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Dar es Salaam: Difference between revisions
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[[File:Dar es Salaam at a bird's view.jpg|400px | thumb|right|]] | |||
'''OVERVIEW''' | '''OVERVIEW''' | ||
In Dar es Salaam, you can purchase birth control pills without a prescription. At local clinics, you can also find the contraceptive shot, implant and IUD, among other contraceptive options. While you technically need a prescription for emergency contraception (the morning after pill), this does not seem to be universally enforced. At certain pharmacies, especially international ones, it's possible to get EC without a prescription. Regarding menstrual products, pads are the easiest to find. Tampons are available in select locations, which we include in the "Menstruation" section. Menstrual cups are extremely uncommon, but there appears to be some organizations that distribute menstrual cups to Tanzanian women and girls. Abortion is generally illegal. It is only permitted when the pregnancy endangers the woman's life or in cases when the woman's physical or mental health needs to be preserved. While some women seek out clandestine abortions, many of these providers are untrained or working in unsafe conditions, so one must exercise extreme caution. | |||
==Contraception (Birth Control)== | ==Contraception (Birth Control)== | ||
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===Laws & Social Stigmas=== | ===Laws & Social Stigmas=== | ||
In Tanzania, you can purchase contraception (birth control) without a prescription. According to a 2015 report, 40.6% of Tanzanian women (who are married or in unions) use some form of contraception.<ref>[http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in | |||
Contraceptive Use Worldwide 2015]</ref> The most popular forms of contraception are injectables (13.7%), birth control pills (8.6%) and female sterilization (4.5%). | |||
In 1959, family planning services were introduced to Tanzania and, in 1989, the government launched the National Family Planning program. | |||
===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
[[File:Microgynon tanzania.jpg|300px | thumb|left|frame|'''Microgynon birth control pills purchased in Tanzania''']] | |||
* If you want condoms, they should be easy to find in stores. You can also buy Bull condoms and Fiesta Premium condoms from [http://www.dkttanzania.org/ DKT Tanzania] clinics. | |||
* If you want '''birth control pills''', you can find them at Tanzanian pharmacies. Some of the brands you can expect to see are Microlut, Microval, Eugynon, Nordiol, Ovral, Lo-Femenal, Microgynon-30, Nordette and Trust. If you go to a DKT Tanzania clinic, they sell Trust birth control pills. | |||
* If you want an '''IUD''', you can get it at [http://mariestopes.or.tz/ Marie Stopes Tanzania]. They're free at outreach sites and 15,000 tshs at other locations. You can also get it at [http://www.trustlife.co.tz/en/our-products/birth-control-methods/the-iud Trust Health & Wellness Clinic], where they have their own line of IUDs, including the copper IUD - you can see a commercial about it [http://www.trustlife.co.tz/en/our-products/birth-control-methods/the-iud here]. | |||
** Information from a local (February 2017): " In Dar, very few hospitals provide the method of IUD, and these hospital are private hospitals only. They are expensive surely, but the exact cost figures I'm not sure about." | |||
* If you want a '''contraceptive implant''', you can get it at [http://mariestopes.or.tz/ Marie Stopes Tanzania]. They're free at outreach sites and 15,000 tshs at other locations. You can also probably get it inserted at major clinics like Sali Hospital. | |||
* If you want a '''contraceptive shot''', you can get it at [http://mariestopes.or.tz/ Marie Stopes Tanzania]. They're free at outreach sites and 15,000 tshs at other locations. | |||
** Information from a local (February 2017): "You can get contraceptive shots at almost every hospital and dispensaries, including governmental and private sectors. They do not cost much almost 30,000/- tsh in governmental, which is almost 12 USD." | |||
Here are some recommended pharmacies in Dar es Salaam: | |||
* [http://www.salihospital.com/new/index.php/services/pharmacy-services Sali International Hospital]: "Our products and services include: a wide range of quality branded and generic medicines, 24/7 dispensing of both in-house and external prescription..." Contact us: Tel: 0222 601296. Email: pharmacy@salihospital.com. | |||
* [http://www.nakietepharmacy.com/ Nakiete Pharmacy]: This is a major pharmacy in Dar es Salaam, in operation since 1998, that is known to have a lot of medications and to help many people find what they need. | |||
* Masaki Pharmacy International: Slipway Road, Peninsula, P.O.Box 33239, Dar es salaam, Tanzania. Phone Numbers: +255 712 700 393, +255 714 999 936. | |||
* As for more recommended pharmacies, one local says, "The one at sea cliff, or Viva Towers in town, or Oysterbay Shopping Center in masaki." | |||
===Costs=== | ===Costs=== | ||
From a Dar es Salaam local (February 2017): "Birth control pills in almost all pharmacies are local and usaully not expensive, the cost around 1000tsh per pack, which is for one month. That is around 0.4 USD. However you can surely find international brands in very few pharmacies and these international brand do cost up to 7 to 10 USD." | |||
==Emergency Contraception (Morning After Pill)== | ==Emergency Contraception (Morning After Pill)== | ||
'''Important Notes:''' Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC '''as soon as possible''' after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click [https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception here] and [http://ec.princeton.edu/info/ecp.html here]. | '''Important Notes:''' Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC '''as soon as possible''' after unprotected sex to prevent pregnancy. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click [https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception here] and [http://ec.princeton.edu/info/ecp.html here]. | ||
===Laws & Social Stigmas=== | ===Laws & Social Stigmas=== | ||
While you technically need a prescription to purchase emergency contraception (the morning after pill) in Tanzania, you can buy it over-the-counter from some pharmacies. According to Tanzanian locals, some pharmacists are sympathetic to women who explain that they're facing an emergency situation and need the morning after pill. This is especially the case at "international" pharmacies (i.e. pharmacies that sell foreign medications that are produced outside of Tanzania), as they're also more likely to be stocked with dedicated emergency contraception. | |||
===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
* In Tanzania, you technically need a prescription to obtain emergency contraception (the morning after pill). However, many pharmacists will give you EC without a prescription (especially pharmacists that work at more international pharmacies). Some dedicated emergency contraception brands you can expect to see are P2 and Trust Daisy. You can find Trust Daisy sold by Trust Health & Wellness Clinic for Tsh 2,000 (they ask you to book an appointment to get the EC).<ref>[http://ec.princeton.edu/worldwide/ Princeton EC Website]</ref> | |||
* If you can't access dedicated emergency contraception, you can use some oral contraceptives as replacement EC instead. To do this, you can use progestin-only or combined progestin-estrogen pills. If you use progestin-only, you can use Microlut or Microval (take 50 pills within 120 hours after unprotected sex). If you use progestin-estrogen combined pills, remember that in 28-day packs, only the first 21 pills can be used. You can use Eugynon, Nordiol and Ovral (take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later). You can also use Lo-Femenal, Microgynon-30 or Nordette (take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later).<ref>[http://ec.princeton.edu/worldwide/ Princeton EC Website]</ref> | |||
===Costs=== | ===Costs=== | ||
You can expect to pay around 2000-5000 tsk for emergency contraception. | |||
==Sexually Transmitted Infections (STIs/STDs)== | ==Sexually Transmitted Infections (STIs/STDs)== | ||
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===Laws & Social Stigmas=== | ===Laws & Social Stigmas=== | ||
=== | In Tanzania, 4.7% of the population is HIV positive. However, women are especially impacted with 6.2% of women infected with HIV (as opposed to 3.8% of men), according to data from 2011-2012. The government has worked hard to minimize the infection rate, which decreased by over 20% between 2010-15. Furthermore, with increased access to antiretroviral drugs in Tanzania, AIDS-related deaths was halved between 2010-15 as well.<ref>[http://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/tanzania HIV AND AIDS IN TANZANIA]</ref> | ||
===Testing Facilities=== | |||
* [http://www.zoomtanzania.com/biz/premier-care-clinic-pharmacy Premier Care Clinic]: "Premier Care Clinic offers a full range of health services including Private GP services, Ultrasound services, Vaccinations, walk in instant HIV testing, Occupational Health, STD/STI tests and referrals for X rays, scans and consultant opinions. We are the only panel physicians for the U.S. Embassy immigrant visa applications." | |||
* It's not open yet (as of 2017) but an LGBT-friendly clinic will be opening up in Dar es Salaam that will provide HIV tests, TB screening, treatment, and support to LGBT people who need these critical services. You can check out the [https://www.globalgiving.org/projects/help-lgbt-access-free-quality-health-service/ funding page] for details. | |||
Information from a local (February 2017): "To get an HIV test, you can almost walk in to any clinics or dispensaries or hospitals to get it. The governmental sector promotes free of cost HIV test, which aims to save lives... And they normally use the rapid test for HIV which, most of the times, is provided to the government by NGOs. However, this doesn't apply to private sectors hospitals. The private sector does usually put up a cost and the cost is not expensive. For a HIV test, the cost in private sector is 2000tsh which is 0.9USD. The other STI test are conducted mostly at the Famous Muhimbili National Hospital, which has the biggest Laboratory in Dar. This hospital is governmental, hence the cost are cheaper. However they are few private labs which also provide few STI test and are more expensive compared to Muhimbili." | |||
====Support==== | ====Support==== | ||
* [http://www.nacp.go.tz/site/publications/care-and-treatment Tanzanian National AIDS Control Program]: This is the authority on HIV/AIDS in Tanzania. | |||
* [http://tacaids.go.tz/tacaids/en Tanzania Commission for AIDS]: "Our Vision: To have a society in which our children can grow up free from the threat of HIV/AIDS and which cares for and support all those who are still infected and affected by HIV/AIDS. Our Mission: To provide strategic leadership and to coordinate the implementation of a national multi-sectoral response to HIV/AIDS leading to the reduction of further infections associated diseases and the adverse socio-economic effect of the epidemic." | |||
* [https://icap.columbia.edu/where-we-work/tanzania/ Columbia University ICAP]: They are working with Tanzania to implement PrEP services for key populations. | |||
* [http://www.unaids.org/en/regionscountries/countries/unitedrepublicoftanzania UNAIDS Tanzania]: Telephone: +255222195113 | +255783202356 | +255682040847. Email: NAAMARAW@UNAIDS.ORG | |||
===Costs=== | ===Costs=== | ||
==Medications & Vaccines== | ==Medications & Vaccines== | ||
[[File:Pharmacy tanzania.jpg|400px | thumb|right|'''Pharmacy in Dar Es Salaam, Tanzania''']] | |||
===Laws & Social Stigmas=== | ===Laws & Social Stigmas=== | ||
===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
* If you have a '''yeast infection''', you can ask for Fluconazole (generic term for the ingredient used in many yeast infection medications). | |||
* There appears to be a small-scale program for '''Pre-Exposure Prophylaxis (PrEP)''' in Tanzania, with an estimated 500-700 PrEP users.<ref>[https://www.prepwatch.org/tanzania-close-up/ PrEPWatch: Tanzania]</ref> To learn more about PrEP in Tanzania, you can read [https://www.thecitizen.co.tz/News/1840340-4553234-26aih8z/index.html this report] from 2018. Two organizations that seem to be running PrEP trials in Tanzania are EMPOWER (Enhancing Methods of Prevention and Options for Women Exposed to Risk) Consortium and PEPFAR, as of April 2018.<ref>[https://www.prepwatch.org/wp-content/uploads/2018/04/Tanzania_PrEP_Studies_Apr2018.pdf Ongoing and Planned PrEP Open Label, Demonstration and Implementation Projects, as of April 2018]</ref> | |||
* It appears that '''Post-Exposure Prophylaxis (PEP)''' is available in Tanzania, and protocols for its usage are included in the [http://www.who.int/hiv/pub/guidelines/tanzania_art.pdf National Guidelines for the Management of HIV and AIDS], but we don't know how widely available it is to people. You should contact a local health care provider for more details. | |||
===Costs=== | ===Costs=== | ||
==Menstruation== | ==Menstruation== | ||
[[File:Tampons daressalaam.jpg|300px | thumb|left|frame|'''Tampons for sale in Dar es Salaam for the equivalent of $15 (February 2017)''']] | |||
'''Note:''' In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click [https://en.wikipedia.org/wiki/Menstrual_cup here]. To learn more about menstrual underwear, click [http://menstrualcupreviews.net/best-period-panties-reviews/ here]. | '''Note:''' In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click [https://en.wikipedia.org/wiki/Menstrual_cup here]. To learn more about menstrual underwear, click [http://menstrualcupreviews.net/best-period-panties-reviews/ here]. | ||
===Laws & Social Stigmas=== | ===Laws & Social Stigmas=== | ||
In Tanzania, menstruation is often a taboo topic for women, and it may be uncomfortable for them to discuss. Some girls don't discuss menstruation with their families and may miss school during their periods. In Tanzania, improved access to menstrual products and sanitary, sensitive toilet facilities is needed, especially for school girls (who often share bathrooms with boys).<ref>[https://raleighinternational.org/blog/tanzania/alpha-2-menstruation-being-girl-in-tanzania/ Alpha 2: Menstruation – Being a Girl in Tanzania]</ref> | |||
===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
In Tanzania, you can find pads. However, tampons are more difficult to find. You may be able to find tampons at [http://www.village-supermarket.com/ Village Supermarket], located on Chole Road, or [http://www.shoppers.co.tz/ Shoppers Plaza], which has multiple locations. You can also find them in some pharmacies, like Nakumatt and Kilimani Pharmacy. | |||
From a local (February 2017): " Tampons are rarely found here. You can find them in very big supermarkets and they are costly. One pack of 9 tampons cost 30,000/- tsh which is almost 15USD. This is due to the demand and the shortage of availability. As the tourist and expats here prefer tampons and there are no local companies which manufacture them, they are imported from UK so they become expensive. Menstrual cups are not available in Dar. You wont be able to find them in any supermarket or anywhere in Tanzania They main usage is of pads. Pads vary from manufacturer and quality. So prices also vary. We have very low-quality pads as well." | |||
Here are some organizations working on menstrual issues in Tanzania: | |||
* [https://www.facebook.com/Princess-D-Menstruation-cup-Tanzania-845271445607886/ Princess D Menstrual Cups Tanzania]: "Creating awareness about Princess D menstruation cups!" | |||
* [https://www.femmeinternational.org/ Femme International]: They have distributed the RubyCup (menstrual cup) to girls in Tanzania. "Femme International is an international non-governmental organization that was founded in 2013 to address the high rates of deliberate absenteeism among adolescent girls as a direct result of their menstrual cycles." | |||
* [https://www.childreach.org.uk/blogs/breaking-menstruation-taboo-tanzania Childreach Tanzania]: "At Childreach Tanzania, we integrate menstrual hygiene across our programmes, from building gender sensitive toilets, to tackling stigma in child clubs." | |||
===Costs=== | ===Costs=== | ||
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===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
* [http://mariestopes.or.tz/ Marie Stopes Tanzania]: They provide gynecological exam with a consultation fee (25,000 tshs). This consultation fee is the same for all women, whether they're Tanzanian nationals or foreigners. | |||
* [http://www.salihospital.com/ Sali International Hospital]: Recommended doctors: Doctor Vindhya and Doctor Nymfer. This hospital has been recommended by multiple locals. One said "They are not the cheapest but they are affordable." Consultation fee for gynecological exam is $50 (as of January 2017). Phone: +255-22-2601265, +255-22-2601296. Email: info@salihospital.com | |||
* [http://www.agakhanhospitals.org/DarEsSalaam Aga Khan Hospital]: Recommended doctor: Dr. Shafiq ("he's the best") - this doctor has been recommended by multiple locals. Also Dr. Meenakshi Pathak. Address: Ocean Road, Dar es Salaam 2289, Tanzania. Phone: +255 22 211 5151. | |||
* [http://premiercareclinic.com/ Premier Care Clinic]: Recommended doctor: Dr Janet Simbakalia. Address 1: 259 Ali Hassan Road, Namanga, Kinondoni. P. O. Box 220, Dar es Salaam , Tanzania. Tel: 0752 254 642; 0715 254 642. E-mail: Premier Care Clinic. Tel.: 0752 254 642; 0715 254 642. | |||
Information from a local (February 2017)" "Gynaecological examination are done almost in all hospitals, which include the Aga Khan hosptial, Regency hosptial, TMJ hospital and many more private small gynaecological centres. These provide maternity care and they are usually more expensive than the governmental hospital, which is only Muhimbili National Hospital. However, private sectors care is better than Muhimbili, as they have few doctors working in their hospital hence cannot provide enough care and they lack devices such as the ultrasound; they have very limited devices." | |||
===Costs=== | ===Costs=== | ||
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===Laws & Social Stigmas=== | ===Laws & Social Stigmas=== | ||
In Tanzania, under the Revised Penal Code, abortion is generally illegal. It is only permitted when the pregnancy endangers the woman's life or in cases when the woman's physical or mental health needs to be preserved. In all other circumstances, including when the pregnancy is the result of rape or incest, when there is risk of fetal impairment, economic/social reasons or when a woman makes a general abortion request, it is illegal. According to the Penal Code, anyone who attempts to procure an abortion (whether they are the pregnant woman or not) can face up to fourteen years in prison. Anyone who attempts to procure a miscarriage for themselves can face up to seven years in prison. Anyone who helps supply drugs or instruments for the purpose of abortion can face up to three years in prison.<ref>[http://worldabortionlaws.com/map/ World Abortion Laws: Tanzania]</ref> | |||
Despite these restrictions, clandestine abortions happen in Tanzania every day. The annual abortion rate is 36 per 1,000 women of reproductive age, which is similar to other East African countries. The highest rate of abortions occur in the Lake Zone and Southern Highlands and the lowest rate is in Zanzibar.<ref>[https://www.guttmacher.org/news-release/2016/unsafe-abortion-common-tanzania-and-major-cause-maternal-death Unsafe Abortion Is Common In Tanzania and Is A Major Cause of Maternal Death]</ref> In 2012, it was found that 30% of all maternal deaths were due to unsafe abortions.<ref>[https://www.reproductiverights.org/document/the-legal-and-policy-framework-on-abortion-in-tanzania The Legal and Policy Framework on Abortion in Tanzania]</ref> | |||
===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
There is an underground network of abortion providers in Tanzania. We cannot recommend any on this site, so we recommend that you consult with people you trust as a first step. You can also contact women's organizations that focus on family planning and reproductive health. Some of them may be able to help you out. Remember that there are many unsafe clandestine abortion providers in Tanzania so you should exercise extreme caution. | |||
===Costs=== | ===Costs=== | ||
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===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
* [http://www.wat.or.tz/index2.html WAT-HST]: "Primarily WAT-HST focuses on empowering low and middle income communities (and especially women) to participate fully and effectively in all aspects of human settlements development, the organization is committed to providing adequate and affordable housing with secure tenure for low and middle income households." | |||
* [https://www.facebook.com/homelessofdsm/ Homeless of Dar es Salaam]: "Homeless of Dar es Salaam is an attempt to raise awareness on the issue of homelessness in Dar es Salaam. The homeless are in such a situation because of various reasons. Many of them have suffered abuse and violence in their homes. Living in the streets puts them at risk of even more danger." | |||
===Costs=== | ===Costs=== | ||
==List of Additional Resources== | ==List of Additional Resources== | ||
* [http://www.rchs.go.tz/index.php/en/about-rchs/36-about-family-planning The United Republic of Tanzania - Ministry of Health and Social Welfare - Reproductive and Child Health Section]: MISSION: To promote, facilitate and support in an integrated manner, delivery of comprehensive reproductive and child health services to men, women, adolescents and children in Tanzania. | |||
* [http://www.mewata.org/ Medical Women Association of Tanzania]: "Professional organization to address issues of women's health, promote interests of women in the medical profession and to advance the health care of women." | |||
* [http://tgnp.org/ Tanzania Gender Networking Programme]: "TGNP’s Ideology and philosophy is built on Transformative feminism, which is a struggle that aims to eliminate all forms of discrimination against women and other marginalised groups, whether due to class, sex, gender, age, ethnicity, disability, geographical and nationality locations." | |||
* [http://wlac.or.tz/ Women's Legal Aid Centre Tanzania]: "A non-profit NGO that works to empower women to attain their rights and to improve vulnerable population’s access to justice across Tanzania." | |||
* [http://www.tamwa.org/ Tanzania Media Women's Association]: "Our Vision:TAMWA vision is to see a peaceful Tanzanian society, which respects human rights with a gender perspective. Our Mission:TAMWA is committed towards advocating for women and children’s rights by conducting awareness raising activities for cultural, policy and legal changes/transformation in society through the use of media." | |||
* [http://www.equaldex.com/region/tanzania Equaldex Tanzania]: This website provides information on LGBTQ rights and laws in Tanzania. It is important to know that homosexuality is illegal in Tanzania. The laws around changing gender are ambiguous. | |||
* [http://lgbtvoicetz.org/ LGBT Voice]: "Our Vision: To be the leading LGBT organization in Tanzania promoting equality, human rights and the upliftment of LGBT people" | |||
==References== | ==References== | ||
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|keywords=contraception, birth control, emergency contraception, morning after pill, std test, sti test, hiv, treatment, medications, pharmacies, abortion, clinic, tampons, women's health, menstruation, menstrual, pregnancy | |keywords=contraception, birth control, emergency contraception, morning after pill, std test, sti test, hiv, treatment, medications, pharmacies, abortion, clinic, tampons, women's health, menstruation, menstrual, pregnancy | ||
|description=Find sexual, reproductive and women's health care in | |description=Find sexual, reproductive and women's health care in Dar es Salaam. | ||
}} | }} | ||