1. Increasing FP access and choice for peri-urban women in Tanzania: the Bajaji model Joseph Komwihangiro Director of Health Services, Marie Stopes Tanzania

2. Why Bajajis? 25% of Tanzanian women have an unmet need for FP FP choice is limited for poor, peri-urban women Growing demand for LARCs and injectables Marie Stopes Tanzania not reaching these women with current models (mobile outreach, static clinics) Marie Stopes International2

3. The Bajaji model Marie Stopes International3 Two people (nurse, driver) and a motorised auto-rickshaw Work in partnership with MoH facilities and CHWs Provide free short and long term FP, and refer for PMs Small team means flexible service delivery, with sites tailored to need: community sites, public facilities, clients’ homes Navigate busy neighbourhoods, traffic, and slums Discreet and low-visibility service provision

4. How did we develop it? Marie Stopes International4 Piloted two Bajajis in Zanzibar and Mwanza Selected sites jointly with MoH in low CPR areas Worked with MoH community educators Unbranded bajajis (in Zanzibar) to reduce visibility PHOTO

5. Results to date Marie Stopes International5 15 Bajajis now serving average of 4,000 women every month 70% of Bajaji clients live under $1.25/day Over half were not using FP before coming for the service Cost per service 20-30% lower than ‘regular’ mobile outreach Breakdown of 42,000 Bajaji clients who received services in 2014

6. Aisha* is a 36-year-old married woman with 10 children. She and her husband have decided not to have more children. She came to a bajaji outreach site to learn about long-acting FP methods, having experienced unwanted side effects from injectables. She left the bajaji outreach site having chosen an implant. As she left, she said proudly, “I am happy now, 10 is enough.” What do clients say?

7. Challenges and lessons Marie Stopes International7 Nurses as drivers didn’t work – adding drivers made nurse recruitment easier, and provided extra pair of hands Community educator networks and strategically located service delivery sites are key to reaching underserved peri-urban clients Model can be tailored to reach specific groups (women who cannot leave their homes, youth, women’s groups, colleges, etc ) Model can be used for provision of other SRH services – currently being piloted for cervical cancer services

8. Future of model Marie Stopes International8 Continued roll-out where need identified Driver-entrepreneurs Cost-sharing with MoH Bajajis with sites tailored to reach specific groups, including adolescents PHOTO