Tanzania

OVERVIEW

In Tanzania, 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)

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

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. 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

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 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 Marie Stopes Tanzania. They're free at outreach sites and 15,000 tshs at other locations. You can also get it at Trust Health & Wellness Clinic, where they have their own line of IUDs, including the copper IUD - you can see a commercial about it here.
• If you want a contraceptive implant, you can get it at 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 Marie Stopes Tanzania. They're free at outreach sites and 15,000 tshs at other locations.

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 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 here and here.

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

• 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).
• 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).

Costs

You can expect to pay around 2000-5000 tsk for emergency contraception.

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

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.

Testing Facilities

You can visit the city pages, like the Dar es Salaam page, for local recommendations.

Support

• Tanzanian National AIDS Control Program: This is the authority on HIV/AIDS in Tanzania.
• 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."
• Columbia University ICAP: They are working with Tanzania to implement PrEP services for key populations.
• UNAIDS Tanzania: Telephone: +255222195113 | +255783202356 | +255682040847. Email: NAAMARAW@UNAIDS.ORG

Medications & Vaccines

Pharmacy in Dar Es Salaam, Tanzania

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. To learn more about PrEP in Tanzania, you can read 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.
• It appears that Post-Exposure Prophylaxis (PEP) is available in Tanzania, and protocols for its usage are included in the 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.

Menstruation

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 here. To learn more about menstrual underwear, click here.

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).

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 Village Supermarket, located on Chole Road, or Shoppers Plaza, which has multiple locations. You can also find them in some pharmacies, like Nakumatt and Kilimani Pharmacy.

Here are some organizations working on menstrual issues in Tanzania:

• Princess D Menstrual Cups Tanzania: "Creating awareness about Princess D menstruation cups!"
• 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."
• Childreach Tanzania: "At Childreach Tanzania, we integrate menstrual hygiene across our programmes, from building gender sensitive toilets, to tackling stigma in child clubs."

Gynecological Exams

What to Get & Where to Get It

You can visit the city pages, like the Dar es Salaam page, for local recommendations.

Pregnancy

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

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.

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. In 2012, it was found that 30% of all maternal deaths were due to unsafe abortions.

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.

Advocacy & Counseling

What to Get & Where to Get It

• 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."
• 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."

List of Additional Resources

• 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.
• 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."
• 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."
• 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."
• 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."
• 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.
• LGBT Voice: "Our Vision: To be the leading LGBT organization in Tanzania promoting equality, human rights and the upliftment of LGBT people"