1. Reproductive Health Component Rationale Since 1998, the German Government supported RH activities through the project “Support to Reproductive Health” The government of Tanzania has been pursuing a consistent policy in this field. Different supportive policy documents are in place In 2003, this area has become one of the components of the TGPSH, building upon the experience of the earlier RH project

2. Component Objectives & Indicators Component objective are: The population in the programme regions, particularly young people, has access to information on sexual and RH and is increasingly using selected good quality reproductive health services Increasing the availability and accessibility of a range of contraceptives options in rural areas. Component Indicators In Districts with youth activities the number of young people with basic knowledge in the area of |RH increases to 70% The contraceptive prevalence rate increases by 25%

3. Approach and Strategy Focus on inter- and multi-sectoral collaboration with different stakeholders at all levels Importance of partnership, ownership, sharing and learning from best practices is realized Activities are developed in a participatory approach, involving all stakeholders Capacity building in SRH, HIV and Aids to a wide range of players (theatre groups, traditional initiators, service providers, decision makers and communities) Development and dissemination of print and audio visual IEC materials targeting different groups including disabled SRH is addressed in a wider context, including socio-cultural factors, gender dimension and rights aspects

4. Achievements (Adolescent SRH) Improved knowledge on SRH and HIV among youth in districts through peer education (PE). 77% of boys and 70% of girls have basic knowledge on HIV and SRH, compared to 64% and 48%, respectively, in schools without peer education Dialogue established with traditional initiators to include new and correct information on SRH aspects into initiation ceremonies Best practices in PE, CBD and adolescents-friendly information materials have been taken up by stakeholders and are being scaled up to other areas, even beyond Tanzania. The 1-9 booklets have been translated into braille (Kiswahili only) and therefore reaching the blind.

5. Achievements (Selected RH services) Contraceptive prevalence rate in programme regions is higher than national average: 24.5% - 30.1%, compared to national 20%. More than 1,300 trained and active CBDs contributed to this achievement CBD are reaching population with poor geographical accessibility, men, youth and poor households Expansion of access to FP methods through introduction of CBD, training on condoms for dual protection on all levels, better method mix to including long term and permanent methods, and piloting of emergency contraception Development of Sexual Reproductive Health and HIV advocacy kit for CBD interventions that will be used at all levels

6. Development of materials on emerging SRH and HIV to fit into the existing CBD national Curriculums In Lindi Regional Hospital, fistulae repairs have been introduced by an expert from Centre for International Migration (CIM). On job trained Doctors continue offering this type of service. Achievements (Selected RH services)

7. Major challenges Maintaining quality of trained service providers, initiators, and community members updated on emerging SRH issues, especially those requiring rewriting of standards, procedures or policy guidelines SRH is currently not “donor priority”. Districts are faced with the reality of not getting enough funds in their Comprehensive Council Health Plans (CCHP) for SRH interventions Shortage of qualified / skilled service providers to carry out specific tasks, or those available being allocated other tasks, hampers constant availability of some RH services, e.g. long term FP methods

8. Questions Which main synergies exist between Sexual Reproductive Health and HIV/AIDS and what should be done to foster them? Which other stakeholders and authorities should be involved to address SRH and rights, HIV/AIDS and gender based violence and how?