OVERVIEW

TAYOA, an AYA-supported program in Tanzania, uses rap music to reach passengers in Dar es Salaam's largest bus terminal.

In Tanzania, AYA works in select districts to complement the National Adolescent Health and Development Strategy. Based on specific criteria (including poverty level, population density and STI/HIV/AIDS prevalence) and in coordination with the Tanzania government, AYA chose the following 10 districts: Ilala, Temeke and Kinondoni in Dar es Salaam region; Arusha Municipality in Arusha region; Tarime in Mara region; Karagwe in Kagera region; Kibondo and kasulu in Kigoma region; and Pemba Island and the Urban West region of Unguja Island in Zanzibar.


From policy to practice in Tanzania

Providing youth with sexual and reproductive health information and education was once a sensitive issue in Tanzania. Despite government endorsement — through the 1994 national policy guidelines and standards for family planning provision that made ASRH information and services accessible to adolescents — concern remained that providing information to youth might provoke irresponsible sexual behavior.

For a long time, non-governmental organizations worked virtually alone in providing ASRH information and services to youth — often small-scale efforts with little governmental involvement. While public health delivery networks offered great potential for providing sustainable services, youth faced any number of hurdles to access, including the timing of service provision, the attitudes of service providers, and limited privacy in health facilities.  Piloting the provision of youth-friendly services, the government’s Infectious Diseases Centre (IDC) saw less than 20 cases per day, despite being the leading YFS provider among public facilities in Tanzania’s capital city, Dar es Salaam.

But with support from AYA, the Centre expanded its services — and within three months had doubled its reach.  Using information learned in data-gathering exercises, the Centre adapted its policies to more effectively serve youth.  Among the highlights of the resulting AYA–supported program —

• Centre staff learned to work with adolescents in a more friendly manner
• The facility was renovated to create separate and more appealing space for youth services
• Motivated by the growing confidence of youth visiting the Centre, staff expanded their working hours to include Saturdays — and did not request additional pay
• Impressed by the success of the AYA-supported initiative, the city council decided to allocate resources to integrate youth-friendly services in additional public health facilities. Three facilities were given support by local government to create youth-friendly corners in their reproductive and child health clinics, with additional backing from the IDC.
• The IDC has become a model for the public health sector — several district authorities are sending their health teams to the IDC to learn how to develop similar youth-friendly services.
  

Overcoming traditional but untested concerns about potential youth behavior, government authorities in Dar es Salaam converted the political will affirmed in national policy into meaningful practice.  Encouraged by the positive response from youth, government officials and health care providers extended their support, allocating resources to make youth-friendly services even more accessible.  The results of this AYA-supported program will be felt for years to come, in the healthier lives of the youth and young adults who will build Tanzania’s future.