Children and Women in Tanzania
Vo l u m e 2
Zanzibar
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© UNICEF/Julie Pudlowski
Children and Women in Tanzania
Credits Layout & Design: Julie Pudlowski Consulting Cover Photo: UNICEF/Julie Pudlowski
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Children and Women in Tanzania Vo l u m e 2
Zanzibar
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Children and Women in Tanzania
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Foreword “A Tanzanian who is born today will be fully grown up, will have joined the working population and will probably be a young parent by the year 2025... What kind of society will have been created by such Tanzanians in the year 2025? What is envisioned is that the society these Tanzanians will be living in by then will be a substantially developed one with a high quality livelihood. Abject poverty will be a thing of the past... Tanzanians will have graduated from a least developed country to a middle income country with a high level of human development.” “Poverty is the single greatest burden for the people. It is not merely the lack of income that determines poverty; it is also the lack of accessibility to basic needs... The challenge, therefore, is to eradicate absolute poverty and set the Zanzibaris free from poverty so that they can participate effectively in the mainstream of social, economic and political life, survive and lead a decent life.” These words, enshrined in the Tanzania Development Vision 2025 and the Zanzibar Vision 2020, resonate today with the same vigour and urgency as when they were written in 2000. This report, the result of a joint collaboration between the Revolutionary Government of Zanzibar and the United Nations Children’s Fund, argues that the vision of economic and social prosperity captured in those two seminal documents can only be realised if the survival, well-being and development of all Zanzibari, and indeed all Tanzanian, children is assured. In fact, every country that has made the breakthrough to middle-income status has invested heavily in children. Their development is amongst the most important drivers of sustainable national growth.
© UNICEF/George Mcbean
Children also represent the foundation of a vibrant democracy and a cohesive, peaceful society. The first cohorts of children to benefit from the Primary Education Development Plan voted in national elections in 2010, while students leaving primary school this year will be eligible to vote in 2015, the target date for the Millennium Development Goals. Young people need to be supported to grow up as informed and empowered citizens. Healthy, educated children also become creative, productive adults. Since children make up over half Zanzibar’s population, investing in their well-being now is arguably the soundest investment that Zanzibar can make to secure economic, social and political stability and prosperity for years to come. This report highlights areas where progress has been made in advancing the rights and well-being of children, and identifies where progress has stalled or is lagging behind. It sheds light on policies and strategies that have worked and those in need of adjustment. Undoubtedly, Zanzibar has seen major progress in child health and education, as well as in HIV and AIDS. Such progress, however, has often been uneven, and must not detract from the fact that other areas of critical relevance to children and women still need attention from policy makers, particularly maternal and newborn healthcare, nutrition, social and child protection, disability and, until recently, early child development and water, hygiene and sanitation. In the quest for accelerating progress in advancing the rights of Zanzibar’s children and women, the question of what ought to be done first does not lend itself to easy answers. Among many competing demands, Zanzibar will need to further refine its priorities, taking account of the capacity to deliver on them. A judicious mix of realism and ambition will be required. Even though rights are indivisible and interdependent, not every issue can be tackled at once. In a context of scarce resources, the fulfilment of rights demands making policy choices with a clear mindset, and delineating a critical path for their progressive realisation. We are confident that the analysis and findings of this report, along with the Children’s Agenda it delineates, will help inform the discussions and setting of priorities for the fulfilment of the rights of all Tanzanian children and of the vision of a strong and prosperous country. Zanzibari children and the future of the Isles can ill afford to wait.
Khamis M. Omar
Dorothy Rozga
Principal Secretary, President’s Office Finance, Economy and Development Planning
Representative UNICEF Tanzania
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Acknowledgements The report on Children and Women in Tanzania, 2010 is the result of a joint collaboration between the Government of the United Republic of Tanzania and UNICEF. Given its breadth and scope, the report would not have been possible without the strong commitment, guidance and support of the members of the National Steering Committee set up in 2009 to advise, oversee and validate the results of the analysis, the findings and the recommendations contained in this publication. Chaired by the Ministry of Finance and Economic Affairs and co-chaired by UNICEF, the Steering Committee had representation from a broad cross-section of Ministries, Departments and Agencies, as well as civil society organisations. Special thanks are due, first and foremost, to the Government of the United Republic of Tanzania and the Revolutionary Government of Zanzibar, and also to the many participants in the stakeholder consultations held during 2009 and 2010 to discuss the preliminary findings from the analytical work commissioned for the publication. Among those who took part in the steering committee and the consultations carried out over the course of several months were representatives from the following institutions: Ministry of Agriculture and Food Security, Ministry of Community Development, Gender and Children, Ministry of Education and Vocational Training, Ministry of Health and Social Welfare, Ministry of Infrastructure Development, Ministry of Justice and Constitutional Affairs, Ministry of Labour, Employment and Youth Development, Ministry of Water and Irrigation, Planning Commission, Prime Minister’s Office, Commission for Human Rights and Good Governance, National Bureau of Statistics, Office of the Chief Government Statistician, Tanzania Commission for AIDS (TACAIDS), Tanzania Social Action Fund (TASAF), Tanzania Food and Nutrition Centre (TFNC), Tanzania Education Network (TEN/MET), Tanzania Federation of Disabled People’s Organisations (SHIVYAWATA), Tanzania Gender Network Programme (TGNP), Tanzania Water and Sanitation Network (TAWASANET), Tanzania Women Lawyers’ Association, CCBRT, Christian Social Services Commission, Family Health International, Ifakara Health Institute, PACT International, Save the Children, SNV, UK Department for International Development (DfID), UNAIDS, UNFPA, USAID, WaterAid, Youth Action Volunteers and Youth Peer Education Network.
© UNICEF/Julie Pudlowski
Background papers for the publication were produced by Paul Smithson (chapter 2), John Msuya (chapter 3), Ben Taylor (chapter 4), Suleman Sumra (chapter 5), Halima Shariff and Rugola Mtandu (chapter 6), and Andrew Dunn and Robert Mhamba (chapter 7). Kate McAlpine contributed a preliminary version of the executive summary and the introductory chapter, and also provided detailed comments and helped revise all the chapters in the report. Chapter 8 is the outcome of broad consultations with a range of stakeholders from Government, leading children’s organisations and children from across the country. Chris Daly proof read and edited the full report. Every section of the UNICEF Office, as well as the Zanzibar sub-Office, was involved in the preparation of the report. Contributions are duly acknowledged from Young Child Survival and Development (chapters 2, 3 and 4), Basic Education and Life Skills (chapter 5), HIV and AIDS (chapter 6), Child Protection and Participation (chapter 7) and Communication and Partnerships (chapter 8). Policy Advocacy and Analysis was responsible for the overall coordination, quality assurance and distillation of the key findings and recommendations of the report. For continuous support as well as the provision of specific inputs, special thanks are also given to the Office of the Deputy Representative, the Planning and Operations sections, and the Emergency Preparedness and Response division of UNICEF. Given the wide range of contributions into this publication, its contents and conclusions may not necessarily reflect the views of every one of the contributors or the institutions they represent.
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Table of Contents Foreword Acknowledgements
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List of Tables
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List of Figures
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List of Acronyms
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Overview
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Fast facts on Zanzibari children and women
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Introduction
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Chapter 1: Establishing a foundation for child rights in Zanzibar
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1.1 Legal and policy environment
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1.2 Generalised insecurity
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1.3 Child-sensitive social protection
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1.4 What is in the best interests of Zanzibari children?
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1.4.1 Children’s experience of family
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1.4.2 Political and societal attitudes towards children
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Chapter 2: Maternal health and child survival and development
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2.1 Status and trends
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2.1.1 Maternal health
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2.1.2 Child survival and well-being
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2.2 Priority areas and recommendations
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Chapter 3: Nutrition
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3.1 A conceptual framework for analysing malnutrition
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3.2 Status and trends
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3.2.1 Nutrition status of women
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3.2.2 Nutrition status of children
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3.3 Feeding practices for children
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3.4 Priority areas and recommendations
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Chapter 4: Water, sanitation and hygiene
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4.1 Status and trends
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4.1.1 Water supply
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4.1.2 Sanitation
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4.2 Institutional framework and fiscal space
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4.3 Priority areas and recommendations
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Chapter 5: Education
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5.1 Status and trends
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5.1.1 Education provision amidst generalised insecurity
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5.1.2 Literacy rates and educational attainment
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5.1.3 Access to education
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5.2 Factors affecting learning outcomes for children
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5.2.1 Teacher supply and quality
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5.2.2 The school environment
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5.2.3 Curriculum and examinations
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5.3 Fiscal space for education
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5.4 Institutional framework
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5.5 Priority areas and recommendations
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Chapter 6: Women, children and HIV and AIDS
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6.1. Overview of HIV and AIDS
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6.1.1 HIV prevalence
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6.1.2 Most-at-risk populations
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6.1.3 The policy and legal environment
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6.2 Socio-economic and cultural drivers of the epidemic
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6.2.1 High risk behaviour and low perception of transmission risk
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6.2.2 Stigma, discrimination and knowledge of HIV and AIDS
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6.2.3 The impact of population mobility
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6.2.4 Gender inequity
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6.3 Status of the response to HIV and AIDS
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6.4 Fiscal space
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6.5 Institutional frameworks
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6.6 Priority areas and recommendations
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Chapter 7: Protection of children against abuse, neglect and exploitation
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7.1 International instruments and domestic legislation for child protection
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7.2 A conceptual framework for child protection
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7.3 Status and trends
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7.4 Child-centred approaches to improve well-being and safeguard rights
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7.5 Social protection for most vulnerable children
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7.6 Fiscal space
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7.7 Institutional framework
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7.8 Priority areas and recommendations
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Table of contents
Chapter 8: The Children’s Agenda
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01. Invest to save the lives of women and children
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02. Invest in good nutrition
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03. Invest in safe water, better hygiene and sanitation in schools and health facilities
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04. Invest in early childhood development
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05. Invest in quality education for all children
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06. Invest to make schools safe
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07. Invest to protect infants and adolescent girls from HIV
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08. Invest to reduce teenage pregnancy
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09. Invest to protect children from violence, abuse and exploitation
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10. Invest in children with disabilities
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Empowering families to care for children: A universal system of social protection
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References
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List of Tables Table 1: Zanzibar’s health targets
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Table 2: Coverage of selected ANC components, 2004/05 and 2010, in percentages
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Table 3: Facility-based delivery, skilled assistance and post-natal care, in percentages
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Table 4: Under-five mortality rates for the ten-year period preceding the TDHS 2010, per 1,000 live births
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Table 5: Percentage of children ill with ARI or diarrhoea in two weeks prior to the survey 37 Table 6: Vaccination coverage, 1999, 2004/5 and 2010 (children 12-23 months)
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Table 7: Zanzibar’s nutrition targets
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Table 8: Iron supplementation for pregnant women, in percentages
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Table 9: Consumption of iodised salt, vegetables and fruits rich in vitamin A, and vitamin A supplements among children under five years of age, 2004/5
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Table 10: Severe anaemia (
