves. I want to see this happen.
3. By reaching both the first-time mother and her husband/partner, we can help bring about positive joint decision-making and couple communication.
“I did not use family planning [before] because I had not yet spoken to my partner about it. I got the opportunity to talk about family planning when the peer groups were introduced. It was a golden opportunity to me.”
—MARRIED FIRST-TIME MOTHER
One of the things I find most interesting about the first-time parent programming is how it engages men as well. We even have activities for the men to discuss topics like healthy timing and spacing of pregnancy and examine the power dynamics in their households. While decision making remains a complicated, evolving subject for these first-time parents, our activities helped pave the way to open discussion.
Now, these men can talk about family planning with their wives, and many even accompany their wives to health facilities to get contraception—which was almost unheard of in the past.
These are big changes. And I think it’s just the beginning.