During her tenure as a practicing intern in an urban district hospital in Dar es Salaam, Dr. Anna Temba remembers the struggle to meet patients’ needs in an already overwhelmed health facility. Services were stretched and supplies were low.
“Women would bring their sick children and we would write a list of things they would have to buy, including fluids for diarrhea that we did not have in stock. Some of them were not able to afford certain medications and I would try to source alternative cheaper prescriptions. With a caseload of more than 1,000 women delivering per month, everyone’s concern was on reducing maternal mortalities.”
Dr. Temba and her colleagues deliver the Engender- Health program and she hopes health workers in other countries can learn from their experiences. She believes health systems should encompass more than just health interventions because using a multidisciplinary approach creates conditions for more successful outcomes. They have seen success working in conjunction with partners delivering other services in the community, such as essential life skills training or income generation activities focused on agriculture.
She also stresses the importance of understanding the conditions women face in their daily lives. “Most of the health programs we are implementing are also designed to integrate gender-based support. We know that the health facility can provide some services for free, but some mothers don’t even have the fare to travel to the health center. It is also important to address the other needs of patients and link them with appropriate programs or for example, HIV support groups.”
Dr. Temba works very closely with the Ministry of Health in Tanzania, providing technical assistance by serving on a number of working groups such as national family planning, the Safe Motherhood Initiative and a gender and youth forum.
For her work, Dr. Temba has received the Going Extra Mile award from EngenderHealth, the “Best Minister with and without a portfolio”
by Pathfinder International and recognition under WHO’s High Impact Practices for her documentation of the “One Stop Shop” Mobile Family Planning Outreach and Service Integration in Southern Tanzania.
Despite the awards, Dr. Temba knows challenges remain. She is concerned by moves to take away access to emergency contraceptives at pharmacies. “Some health center providers are biased and not comfortable with contraception for adolescents. They chase them away.” She argues this would be “going backwards”, leading to unintended pregnancies and an increase in HIV rates.
“Many young people are not comfortable going to a health center to access contraception. We have to have very different conversations than the ones we are having by those who are pushing that agenda. We currently try to meaningfully engage young people, but at times that doesn’t translate into meaningful participation.”
Dr. Temba believes that including competent and committed women from the community in health leadership would ensure greater relevance in health programs.
“Sometimes we bring up issues being experienced in the community and they don’t get any further because those issues are not viewed as important. When we are talking about access to care, access to insurance–some things have to be put in context. If we were strategic and deliberate about including women, if we listened to them and showed our appreciation of their perspective, we would have a greater opportunity to engage more people.”
