4. Women’s and girls’ physical autonomy

Abstract

This chapter focuses on women’s physical autonomy in Tanzania, building on data collected within the framework of the SIGI Tanzania. It identifies and assesses the prevalence of gender-based violence against women and girls, including female genital mutilation/cutting, and highlights factors associated with restrictions on women’s reproductive autonomy such as unmet need for family planning, adolescent pregnancy and access to sexual education. The analysis considers both the current situation of women and girls and uncovers underlying factors, including specifically discriminatory social norms.

Key takeaways

Violence against women and girls

Addressing violence against women and girls is a key policy priority in Tanzania. National action plans in both Mainland Tanzania and Zanzibar are dedicated to addressing this issue.
More than half of all women in Tanzania have suffered from at least one form of violence in their lifetime.
Intimate partner violence (IPV) is a pervasive feature of Tanzanian society, and affects predominantely women. Two-thirds of ever-partnered women who have survived intimate partner violence have experienced at least two different forms of IPV including sexual, physical and psychological abuse.
Younger women and those with children are more likely to have experienced intimate partner violence.
Half of the population believes that a man can be justified in hitting or beating his wife under certain circumstances. Broad social acceptance of violence against women perpetuates violence and is strongly associated with higher rates of IPV.
Women are more likely than men to justify IPV: 56% of women believe a husband may be justified in beating or hitting his wife under certain circumstances compared to 47% of men.
Persistent non-partner violence committed by family members and authority figures, specifically teachers, likely during childhood contributes to the acceptance of violence and cycles of violence.
Restrictive masculinities that support men’s control over women underpin the high prevalence rates of IPV and wide acceptance of violence in Tanzania.

Female genital mutilation/cutting

More than 2 million Tanzanian women report having been excised or experiencing FGM/C.
The practice of FGM/C is confined mainly to certain regions of Tanzania, specifically in northern Tanzania.
FGM/C is being progressively abandoned as a harmful practice.
On average, the vast majority (91%) of the population agrees that the practice of excision should be abandoned. This majority is also aware of and supports legislation prohibiting FGM/C.

Reproductive autonomy

In Tanzania, an average of 38% of women of reproductive age report having an unmet need for family planning.
Among the population aged 15-49 years using any contraception method, 88% rely on modern methods.
Among young women aged 15-19 years, 54% report having an unmet need for family planning. Women in this age group who do use contraception are more likely to rely on less effective methods.
In the face of limited decision-making power, limited agency and spousal opposition, many women in Tanzania use contraceptives covertly.
Among the total population, 37% of people declared that women should not have the right to decide whether to use contraception.
Among women who have at least one child, 33% had their first pregnancy before they were 20 years of age.
Slightly more than half of the population in Tanzania has received sexual education mainly through health centres and schools.
While the vast majority of the population believe that sexual education should be provided, a greater share believes that girls should receive this education (97%) than boys (90%).

Women’s and girls’ physical autonomy relates to their independence and self-determination over their own bodies and reproductive functions. Both globally, and in Tanzania, violence and other harmful practices infringe on women’s and girls’ physical autonomy with significant implications for their health, well-being, empowerment and opportunities. Using the data collected within the framework of the SIGI Tanzania, this chapter explores issues of violence against women and girls, including female genital mutilation/cutting (FGM/C), as well women’s reproductive autonomy in Tanzania. Each section examines commitments and actions made by Tanzania to address these harmful practices, analyses their prevalence at different geographical levels, and uncovers the critical role played by social norms and other underlying factors.

Violence against women and girls

Violence against women and girls has far-reaching effects on women and girls as well as society as a whole. Perpetuated by power imbalances between women and men, gender-based violence against women and girls encompasses a wide range of harmful practices including intimate partner, non-partner and family violence – including physical, sexual, psychological and economic abuse – as well as FGM/C. In jeopardising the health, well-being and opportunities of women and girls, gender-based violence against women and girls also represents a significant cost to the economy (Vyasa, 2019[1]). The need to end violence against women and girls has received broad international and regional recognition, and has been identified by the Government of Tanzania as a key priority in its recent national action plans (Government of Tanzania, 2019[2]).

Both Mainland Tanzania and Zanzibar have created action plans to eliminate violence against women and girls. Mainland Tanzania’s National Plan of Action to End Violence against Women and Children 2017/18-2021/22 establishes a policy framework for dedicated actions including efforts to reduce the rates of FGM/C and to improve the welfare of women and girls. Composed of eight strategies, the plan covers issues related to norms and values, safe schools and life skills, response and support services, co-ordination, monitoring and evaluation and more, with specific operational targets for each strategy (MHCDGEC, 2016[3]). In Zanzibar, the National Action Plan to End Violence against Women and Children 2017-2022 aims to create a comprehensive framework to prevent and address violence against women and children. The plan features three outcomes to be achieved by 2022: the creation of an enabling environment in Zanzibar for the protection and empowerment of women and children, the strengthening of prevention programmes and services, and the establishment of a comprehensive and integrated national response system (Ministry of Labour, Empowerment, Elders, Youth, Women and Children, 2017[4]). In an effort to implement these plans, Tanzania supports programmes and services that assist victims/survivors of violence against women and girls (Box 4.1).

Box 4.1. Programmes and services related to violence against women and girls in Tanzania

Over the last five years, Tanzania has prioritised the creation and strengthening of services for victims/survivors of gender-based violence. The government has established reporting mechanisms aimed at facilitating victims/survivors’ access to justice and services. For example:

In 2013, the government set up a toll-free helpline for children (116) to provide advice and support, and to facilitate the reporting of violence against women and children. The hotline is accessible across all networks in Mainland Tanzania and Zanzibar, and responds to about 3 500 calls per day from women and girls at risk of violence as well as community members reporting abuse (UN, 2021[5]).

Services dedicated to supporting survivors/victims and their families have been strengthened:

Between 2014 and 2019, the number of One-Stop Centres providing comprehensive essential services such as medical care, psychological support and legal assistance for survivors increased from 1 to 13. The centres are located in both Mainland Tanzania and Zanzibar
Protection committees are local-level co-ordination bodies that handle referrals and enhance collaboration among the health, justice, education and social sectors to better support women and children at risk of violence. These bodies also play an important role in implementing the National Plan of Action to End Violence against Women and Children.
The Tanzania Police Force has dedicated set up Police Gender and Children Desks to address barriers to justice for women and children. These desks aim to build a more supportive reporting environment. As of 2018, desks had been formally established in 420 police stations.

The government has also launched awareness-raising activities to shift attitudes and practices related to violence against women and girls. For instance:

Over the 2017-18 period, the government developed and led campaigns addressing adolescent pregnancy and child marriage, engaging with children, teachers, parents, decision makers and religious leaders.
The government also developed and disseminated a toolkit for teachers aimed at ending the use of violent disciplinary action. The toolkit was disseminated to 1 539 teachers in Kusini and Kaskazini.
During the COVID-19 pandemic, with the support of UN Women, communications materials on the pandemic and violence against women were spread through radio and television. In the context of this partnership protocols were also developed to aid service providers in screening for violence against women and children (UN Women, 2021[6]).

Source: (Government of Tanzania, 2019[2]), Country Report on the Review and Progress made in Implementation of the Beijing Declaration and Platform for Action – Beijing +25, www.unwomen.org/-/media/headquarters/attachments/sections/csw/64/national-reviews/united-republic-of-tanzania-en.pdf?la=en&vs=711.

More than half of women and girls in Tanzania face often overlapping, forms of violence

Violence against women and girls is a persistent and important problem in Tanzania. Indeed, more than half of all women in Tanzania (55%) have suffered from at least one form of violence in their lifetime and are more likely than men to experience any kind of violence 1 – intimate-partner violence (IPV) and non-partner violence alike. Significant shares of women in Tanzania experience intimate partner as well as non-partner violence including physical, sexual, economic and psychological abuse. In addition, many women suffer multiple forms of violence in their lifetime as well as violence committed by multiple perpetrators. The prevalence of violence against women is also reflected in women’s fear of violence in public spaces where they live. Gaps in the legal framework on violence against women may contribute to the continued prevalence of these acts. For example, no law specifically addresses gender-based violence against women and existing legislation permits the use of violence against children (see Annex 4.A).

A significant share of women in Tanzania are subjected to intimate partner violence (IPV)

Intimate-partner violence against women is pervasive in Tanzania. While reporting likely underestimates the total instances of violence, 23% of ever-partnered women in Tanzania reported experiencing some form of IPV over the past year, and 48% of women reported experiencing such violence at least once in their life (Figure 4.1, Panel A). In comparison, data from the global SIGI estimated that in 2019, on average, 36% of women in East Africa experienced some form of IPV at least once in their lifetime while 24% reported the same in a 12-month period (OECD, 2021[7]).

Figure 4.1. Intimate partner violence against women is pervasive in Tanzania

Although rural and urban areas present similar levels of IPV against women, rates are significantly higher in Mainland Tanzania than in Zanzibar. In Mainland Tanzania, 24% of women reported experiencing some form of IPV over the last 12 months, but only 7% of women made similar reports in Zanzibar. Likewise, the lifetime IPV rate is 49% in Mainland Tanzania compared to 20% in Zanzibar. The prevalence of IPV against women also varies among Tanzania’s regions. Prevalence rates of violence in the last 12 months range from 4% in Mjini Magharibi and Kaskazini Unguja, and 7% in Zanzibar to 40% in Mbeya and 46% in Arusha (Figure 4.1, Panel B). In the rural Mbulu District of Manyara – where rates of violence against women over the last 12 months stand at 37% – a study found that most people attribute high rates of IPV to socio-economic stress, including factors such as a lack of food and other resources, declining household income, and misuse of income or property among others (Rugira, 2015[9]).

IPV takes various forms, with physical and psychological violence being the most pervasive. At the national level, 15% of ever-partnered women report having been physically assaulted by their current or former partner or spouse over the past year, and 38% of these women report having experienced this form of physical violence at least once in their lifetime. In regard to psychological IPV, 16% of women report that they have been humiliated, threatened, insulted or frightened by a current or former partner or spouse within the last 12 months, while 35% had experienced such behaviour at least once in their lifetime. Intimate partner sexual violence is seemingly less prevalent, but remains significant: 9% of women report that their current or former spouse or partner forced them to have sexual intercourse without their consent over the last 12 months and 16% report having experienced this at least once in their lifetime (Figure 4.1, Panel A).

Younger women, especially those aged 20-39 years and those with children, are more likely to have experienced IPV (Figure 4.2). Rates of IPV over the last 12 months differ among the different age groups of ever-partnered women. The share of women aged between 30 and 39 years who report having experienced IPV in the last year stands at 30%, the highest rate compared to all other age groups. Women aged 20-29 years follow closely with 27% reporting having survived IPV in the last year. Women from the oldest age groups – 50-59, 60-69 and 70+ years – had the lowest 12-month prevalence rates of IPV, at 17%, 13% and 11%, respectively. Women with children are also more likely to face IPV at least once in their lifetime than women who do not. Moreover, women with two or three children are also more likely to report IPV occurring in the last 12 months than women without children.

Figure 4.2. Factors associated with experiencing intimate partner violence

Factors such as age at marriage, type of marriage and exposure to other types of violence also increase women’s likelihood of experiencing IPV (Figure 4.2). Child marriage is associated with higher rates of IPV, and women who married before the age of 18 years are more likely to have experienced IPV both during the past year and over their lifetime (Izugbara, 2018[10]).2 In 2021, 24% of such women experienced IPV in the last 12 months and 53% suffered from IPV at least once in their lifetime. Among women who were married after the age of 18 years, prevalence rates were lower with 17% experiencing IPV in the last 12 months and 35% suffering from IPV at least once in their lifetime. Age differences between spouses which are characteristic of many child marriages, especially in sub-Saharan Africa, may lead to greater power imbalances, thus amplifying the risk of IPV among women married before the age of 18 years (Ahinkorah et al., 2021[11]). In addition, the fact that women who are not married during childhood tend to have higher levels of education may also play a role in explaining lower rates of violence among women married after the age of 18 as educational attainment may improve women’s bargaining power within the household. also makes them more likely to have experienced IPV in the last 12 months than women in non-polygamous marriages. This finding may be a reflection of the fact that women in polygamous marriages have less power and are more likely to be dependent on their husband/partner, which in turn increases their vulnerability (Vyas and Jansen, 2018[12]). In addition, women who experience non-partner violence are more likely to also face IPV. In other words, surviving violence committed by someone other than an intimate partner can put women at greater risk of facing violence from an intimate partner.

Among those who report surviving IPV, many women have experienced multiple forms of abuse. Of those women who have survived IPV over their lifetime – accounting for 48% of Tanzania’s ever-partnered women – about one-third have experienced only one form 3 of IPV. In other words, two-thirds of Tanzanian women who have survived IPV throughout their lives have actually survived two different forms of violence (Figure 4.3). More precisely, 32% of survivors have survived two distinct forms of IPV, 22% have survived three forms and 13% have been subjected to all four types of IPV: physical, psychological, sexual and economic. These data show that many women victims/survivors of IPV experience multiple and potentially overlapping forms of violence throughout their lifetime.

Figure 4.3. Many women have experienced multiple forms of abuse

Evidence suggests that violence against women and especially IPV remains significantly underreported in Tanzania despite the existence of mechanisms for reporting violence. Evidence from a 2005 study in Dar es Salaam and Mbeya revealed that 60% of victims of physical IPV never sought help (WHO, 2005[13]). This reluctance is related not only to shame and stigma around violence against women but also to the belief that such violence is normal (Rugira, 2015[9]). Among the women in Dar es Salaam and Mbeya who never sought help, 56% and 48%, respectively, say that they did not do so because they thought violence was normal or not serious enough (WHO, 2005[13]). While focus group discussions reveal wide awareness of reporting channels for gender-based violence, this violence is continually underreported, likely due in part to social norms that view this violence as normal and even acceptable (Mbuyita, 2021[14]). Indeed, underreporting may be reflected in the low case numbers of this kind of violence in the court system. Indeed, over the 2017-18 period, only 1 091 cases of violence against women and children were prosecuted (Government of Tanzania, 2019[2]).

Non-partner violence is also pervasive for both men and women

In Tanzania, non-partner violence – that is violence committed by a person other than the survivors’ current or former intimate partner – is prevalent. Many women and men have experienced both physical and sexual non-partner violence.4 Over the course of their lifetime, 26% of women and 29% of men have been beaten, slapped, kicked or physically assaulted with another kind of object by someone other than their spouse/partner. A greater share of men (7%) than women (5%) in Tanzania report having experienced non-partner sexual assault 5 at least once in their lifetime, and about 2% of men and women alike have experienced non-partner rape 6 in their lifetime. The share of people in urban areas who have experienced non-partner physical and sexual violence is higher than in rural areas. For instance, the rate of non-partner sexual assault is significantly higher in urban areas (9%) than in rural settings (5%). This may indicate that the risk of experiencing non-partner violence is also higher in urban areas.

A notable share of Tanzanian women (26%) report having experienced non-partner physical violence at least once in their lifetime. Among Tanzania’s regions, there is significant variation in the rates of non-partner physical violence. For example, in Lindi, only 2% of women report experiencing non-partner physical violence once in their lifetime, compared to 77% of women in Kaskazini Pemba.

For both women and men who have experienced non-partner physical violence, parents and teachers were the main perpetrators, signalling that it likely took place during childhood or adolescence. In Zanzibar, research found that more than 60% of respondents believe that teachers in schools and Koranic madrassas use violence against children (UNICEF, 2017[15]). Violence, particularly when perpetrated against young people, contributes to the view that violence, in general, is normal, and thus socially acceptable or at least tacitly condoned (UNICEF, 2017[16]). Indeed, data from Zanzibar show that 42% of people believe that “it is necessary for parents to physically punish a child in order to raise him or her well” (UNICEF, 2017[15]). Violence committed by parents may also contribute to a cycle of violence whereby women find themselves facing violence from an intimate partner (Vyas and Jansen, 2018[12]). The data show that women who experienced violence from a parental figure were more likely than those who did not to experience IPV at least once in their lifetime. Among women who faced violence from a parent, 57% also experienced IPV, compared to 47% of women who did not experience parental violence.

Men’s experiences of violence in childhood can be a key determining factor in their perpetration of violence. Among the 29% of men who experienced non-partner physical violence at least once in their lifetime, a majority (52%) stated that this violence was committed by their father. Having experienced violence committed by one’s father, a role model in many children’s lives likely contributes to a higher acceptance of violence and a belief in its legitimacy. Research in Tanzania shows that men who experienced violence as children or witnessed violence against their mothers during childhood were more likely to perpetrate violence later in life (Vyas and Jansen, 2018[12]). Data also show that a large share of men in this category experienced violence at the hands of their mothers (43%) and their teachers (41%), indicating that these instances likely took place during childhood or adolescence.

While similar shares of men and women report experiencing non-partner sexual violence in their lifetime, women faced a wider range of perpetrators than men. Among the men who survived non-partner sexual assault, the majority (61%) stated that a friend or acquaintance groped or tried to kiss them against their will. A smaller percentage reported that these actions were committed by a family member other than their parents or siblings (20%), their siblings (14%) or a classmate (11%). Among women, friends and acquaintances are cited as the most common perpetrators of non-partner sexual assault (42%), followed by family members other than parents or siblings (33%) and siblings (24%). A much smaller proportion of women who have survived non-partner sexual assault reported that they did not know the perpetrator (11%). While a similar share of men and women report having experienced rape committed by a non-partner, the perpetrators of this violence differ. For surviving men, 63% reported that the perpetrator was a friend or acquaintance, while 11% identified the assailant as their father. For women, there is significantly more variation with 24% saying the violence was committed by a friend or acquaintance, 17% identifying the assailant as a family member other than their parents or siblings, and 13% reporting that the assault was committed by a housemate. In 16% of cases, women stated that the perpetrator was unknown. Overall, a much larger share of women than men reported that their perpetrator was unknown, which likely contributes to their physical insecurity and overall fear of violence.

Many people in Tanzania, and women, in particular, experience insecurity in public spaces. At the national level, 38% of the population state that they do not feel safe walking alone at night where they live. In every region, a greater share of women than men systematically report feeling unsafe (Figure 4.4). This feeling of insecurity is significantly higher for women than men. Nearly half of women in Tanzania (49%) declare not feeling safe walking alone at night where they live compared to 25% of men. These feelings of insecurity vary across Tanzania. Although similar shares of men and women feel unsafe in rural and urban areas, the proportion of both men and women who feel unsafe is significantly lower in Zanzibar than in Mainland Tanzania. Variations are also important at the regional level. For example, in Morogoro, 6% of women report not feeling safe while walking alone at night compared to 75% of women in Singida, 76% in Dodoma and 78% in Kagera.

Figure 4.4. Half of Tanzanian women feel unsafe

More women than men fear walking alone at night in the place where they live because they fear violence specifically. Fear of violence is the main reason given by women with 45% citing fears of physical assault, being robbed, kidnapping, rape, being sexually harassed, verbal assault and obscene words, and exhibitionism. The share of men reporting the same fear was less than half as high (22%) (Figure 4.5). More specifically, 33% of all women fear being robbed, 28% fear being physically assaulted and 25% fear being raped. In some regions, women’s fear of violence is more widespread. For instance, 52% of all women in Kagera report not feeling safe due to a fear of physical assault, while only 2%, 4% and 6% report the same fear in Mogoro, Kusini Pemba and Kaskazini Pemba, respectively. In some regions, a large share of women cite feeling unsafe specifically because of a fear of being raped. In three regions,7 more than 50% of women report not feeling safe because they fear rape.

Figure 4.5. Tanzanian women primarily fear physical violence

Persistent violence against women and girls is rooted in social norms justifying violence

Social acceptance of violence against women in Tanzania remains very high and is closely associated with higher rates of IPV. In Tanzania, as well as globally, there is a very close relationship between attitudes justifying violence and prevalence of IPV (Figure 4.6) (OECD, 2019[17]; Vyas and Jansen, 2018[12]). In Tanzania, half of the population thinks that a man may be justified in hitting or beating his wife under certain circumstances (Figure 4.7). Social acceptance of domestic violence against women is significantly higher in Mainland Tanzania than in Zanzibar, where only 29% of the population thinks that a man may be justified in hitting or beating his wife under certain circumstances, compared to 50% in Mainland Tanzania.

Figure 4.6. Attitudes justifying IPV are closely related to higher rates of violence against women

Social acceptance and justification of violence against women is higher in certain circumstances, and is often associated with women failing to fulfil the traditional gender roles assigned to them. At the national level, 59% of the population thinks that a man is justified in committing an act of violence against his wife if she cheats on him; 37% believe he is similarly justified if she argues with him, and 29% agree that he is justified if she neglects the children, or applies for a new job or engages in a new livelihood without his consent (Figure 4.7). Violence in these cases may be viewed as a punishment or reprimand for a woman failing to fulfil the rigid gender role assigned to them within the household or in partnerships, which includes being submissive 8 among other characteristics (Mbuyita, 2021[14]). In this respect, norms of restrictive masculinities which promote the expectation that “real” men have the final say play a role in promoting violence and its acceptance.

Figure 4.7. Social acceptance of violence against women in Tanzania remains very high

There is very little difference among different age groups regarding the acceptance of IPV. While the oldest generations are least likely to believe a husband may be justified in hitting or beating his wife if she burns the food, goes out without telling him, neglects the children or argues with him, 43% of the population aged 70 years and older report still maintain this view. The population aged 60-69 years and 50-59 years have the next lowest rates of acceptance of IPV at 46% and 47% respectively. This discriminatory attitude was most widespread among 20-29-year-olds, with 52% agreeing that a husband could be justified in hitting his wife under the abovementioned circumstances, while 50% of 30-39-year-olds and 40-49-year-olds concurred with this view. The youngest age group aged 15-19 years also widely accepted IPV with 49% reporting that such violence can be justified. Among women alone, there is even less variation in attitudes towards IPV across age groups. High rates of acceptance of violence, particularly among young people, pose a serious challenge for efforts to change social norms in this regard which will likely require work across multiple generations.

Women are more likely than men to justify IPV and having personally experienced IPV is associated with greater acceptance of such violence among women (Table 4.1). A greater share of women (56%) than men (47%) justify violence in at least one circumstance. Moreover, for each of the eight circumstances surveyed,9 a greater proportion of women than men thought that violence could be justified. Conversely, the share of men who say that such violence can never be justified (47%) is higher than the proportion of women reporting the same (39%). Focus group discussion revealed some variation in women’s attitudes on violence: some regarded it as a proportionate punishment for wives’ bad behaviour, while others saw violence as a way for men to reaffirm their manhood and reassert their role as head of the household (Mbuyita, 2021[14]). Evidence shows that the proportion of women who justify violence is significantly higher among those who have experienced IPV compared to those who have not. Indeed, the share of women who have experienced violence and justify IPV (59%) was eight percentage points greater than the share of women who had never experienced this form of violence (51%). This suggests that experiencing violence normalises the act of violence, which can have implications for reporting and help-seeking behaviours. Indeed, when women believe that IPV is normal and justifiable, they may be less likely to report incidences of violence to the police and other relevant authorities (Rugira, 2015[9]).

Table 4.1. Determinants of attitudes justifying intimate-partner violence against women
Marginal effects and significance of key characteristics on discriminatory attitudes
		Dependent variables: Attitudes justifying intimate-partner violence if:
		(i)	(ii)	(iii)	(iv)	(v)	(vi)	(vii)	(viii)	(ix)
		A wife burns the food, goes out without telling her husband, neglects the children or argues with him	A wife burns the food	A wife burns the food	A wife neglects the children	A wife argues with her husband	A wife buys things without her husband's consent	A wife applies for a new job or engages in a new livelihood without her husband's consent	A wife cheats on her husband	A wife files a complaint against her husband to a higher authority or the police
Independent variables
Being a woman
Living in urban areas		o	o	o		o	o	o	o
Age		o	o	o	o	o	o	o	o	o
Age squared		o	o	o	o	o	o	o	o	o
Number of children		o	o	o	o	o	o	o	o	o
Size of the household			o	o		o		o		o
Education (omitted: no formal education)	Primary incomplete	o	o	o	o	o	o	o	o	o
	Primary complete	o			o		o	o	o	o
	Secondary complete
	University complete		o		o		o			o
Marital status (omitted: married)	Living together						o		o	o
Marital status (omitted: married)	Single								o	o
Wealth (omitted: 1st quintile)	2nd quintile	o	o	o	o	o	o	o	o	o
	3rd quintile	o	o	o		o	o	o		o
	4th quintile							o		o
	5th quintile
Zanzibar’s regions
Note: The table reports the sign of independent variables from nine probit models where the dependent variables are the share of the population declaring that a husband is justified in hitting or beating his wife if: (i) she burns the food, goes out without telling him, neglects the children or argues with him (SIGI indicator), (ii) she burns the food, (iii) she goes out without telling him, (iv) she neglects the children, (v) she argues with him, (vi) she buys things without his consent, (vii) she applies for a new job or engages in a new livelihood without his consent, (viii) she cheats on him and (ix) she files a complaint against him to a higher authority or the police. Additional control variables include regional dummies. o = no significant effect; = a significant positive effect; = a significant negative effect.
Source: (OECD, 2021[8]), SIGI Tanzania database, https://stats.oecd.org.
StatLink https://stat.link/yl9msb

Higher levels of educational attainment as well as other factors are associated with lower acceptance rates of violence against women. Among people with tertiary education, only 23% reported that a husband may be justified in hitting or beating his wife in at least one of the following circumstances: if she burns the food if she goes out without telling him, if she neglects the children or if she argues with him. The share of people with secondary education who agreed with this statement was much higher at 44%. Among people with primary education, more than half (51%) were in agreement with the statement. Finally, the greatest share of individuals justifying IPV was found among individuals with no education (53%). Other socio-demographic factors, such as lower wealth and smaller household size or marital status, are also loosely associated with wider acceptance of violence against women (Table 4.1). For instance, as wealth increases, the likelihood of an individual holding attitudes that justify IPV decreases. Likewise, individuals living in larger households are less likely to justify violence than those who live in smaller households. Non-married individuals – single or living together with someone else without being married – are also more likely to justify IPV than married ones.

Restrictive attitudes regarding women’s sexual autonomy may also create contexts conducive to sexual violence in partnerships. At the national level, 42% of the population disagree or strongly disagree that a woman should decide when she wants to have sex. The same percentage of people also report that they do not agree that a woman has the right to refuse to have sex with her husband, with no significant differences between women and men. This result indicates that social norms view men as the main decision makers when it comes to sexual activity in relationships. A woman is expected by many to engage in sexual activity with their partner/husband regardless of her personal preference. These social norms create a context in which sexual violence in partnerships is not only tolerated but accepted (OECD, 2021[18]). In this regard, focus group discussions in Zanzibar showed that forced intercourse between a man and his wife is not necessarily considered as a form of violence (Mbuyita, 2021[14]).

Restrictive masculinities promote a cycle of violence against women in Tanzania

Restrictive masculinities that support men’s control over women underpin the high prevalence rates of IPV and wide acceptance of violence in Tanzania (Halim et al., 2019[19]; OECD, 2021[18]). Restrictive masculinities encompass various socially constructed ways of being and acting as well as values and expectations associated with being and becoming a “real” man that, in practice, confine men to their traditional role as the dominant gender group and undermine women’s empowerment and gender equality (OECD, 2021[18]; OECD, 2019[20]). In Tanzania, some norms of restrictive masculinities 10 are particularly strong – for example, that a “real” man should protect and exercise guardianship, especially over women, and that a “real” man should be the breadwinner and financially dominant. These norms and the behaviors they entail, in particular violence against women, represent a serious cost to the economy of Tanzania.

In practice, the norm that “real” men should protect and exercise guardianship is enacted when social norms dictate that women need to ask for their husbands’ permission to go outside of the home (OECD, 2021[18]). In Tanzania, the belief that women should ask for such permission is widespread. In regard to going to the market, 71% of the population believes that a woman should ask for her husband’s/partner’s permission beforehand, with a slightly higher share of women (73%) holding this view than men (69%). The belief that women need permission is most popular in regard to leisure activities such as visiting bars and movie theatres – 83% and 84% think women need permission, respectively. Finally, in terms of interacting with the justice system, many believe that women need permission – 77% of the population agree that this is the case for going to the police, and 78% say the same for the courts. These attitudes indicate wide acceptance of men’s control over women’s freedom of movement. Failure to comply with this norm may be used to justify violence, with 29% of people believing that a man can be justified in hitting or beating his wife if she goes out without telling him. Focus group discussions revealed that some women expressed a belief that violence can be legitimately used by husbands to punish their wives for disobedience (Mbuyita, 2021[14]).

The norms that “real” men are breadwinners and financially dominant entail working for pay to provide for the household and being the primary earner (OECD, 2021[18]). In Tanzania, 92% of the population believes that a “real” man should be the breadwinner. Nevertheless, in Tanzania, a large share of women also provide financially for the household. Women’s growing economic empowerment and influence may be seen as a challenge to traditional masculinities and a threat to men’s opportunities to live out this important norm which gives them status as “real” men. In this context, violence may emerge as a way for men to reinforce asymmetric gender norms, relations and treatment, especially when women and men diverge from their traditionally assigned gender roles (Halim et al., 2019[19]; Vyas and Jansen, 2018[12]). This may at least in part explain why the lifetime prevalence of IPV is slightly higher among employed women (46%) than unemployed women (44%), discouraged women workers (41%) and inactive women (33%). Similarly, other studies in Tanzania have found that men engaged in unpaid or paid in-kind work had higher rates of physical or sexual violence against women in relationships (Vyas and Jansen, 2018[12]).

Female genital mutilation/cutting (FGM/C)

FGM/C is concentrated in specific regions of Tanzania

More than 2 million women in Tanzania (12% of the female population) report having experienced FGM/C. In comparison, data from the global SIGI estimated that 38% of women and girls had undergone FGM/C in East Africa 11 in 2019 (OECD, 2021[7]). Tanzania’s national average conceals wide regional variations, and, the practice of FGM/C is mainly confined to specific regions within the country, as demonstrated by the significant regional variation in the prevalence of excision. FGM/C is most widespread in northern Tanzania but virtually inexistent in Zanzibar. While data show that FGM/C is not practised in 12 of the country’s regions,12 its prevalence exceeds 30% in six regions,13 including 58% in Arusha and 63% in Manyara. Moreover, the share of rural women who have undergone excision (15%) is significantly higher than the share of urban women who report the same (7%) (Figure 4.8).

Figure 4.8. The age profile of women who have suffered from FGM/C indicates a decline in the practice

Share of women aged 15 years and over who have experienced FGM/C

Note: Differences between urban and rural areas are statistically significant at the 5% level. Differences between 15-19 and all age groups of women aged more than 40 years are significant at the 1% level. Differences between 20-29 and all age groups of women aged more than 40 years are significant at 1%-level. Differences between 30-39 and all age groups of women aged more than 40 years, except for women aged more than 70 years, are significant at the 1% level.

Source: (OECD, 2021[8]), SIGI Tanzania database, https://stats.oecd.org.

StatLink https://stat.link/b23poy

The age profile of women who have been cut suggests that the practice of FGM/C is gradually disappearing in most parts of Tanzania. At the national level, 20% of women aged between 60-69 years have been subjected to FGM/C. This rate decreased to 17% and 18% for women aged 50-59 years and 40-49 years, respectively. Furthermore, this rate drops to 10% for women aged 30-39 years. Among the youngest generations – women aged 15 to 19 years and 20 to 29 years – the share of women who have been excised is just 5% and 6%. This statistically significant downwards trend across generations suggests that FGM/C is being progressively abandoned as a harmful practice (Figure 4.8).

There are four forms of FGM/C all of which are known to provoke severe health consequences for women and girls and have far-reaching implications for their human capital development (Table 4.2). In Tanzania, the most common forms of FGM/C are Types 1 and 2, which entail the partial or total removal of the clitoris and/or cutting of the labia minora to remove flesh (28 Too Many, 2013[21]). It is well documented that all types of FGM/C can have serious and long-lasting health consequences for women and girls including urinary and vaginal problems, and increased risk of complications during childbirth, as well as psychological problems (WHO, 2020[22]). In Tanzania, 18% of women and girls who have been cut report having experienced health complications as a result. As the health consequences of FGM span generations, the practice can represent an important economic burden for countries. Using the prevalence rate found by the SIGI Tanzania, the World Health Organization’s (WHO) FGM Cost Calculator estimates that the practice resulted in health care-related costs of nearly USD 9.4 million in 2019 14 (WHO, 2021[23]).

Table 4.2. Types of FGM/C
Form of of FGM/C	Description
Type 1	Excision of the prepuce and part or the entire clitoris
Type 2	Excision of the prepuce and clitoris together with partial or total excision of the labia minora
Type 3	Infibulation – excision of part or all of the external genitalia and stitching together of the two cut sides, to varying degrees
Type 4	Pricking, piercing, incision, stretching, scraping or other procedures harming the clitoris or labia, or both
Source: (OHCHR, UNAIDS, UNDP, UNECA, UNESCO, UNFPA, UNHCR, UNICEF, UNIFEM, WHO., 2008[24]), World Health Organization: Eliminating female genital mutilation: An interagency statement, http://apps.who.int/iris/bitstream/handle/10665/43839/9789241596442_eng.pdf.

FGM/C in Tanzania is performed primarily on young adolescents by a traditional cutter upon instructions from the parents – and in many cases the mother of the girl. Although the reported age at excision ranges from 1 to 29 years, the average age for Tanzanian women is 10.7 years with a median age of 10 years. These characteristics tend to hold true regardless of the women’s current age or area of residence. The majority of Tanzanian women who have been cut (60%) reported that a traditional cutter performed the practice while a significant share reported being excised by a traditional midwife (18%). Some 13% of women did not know who performed their excision, likely reflecting their young age at the time.

In the vast majority of cases, the decision to perform FGM/C is not made by the woman or girl herself, due in part to the young age at which FGM/C is performed. Indeed, only 5% of women who have been cut took the decision themselves. The low percentage of women who chose to undergo FGM/C is likely related, at least in part, to the age at which the practice is performed in Tanzania – between 9 and 11 years old. Children often lack decision-making power, and this appears indeed to be the case with FGM/C. The majority of women (55%) reported that both of their parents made the choice, while 18% stated that their mother took the decision, and 6% identified their father as the decision maker; 7% of women did not know who took the decision.

The six regions where FGM/C is most common – Arusha, Dodoma, Kilimanjaro, Manyara, Mara and Singida – present similar characteristics in terms of the practice. However, there are some specific differences relating to the average age at which excision takes place as well as the primary decision maker. In four of these six regions – Arusha, Dodoma, Manyara and Singida – the average age at which girls are cut is below the national average. For example in Dodoma, the average age is 8.8 years, nearly 2 years younger than the national average age. In Dodoma and Singida, a sizeable proportion of women – 45% and 38%, respectively – did not know at what age they were cut, likely signalling that they were very young at the time. In the other two regions, Kilimanjaro and Mara, the average age at which girls are cut is above the national average at 12.7 years. In terms of decision making, the majority of women in all of these regions, as with Tanzania as a whole, reported that both of their parents took the decision. However, in some regions, the individual decision maker was not identified.15 In all of these regions combined, 12% chose “other” when asked who took the decision to carry out FGM/C, a proportion that was as high as 23% in Mara. In Tanzania as a whole, less than 4% chose this option.

Discriminatory norms perpetuate the practice of FGM/C and are particularly acute in regions where FGM/C is more common

FGM/C is widely opposed in Tanzania as a harmful practice. On average, 91% of the population, including very similar shares of women and men, agrees that the practice of excision should be abandoned. Opinions in favour of the abandonment of FGM/C are slightly but significantly lower in Zanzibar with only 86% of the population in favour. Moreover, 94% of respondents across all of Tanzania report that if they have or had a daughter, they would not want her to be excised. Interestingly, the share of the population affirming this view is higher in Zanzibar than in Mainland Tanzania. Conversely, just 6% of the population on average held the view that FGM/C should continue and would want their daughter to undergo the practice.

While on average the vast majority of people in Tanzania believe that FGM/C should be abandoned, regional variations in attitudes persist. In 23 regions,16 the share of people in favour of abandoning the practice is at or greater than 90%. The regions with the smallest share of people agreeing with this view were Morogoro (55%) and Kaskazini Pemba (58%). Notably, in the six regions 17 where FGM is most prevalent, 88% think that the practice should be abandoned.

FGM/C is rooted in beliefs about sexually appropriate behaviour and norms for women and is performed as part of a rite of passage marking a girl’s transition to womanhood with implications for marriage. In Tanzania, some communities continue to believe that FGM/C preserves virginity, prevents promiscuity and ensures faithfulness in marriage (UNFPA Tanzania, 2019[25]; Children's Dignity Forum; FORWARD, 2010[26]). Furthermore, in some communities, FGM/C is a prerequisite for marriage. As a result, women and girls often face social pressure to undergo FGM/C, and the practice can impact the bride price given for her marriage (Avalos et al., 2015[27]).

Perceptions of FGM/C as a practice closely related to customs persist in certain parts of the country. Although only a very small share of the population (6%) consider the practice to be mandated by religion, a large proportion regard FGM/C as part of traditional customs (79%). The latter perception is significantly more widespread in Mainland Tanzania, where 80% of the population believe that the practice is mandated by traditional customs, than in Zanzibar where these beliefs are shared by 52% of the population. There is significant variation on this matter across regions. In only seven regions,18 less than half of the population holds the view that FGM/C is mandated by traditional customs, while more than 90% of people take this view in 11 of Tanzania’s regions.19 Of particular interest is the case of Singida, which has one of the highest prevalence rates of FGM/C; however, just 27% of the population states that FGM/C is a practice mandated by traditional customs.

In certain regions, discriminatory attitudes that support the continuation of FGM/C have a bearing on the relatively high shares of women that have been cut. Controlling for various socio-demographic factors, more acute levels of discriminatory attitudes in regions of Mainland Tanzania result in higher shares of women who have been subjected to FGM/C (Figure 4.9, Panel A).20 Likewise, the share of the population declaring that they would want their daughter, if they have or had one, to be excised, has a strong and significant bearing on the prevalence rate of FGM/C as measured in Mainland Tanzania (Figure 4.9, Panel B).21 At the regional level, there is some variation in this attitude. On the one hand, in 16 regions 22 the share of people that say they would want their daughter to undergo FGM/C is smaller than 3%. Among these is Dodoma, which features one of the highest prevalence rates of FGM/C among Tanzania’s regions. On the other hand, 26% of people in Arusha and 14% in Kilimanjaro and Tanga would want their daughter to be excised. Arusha and Kilimanjaro are also among the regions where FGM/C is the most widespread.

Figure 4.9. Discriminatory attitudes that support the continuation of FGM/C have a bearing on the share of women who have been cut

A high percentage of men and women are aware of and support laws that criminalise FGM/C. At the national level, 83% of men and 80% of women are aware of the existence of a civil law criminalising FGM/C (Box 4.2). Furthermore, focus group discussions revealed that many people believe the practice of FGM/C has declined significantly in their community and is mainly kept secret, due to the strict disciplinary measures introduced by the government (Mbuyita, 2021[14]). Overall, the population also seems supportive of legislation to criminalise the practice. Furthermore, 94% of men and women agreed that if there was a law enacted to address violence against women, it should include criminal penalties for FGM/C.

Box 4.2. Legal frameworks on FGM/C in Tanzania

Tanzania does not have a comprehensive law on FGM/C. However, under the Sexual Offences Special Provisions Act 1998 (SOSPA), individuals who have custody, care or charge over a girl under the age of 18 years, face criminal penalties if they cause her to undergo FGM/C (Government of Tanzania, 1998[28]). The law does not offer a specific definition for FGM/C. The offense is subject to imprisonment and/or fines and the law provides for the compensation of the victim by the perpetrator. Nevertheless, the law does not offer a specific definition for FGM/C and it remains legal for women over the age of 18 years to be cut.

Reproductive autonomy

Women’s sexual and reproductive health and rights, including their freedom to control their own fertility, have been widely recognised by the international community as fundamental human rights. Women’s reproductive autonomy entails the ability and freedom to control and make decisions concerning contraceptive usage, childbearing and pregnancy. These abilities and freedoms are critical for women’s empowerment as they impact their health as well as their capacity to pursue activities such as education, employment and entrepreneurship. As such, restrictions on women’s reproductive health represent a cost to Tanzania’s economy by limiting the human capital development of women. This section begins with an overview of Tanzania’s commitment to this area. It then discusses issues surrounding family planning including contraceptive usage and unmet need for family planning, as well as adolescent pregnancy, access to sexual and reproductive education and healthcare, and abortion-related services. Evidence is presented throughout the section to illuminate the role discriminatory social institutions play in restricting women’s reproductive autonomy in Tanzania.

In Tanzania, numerous plans are in place to address sexual and reproductive health. The Health Sector Strategic Plan July 2021–June 2026 (HSSP V), like its predecessors, includes Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH) as a priority area (MHCDGEC, 2021[29]). The HSSP V seeks to improve maternal, newborn, child and adolescent well-being by strengthening the availability and accessibility of health and nutrition services. In the context of this long-term commitment, the number of health facilities providing these services has increased from 3 369 to 7 268 between 2007 and 2019 (MHCDGEC, 2021[29]). The HSSP V also aims specifically to reduce adolescent pregnancy by improving the availability of sexual and reproductive health services for young people (MHCDGEC, 2021[29]). In addition, the National Family Planning Costed Implementation Plan 2019-2023 aims to improve access to, demand for and quality of family planning services and information in Tanzania (MHCDGEC, 2019[30]). Notably, the plan’s strategic priorities seek to address “social norms that hinder individuals from using contraception to delay, space, or limit births” and to increase “age-appropriate information about, access to, and use of contraceptives among young people aged 10–24” (MHCDGEC, 2019[30]). Finally, the Zanzibar Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH) Strategic Plan 2019–2023 includes multiple strategic objectives to improve service delivery and quality, in order to promote reproductive health among other goals (Ministry of Health, Social Welfare, Elderly, Gender, and Children Zanzibar, 2019[31]).

Access to and uptake of family planning among women and men in Tanzania is uneven across geography, age group and other sociodemographic factors

Family planning enables individuals and families to choose and attain their desired family size by controlling the number of children they have and spacing their births. The ability to limit and control the spacing of births can have a critical impact on women’s health, well-being and empowerment. The Protocol to the African Charter on Human and Peoples' Rights on the Rights of Women in Africa (the “Maputo Protocol”) calls on states to ensure women’s sexual and reproductive health, which entails their rights to control their fertility; decide whether, when and how many children to have; and to choose a method of contraception, as well as to have access to family planning education (Article 14). Furthermore, the Protocol calls on States parties to authorise “protect the reproductive rights of women by authorising medical abortion in cases of sexual assault, rape, incest, and where the continued pregnancy endangers the mental and physical health of the mother or the life of the mother or the foetus” (Article 14, Section 2) (Box 4.3).

Box 4.3. Laws and social norms related to abortion in Tanzania

Abortion is illegal under Tanzania’s law

Abortion is illegal under the Penal Code for both the woman herself and practitioners such as medical professionals. The Code states that “Any person who with intent to procure miscarriage of a woman whether she is or is not with child unlawfully administers to her or causes her to take any poison or noxious thing or uses any force of any kind, or uses any other means whatsoever, is guilty of a felony and is liable to imprisonment for fourteen years” (Government of Tanzania, 1981[32]). Moreover, section 151 of the Code states that “Every woman being with child who with intent to procure her own miscarriage unlawfully administers to herself any poison or other noxious thing, or uses any force of any kind, or uses any other means whatsoever, or permits any such thing or means to be administered or used to her, is guilty of a felony, and is liable to imprisonment for seven years.” Tanzania has not adapted its domestic law to align with Article 14, Section 2 of the Maputo Protocol.

Views on abortion depend on circumstances

Some 96% of the population, including similar shares of men and women, disagree that abortion should be available without restriction. However, examination of specific situations and circumstances reveals more nuanced attitudes towards abortion. There is wide support for abortion in circumstances where the mother’s or foetus’s life is at stake. At the national level, 76% of the population considers that abortion should be allowed to save a woman’s life and 79% believes it should be allowed in cases of foetal unviability. Conversely, there is less support for legalising abortion under other circumstances. For example, 25% of the population believes that abortion should be permitted in order to preserve the mental health of the woman, 28% believes it should be allowed to preserve a woman’s physical health, and 26% believes it should be permitted in cases of rape, statutory rape or incest (Figure 4.10).

Figure 4.10. Support for legal abortion varies depending on the circumstances

In Tanzania, there is wide variation in the use, methods and sources of contraceptives

The use of contraception methods entails a number of health benefits. These include preventing unwanted pregnancies, ensuring an optimal spacing of children, and reducing the risks of adverse maternal and perinatal and infant mortality (Chen et al., 2016[33]; Singh, Bankole and Darroch, 2017[34]; Ajayi, Adeniyi and Akpan, 2018[35]). Among the total population, 31% of people report that they and/or their partner use a contraceptive method to delay or avoid pregnancy (Figure 4.11, Panel A). There are no differences in this figure among urban and rural areas; however, in Zanzibar the share of the population that reports using contraceptives (17%) is much lower than the equivalent share in mainland Tanzania (32%).

Figure 4.11. Women primarily use modern contraceptive methods

While the majority of women using contraceptive methods rely on modern methods, the use of traditional and natural methods is also prevalent in Tanzania. Such natural methods of contraception have been shown to have lower efficacy in typical use than modern methods of contraception (WHO, 2020[36]). Modern contraceptives methods include female and male sterilisation, intrauterine devices, injectables, implants, pills, male and female condoms, and emergency contraception. Natural methods include the calendar rhythm method, as well as the Lactational Amenorrhea method, withdrawal and more. A third category consists of traditional methods usually provided by traditional healers. In Tanzania, among women using any contraception method, 88% rely on modern methods compared to 7% who practice a natural method and 5% who report using a traditional method (Figure 4.11, Panel B). The use of traditional and natural contraceptive methods is more common in some regions than others. For example, the share of women using natural methods exceeds 20% in Kilimanjaro, Tanga and Singida, and in Singida and Kaskazini Pemba the share of women using traditional methods is greater than 20%.

Understanding the available sources of modern family planning methods and how they vary across different groups of women is crucial to improving women’s access to contraception and guaranteeing equitable access. In Tanzania, the public sector plays an important role in providing modern methods of contraception. Almost 38% of women of reproductive age rely on public dispensaries and 16% of women obtain their contraception method from public centres. In addition, over one-third of women aged 15-49 years who are using contraception seek contraceptive services from public hospitals, while only 3% of women use these services from private hospitals. Young women, more so than any other age group, receive contraceptives from pharmacies – 18% and 10% of women aged 15-19 and 20-24 years use a pharmacy compared to less than 4% of older women. Research on contraceptive usage in Morogoro found that young people fear the stigma and lack of privacy at health centres, and prefer to use pharmacies to obtain contraceptives (Rusibamayila et al., 2017[37]).

The data on decision making show that choices regarding contraceptive usage and family size are often made jointly in Tanzania. Overall, 62% of women report that they and their partners decided together to use a specific contraceptive method. However, joint decision making does not necessarily imply equal influence, and in practice, men often adopt the role of the primary decision maker (Sundararajan et al., 2019[38]). Just 28% of women report taking the decision to use contraceptives by themselves, while 10% report that the decision was made by their partner alone. Similarly, decisions on how many children to have are made mostly by both partners/spouses, while 15% say it was the man alone and 12% say it was the woman alone. Only marginal differences in decision making are apparent between rural and urban areas, with 70% of people in rural areas and 67% in urban areas reporting that decisions on the number of children are taken as a couple. At the regional level, joint decision making regarding family size is more common in some regions than in others. For example, in Kilimanjaro and Gieta more than 90% of respondents report making these decisions jointly with their partner, while this proportion was significantly smaller in Kusini Unguja at 9%. Notably, 90% of women in Kusini Unguja report making this decision themselves, while 84% of men also report taking this decision alone.

In the face of unequal decision-making power, even in joint decision-making processes, as well as actual or perceived opposition to contraception particularly from partners and spouses, many women choose to use contraceptives covertly (Mbuyita, 2021[14]; Mosha, Ruben and Kakoko, 2013[39]). Discussions with Tanzanian women revealed that many women did not inform their husbands that they were using contraceptives, believing that their husbands would not approve (Mbuyita, 2021[14]). In Tanzania, among women using contraceptives, 11% report that their spouse/partner did not know that this was the case, rising to nearly 15% among women aged 20-24 years. Covert contraceptive usage 23 among women was also more prevalent in Zanzibar (19%) than in Mainland Tanzania (11%). Moreover, in urban areas, the share of women using contraceptives without informing their husband/partner (14%) was higher than in rural areas (9%). Across regions, there is variation in the prevalence of covert contraceptive usage, ranging from 31% in Mara and Njombe to less than 3% in Kilimanjaro and Rukwa.

A large share of Tanzanian women and especially adolescent women have unmet needs for family planning

Women’s unmet need for family planning refers to the proportion of women of reproductive age 24 who report not desiring any more children or who want to postpone having their next child but who are not using contraception (United Nations, n.d.[40]). In Tanzania, an average of 38% of women of reproductive age report having an unmet need for family planning (Figure 4.12). At the sub-national level, the share of women aged 15-49 years reporting an unmet need for family planning is higher in Zanzibar (56%) than in Mainland Tanzania (37%). Moreover, in rural areas, the prevalence of unmet need for family planning (39%) is slightly higher than in urban areas (35%). There are important variations across regions. The prevalence of unmet need for family planning ranges from 8% in Mtwara to 74% in Mwanza. In 11 regions,25 the share of women who do not desire to have more children or want to postpone having their next child but who are not using contraception is higher than 50%.

Not currently having a partner or a spouse is the most common reason for not using contraception methods among Tanzanian women. In fact, 48% of women with unmet needs for family planning cited not currently having a partner or spouse as the reason for not using any contraceptive method. In addition, 12% of women cite concerns about side effects associated with contraceptive usage, 4% report that they have sex infrequently and nearly 3% cite religious reasons. Opposition by husbands was rarely cited among the reasons women gave for not using contraception (3%). Married women were much more likely to report not using contraceptives because their spouse does not approve of their use – this was the case for 7% of married women compared to less than 1% of single and un-married cohabiting women.

Unmet need for family planning is highest among 15-19 year-old and 40-49 year-old women. Among women aged 45 to 49 years, 60% report having unmet needs for family planning. Likewise, a large share of women (44%) aged between 40 and 44 years declare having unmet needs. These high shares of older women with unmet needs for family planning may reflect the fact that they are biologically less likely to become pregnant than younger women. At the other end of the age distribution and at greater risk of unintended pregnancy are women aged 15-19 years, among whom 54% indicate having an unmet need for family planning. The age group with the smallest unmet need for family planning is women aged 30-34 years, among whom 22% report having an unmet need for family planning.

Figure 4.12. More than one-third of Tanzania women have unmet needs for family planning

At the national level, 33% of women were pregnant for the first time before reaching 20 years of age. The share of women who had their first pregnancy before 20 years of age was higher in mainland Tanzania (33%) than in Zanzibar (27%). Furthermore, adolescent pregnancy was more common in rural settings than in urban areas: 35% of women had their first pregnancy before turning 20 in the former compared to 29% in the latter (Figure 4.13). Across Tanzania’s regions, there is clear variation in the prevalence of adolescent pregnancy. In nine regions,26 more than 40% of women who have had at least one child, had their first pregnancy before the age of 20 years old. Meanwhile, the share of women who were pregnant during adolescence was lower than 20% in just three regions – Kilimanjaro, Mjini Magharibi and Tanga.

In recent years, the prevalence of adolescent pregnancy seems to have increased (UNFPA Tanzania, 2018[41]). The share of women who had their first pregnancy below the age of 20 years varies among different age cohorts, but analysis across age groups shows that it has become increasingly common. Among women aged 30-34 years old, 33% had their first pregnancy before the age of 20 years. This share increased to 35% for women aged 25-29 and to 45% among women aged 20-24 years. This 10-percentage point rise signifies a notable increase in adolescent pregnancy in Tanzania (Figure 4.13).

Figure 4.13. Rates of adolescent pregnancy in Tanzania are high and worsening

In Tanzania, addressing adolescent pregnancy is a key priority, especially taking into consideration the serious consequences for women’s and girls’ health, education, well-being and empowerment (Hindin, 2012[42]). Globally pregnancy and childbirth-related complications are the leading cause of death among adolescent girls, and adolescent pregnancy also entails severe consequences for the lives of women and girls as well as society as a whole (WHO, 2021[43]). Adolescent pregnancy, especially among girls whose bodies are not yet physically ready, presents significant risks including complications during labour, postpartum haemorrhaging and obstetric fistula. Moreover, evidence shows that the children of adolescent mothers face higher rates of mortality and malnutrition (UNDP, 2016[44]). Furthermore, adolescent mothers may face stigma and social isolation as pregnancy and childbearing outside of marriage is regarded by many in Tanzania as a source of shame (see Chapter 3). Adolescent pregnancy also negatively affects Tanzanian society as a whole, notably by suppressing human capital. Pregnancy during adolescence can lead to interruptions in women’s and girls’ education and accumulation of skills, with negative impacts on their economic empowerment and Tanzania’s overall levels of human capital.

Women who have their first child before the age of 20 years have lower levels of overall educational attainment and face higher rates of child marriage and IPV than women who had their first child at or after the age of 20 years. A higher share of women who were pregnant during adolescence have no formal education or did not complete primary education than women who had their first child after reaching 20 years of age. Under such circumstances, women leaving or never entering schooling may be related to the pregnancy and related time demands of childrearing. Furthermore, the average age of marriage among women who were pregnant as adolescents (18.7 years) is nearly three years lower than the average age of marriage among those who were not (21.5 years). Here, early pregnancy may drive girls to get married in order to avoid the shame of a pregnancy outside of marriage. Alternatively, early pregnancy may follow an early marriage (see Chapter 3 for details on the link between child marriage and adolescent pregnancy). Finally, prevalence rates of lifetime IPV are higher among women who had their first child before the age of 20 than among those who had their first child after that age. While 65% of women who were pregnant as adolescents report having experienced IPV at least once in their lifetime, the same rate for women who had their first pregnancy after reaching 20 years was lower at 51%.

Discriminatory social norms and gendered power imbalances restrict women’s and girls’ reproductive autonomy

One of the norms of restrictive masculinities is that “real” men should dominate sexual and reproductive choices. This norm maintains that men should be the primary initiators of sexual activity and deciders over contraceptive usage, family size and birth spacing (OECD, 2021[18]). In Tanzania, attitudes associated with this norm vary among the population, specifically in relation to women’s reproductive autonomy. Among respondents, 37% declared that women should not have the right to decide whether to use contraception. While there was little difference between rural and urban areas in terms of agreement with this view – 38% and 34%, respectively – the difference was much more significant between Mainland Tanzania and Zanzibar. In Mainland Tanzania, 36% of respondents believe that women should not have the right to take decisions regarding their own use of contraception; in Zanzibar, the share is somewhat higher at 51%. There are also important differences in the popularity of this attitude among Tanzania’s regions. In Pwani and Kusini Unguja, 16% and 19% of people hold this view, respectively, while in Kaskazini Pemba and Kusini Pemba, the equivalent shares are 70% and 66%.

While family planning may be widely regarded as a “woman’s issue”, men play an important role in reproductive decision making, whether as sole deciders or partners in joint decision making (Sundararajan et al., 2019[38]; Mosha, Ruben and Kakoko, 2013[39]). As such, their attitudes regarding contraceptives strongly guide outcomes. The share of men in Tanzania who disagree or strongly disagree that a woman should have the right to decide whether to use contraception is 34%, while among women it is 29%. Religious belief plays an important role in attitudes towards contraceptive usage (Sundararajan et al., 2019[38]). Indeed, in focus group discussions, a majority of men, as well as community and religious leaders, spoke out against the use of contraceptives (Mbuyita, 2021[14]). For example, discussions with men aged 20-50 years in Shinyanga highlighted the role that religious beliefs play in reproductive choices, and in discussions with religious leaders it was clearly stated that child spacing should not be managed by individuals through the use of contraceptives, but rather left to God (Mbuyita, 2021[14]). Opposition among men to women’s use of contraceptives is also linked to fears about marital infidelity as the use of a contraceptive would prevent an affair from being discovered, with additional concerns related to the potential health-related side-effects associated with the use of modern contraceptives (Mosha, Ruben and Kakoko, 2013[39]).

Reproductive choices, especially those concerning family size, are influenced by attitudes in favour of traditional decision-making processes, which are characterised by power imbalances between men and women in which men hold the final word on decisions, especially within the context of relationships (OECD, 2021[18]; Mbuyita, 2021[14]). In Tanzania, 40% of men disagree or strongly disagree that a woman should have the right to decide how many children she wants to have, and 38% disagree or strongly disagree that a woman should have the right to decide when she wants to have a child. The share of men holding these discriminatory attitudes was higher in rural areas than in urban areas, and greater among married/cohabiting men than among single men. Furthermore, in some regions, these beliefs were more widespread. For instance, Kaskazini Pemba and Kusini Pemba were the regions where the highest share of men report having these discriminatory views with 77% and 73% of all men opposing women’s right to decide how many children she wants to have.

Gender inequality and power imbalances between women and men and boys and girls impede women’s and adolescent girls’ ability to negotiate safe sex and avoid unwanted pregnancy. Rooted in gendered power imbalances, sexual violence against girls is an important factor that likely contributes to adolescent pregnancy. In rural Tanzania, 17% of women reported that their first sexual encounter was forced intercourse and 43% stated that their first experience of sex took place at the age of 14 (McCleary-Sills et al., 2013[45]). Furthermore, many girls report feeling pressure, mainly from men and boys, to engage in sexual activity from a young age (McCleary-Sills et al., 2013[45]). Among women and girls aged 13-24 years who had ever been pregnant, more than 6% reported that a least one pregnancy was the result of sexual violence (Government of Tanzania, 2011[46]).

Among all respondents, 39% of people are of the opinion that a girl could become a mother before the age of 18 years. This share of the population is much larger in rural than in urban areas at 46% and 28%, respectively. In Tanzania, the average age at which respondents believed a girl can get pregnant/become a mother was 17.5 years. In Mainland Tanzania, the average age was 17.4 years, while in Zanzibar the average age was 18.2 years. In urban areas, the average age was one year older (18.1 years) than in rural areas (17.1 years). Furthermore, there is variation in the average age given by respondents across regions. Indeed, the average age at which individuals believe a girl can become pregnant/a mother ranged from 19.6 years in Morogoro to 15.0 years in Kigoma. Notably, the average age at which a boy could become a father was systematically higher at 20.2 years, and only 21% of respondents supplied an age below 18 years.

Sexual education can have an important bearing on sexual and reproductive health outcomes

Sexual and reproductive education can contribute greatly to reducing unmet needs for family planning and adolescent pregnancies (Figure 4.14). This education equips individuals with the information they need not only to avoid unwanted pregnancy, sexually transmitted diseases and infections including HIV-AIDS but also to learn about sexual and reproductive rights. Slightly more than half of the population in Tanzania has received sexual education (55%), with the share of women who report having received this education or knowledge (66%) higher than the share of men (45%). There are also important differences in the share of the population with sexual education within Tanzania. While 84% of the population in Manyara received sexual education, there are four regions 27 where this share is at or below 40%. Knowledge about family planning in particular can be a key determinant in the use of family planning methods.

While knowledge of sex and reproduction is critical for both men and women, social norms continue to position this as a “women’s issue”. In Tanzania, the vast majority believe that sexual education should be available to both boys and girls; however, a greater share of the population supports sexual education for girls (97%) than for boys (90%). There is little difference in these views among urban and rural areas. The belief that sexual education is not as important for men and boys as it is for women and girls contributes to suboptimal sexual and reproductive health outcomes. For example, research shows that men in Pwani who received family planning knowledge were 26 times more likely to use family planning methods than those who did not (Msovela et al., 2020[47]). Furthermore, as men have significant influence, if not the final say, in sexual and reproductive choices, sexual education is critical to improving the likelihood of fact-based decision-making.

Figure 4.14. Women's sexual education may delay first pregnancies

Sexual education is also an important part of addressing unmet needs for family planning. Misinformation around contraceptives, especially modern contraception methods, is a factor contributing to low uptake rates (Rusibamayila et al., 2017[37]). Focus group discussions in Mwanza revealed that both women and men were concerned about false information they had received about side effects related to contraceptive usage. Some men stated that these fears prevented them from allowing their wives to use contraceptives including the potential financial implications of these side effects (Mosha, Ruben and Kakoko, 2013[39]). In a context in which women face limited agency over their access to family planning, misinformation about contraceptives, especially among men, is a critical barrier.

Health centres function as the main source of sexual education and knowledge for both men and women in Tanzania, accounting for 88% of women and 67% of men who received this information. One of the reasons for this gendered difference may be that antenatal and postnatal visits to health centres were a forum in which women learned about family planning, while men did not accompany women on these visits (Sundararajan et al., 2019[38]; Msovela et al., 2020[47]). Schools and media were also important sources for knowledge on sex and reproduction. Some 25% of men and 13% of women stated that they received sexual education in school. While the quality of the information received cannot be evaluated, 28% of men and 17% of women reported receiving sexual education via radio, television and/or the Internet. In focus group discussions, participants confirmed the availability of sexual and reproductive services and information in the health facilities in their areas (Mbuyita, 2021[14]).

Policy recommendations

Violence against women

Consider the enactment of legislation that specifically addresses gender-based violence against women and girls and includes a comprehensive definition of domestic violence that covers physical, sexual, psychological and economic abuse.
Consider expanding the statute of limitations on sexual harassment beyond 60 days to allow victims/survivors more time to file complaints and access justice.
Ensure that the legal definition of rape provides protection from marital rape.
Support programmes, including those offered by civil society organisations, that engage men and boys as allies in ending violence against women and girls.
Collect regular data on masculine norms to inform policies and programmes to support the transformation of masculinities.
Develop and run advocacy campaigns designed to promote the reporting of violence, specifically gender-based violence.
Establish educational programmes and campaigns to shift norms around the use of corporal punishment on children by parents and guardians.
Adopt a complete ban of corporal punishment in schools and continue work with teachers and school administrators to end this practice.
Support programmes that take a gender-transformative approach that actively engage men and women in identifying and challenging gender norms, especially those related to violence.
Undertake quantitative and qualitative research on women’s and girls’ public safety concerns and analyse and disseminate this data and its ability to inform policy discussions (such as on policing) as well as those related infrastructure projects (e.g. related to public transportation, sanitary facilities and more).
Further fund and develop the capacity of One Stop Centres throughout all regions of Tanzania to expand the network and increase access and follow up.

FGM/C

Continue efforts to sensitise the population to the adverse impact of FGM/C on women’s and girls’ health and well-being as well as on society as a whole.
Continue awareness-raising activities and programmes to address and prevent FGM/C in the regions where the practice is most common – Arusha, Dodoma, Kilimanjaro, Manyara, Mara and Singida.
Work within traditional structures to replace the practice of FGM/C in rites of passage into womanhood. Ensure that this work considers the important role that FGM/C plays in the livelihoods of traditional cutters and midwives, and involve them in discussions.
Consider a legal revision that would prohibit FGM/C for women over the age of 18 years.

Reproductive autonomy

Continue efforts to increase demand for and the accessibility of safe, modern contraceptives and information on sexual and reproductive health among the entire population and specifically adolescents.
Work with religious leaders and groups to improve the acceptability of contraceptive usage and to promote women’s role and power in reproductive decisions.
Develop programmes to facilitate men’s and boys’ access to quality information on family planning, reproductive rights and the use of modern methods of contraception.
Support gender-transformative sexual health and reproductive rights programming that targets discriminatory social norms related to women’s reproductive autonomy.
Consider the revision of laws prohibiting abortion in alignment with the Maputo Protocol, specifically to permit the procedure in circumstances widely supported by the population (to save a woman’s life and in cases of foetal unviability).
Make information on the impact and side-effects of contraceptive usage widely available and ensure that health centres and other facilities providing family planning services are equipped with the necessary material to dispel misinformation.

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[1] Vyasa, S. (2019), “Violence Against Women in Tanzania and its Association With Health-Care Utilisation and Out-of-Pocket Payments: An Analysis of the 2015 Tanzania Demographic and Health Survey”, East African Health Research Journal, Vol. 3/2, https://eahrj.eahealth.org/index.php/eah/article/view/609/1028.

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Annex 4.A. The legal framework on violence against women and girls in Tanzania

Legal framework in Mainland Tanzania

In Mainland Tanzania, there is no singular piece of legislation addressing violence against women and girls or gender-based violence specifically. Rather, various forms of violence are covered independently through multiple pieces of legislation. Similarly, no law specifically criminalises domestic violence, although the Law of Marriage Act of 1971 clearly states that “no person has any right to inflict corporal punishment on his or her spouse” (Government of Tanzania, 1971[48]). The Penal Code criminalises acts of physical violence as well as actions, words or gestures that insult the modesty or intrude upon the privacy of a woman (Government of Tanzania, 1981[32]).

The Sexual Offences Special Provisions Act 8 of 1998 (SOSPA) criminalises various sexual offences, including rape, sexual assault and harassment (Government of Tanzania, 1998[28]). Rape is defined as a male having sexual intercourse with a girl (under the age of 18) or woman without her full consent which cannot be gained through fear, intimidation or in a context of intoxication or drugs. The Act recognises marital rape only in instances where the couple is separated, therefore spousal rape is not criminalised. SOSPA as well as the Employment Act No. 11 of 2005 address and penalise sexual harassment (Government of Tanzania, 2005[49]). However, a statute of limitations in the Penal Code prohibits prosecution of harassment after more than 60 days.

Mainland Tanzania’s Law of the Child Act 2009 prohibits “torture, or other cruel, inhuman punishment or degrading treatment” (Article 13); however, corporal punishment is not expressly prohibited (Government of Tanzania, 2009[50]). In 2019, the government banned teachers in the lower grade of primary school from entering classrooms with canes. Nevertheless, the Education (Corporal Punishment) Regulations 1979 established under the National Education Act 1978, which permits the Minister overseeing education to produce regulations on corporal punishment in schools, permits the beating of students’ hands and buttocks with a stick as a legitimate punishment in cases where the student has committed a serious offense (Law Reform Commission of Tanzania, 1994[51]).

Legal framework in Zanzibar

In Zanzibar, a number of laws address violence. As a result of a recent review, new laws were enacted including the Evidence Act 6/2016, which amended the law to permit evidence given by children as well as electronic evidence. The Penal Act 6/2018 replaced the Penal Act of 2004 and increased the punishment for “moral related offences”, including rape. The Criminal Procedure Act 7/2018, which repealed the Criminal Procedure Act No. 7 of 2004, includes a new provision that denies bail to persons accused of gender-based violence, and increases sentences (Zanzibar Assembly, 2016[52]; Zanzibar Assembly, 2018[53]; Zanzibar Assembly, 2018[54]).

Zanzibar’s Children’s Act 2011 states that “no child shall be subjected to violence, torture, or other cruel, inhuman or degrading punishment or treatment or any cultural or traditional practice which dehumanizes or is injurious to his physical and mental wellbeing” (Article 14) (Government of Zanzibar, 2011[55]). The Ministry of Education also has a policy in place prohibiting corporal punishment in schools. Nevertheless, the practice remains legal under the Education Act 1982 (Government of Zanzibar, 1982[56]).

Notes

← 1. Results are based on four probit models measuring (i) the likelihood of having suffered from intimate-partner violence during the last 12 months; (ii) the likelihood of having suffered from intimate-partner violence over the lifetime; (iii) the likelihood of having suffered from non-partner violence over the lifetime; and the likelihood of having suffered from any type of violence over the lifetime. Sex is the main independent variable. For all four models, control variables include: residence (urban/rural and Mainland Tanzania/Zanzibar), age, age squared, marital status, whether the respondent was married before the age of 18 years, level of education, size of the household and wealth quintiles (based on the type of construction material, distance to water and distance to cooking energy). For all four models, coefficients and marginal effects of sex are significant at 1%-level.

← 2. Results are based on two probit models measuring (i) women’s likelihood of having experienced intimate-partner violence over the past 12 months, and (ii) women’s likelihood of having experienced intimate partner violence over the course of their lifetime. Sex is the main independent variable in both models. Control variables include residential status (urban or rural), age, age squared, education level, marital status, child marriage, household size, wealth quintiles (based on the type of construction material, distance to water and distance to cooking energy) and regions. For both models, coefficients and marginal effects of sex are significant at 1%-level.

← 3. Four forms of IPV were assessed: (i) being beaten, slapped or kicked, or being physically assaulted with use of an object; (ii) being humiliated, threatened, insulted, frightened in private or in front of others; (iii) having work or tools used for work damaged, sabotaged or destroyed; and (iv) being forced to have sexual intercourse without consent.

← 4. Non-partner sexual violence refers to rape or forced intercourse and sexual assault, which occurs when one gropes or tries to kiss another person against their will.

← 5. Non-partner sexual assault is defined as the share of individuals who declared that someone other than their current or former spouse/partner has ever groped or tried to kiss them against their will.

← 6. Non-partner rape is defined as the share of individuals that someone other than their current or former spouse/partner has ever forced to have unwanted sexual intercourse.

← 7. Kagera, Manyara and Songwe.

← 8. See SIGI Tanzania Qualitative Report: across all study sites, individuals agreed that women should be submissive among other characteristics.

← 9. The eight circumstances surveyed under which a man could be justified in hitting or beating his wife are if she: burns the food, goes out without telling him, neglects the children, argues with him, buys things without his consent, applies for a new job or engages in a new livelihood without his consent, cheats on him, and files a complaint against him to a higher authority or the police.

← 10. Restrictive norms of masculinities imply that a “real” man should: be the breadwinner, be financially dominant, work in “manly” jobs, be the “ideal worker”, be a “manly” leader, not do unpaid care and domestic work, have the final say in household decisions, control household assets, protect and exercise guardianship, and dominate sexual and reproductive choices.

← 11. Data is available for Djibouti, Eritrea, Ethiopia, Kenya, Somalia, Sudan, Uganda and Tanzania.

← 12. Geita, Kaskazini Pemba, Kaskazini Unguja, Kusini Pemba, Kusini Unguja, Lindi, Mjini Magharibi, Pani, Shinyanga, Simiyu, Songwe and Zanzibar.

← 13. Arusha, Dodoma, Kilimanjaro, Manyara, Mara and Singida.

← 14. Parameters used: Baseline adult prevalence of FGM of 0.12; Baseline FGM type 1/2 proportion of 0.81; and Baseline FGM type 3 proportion of 0.7.

← 15. The options for respondents were: Father, Mother, Both parents, Spouse/partner, Groom, Male relative, Female relative, Yourself, Unknown and Other (specify).

← 16. All except Arusha, Iringa, Mara, Manyara, Morogoro, Kaskazini Pemba, Kusini Pemba and Singida.

← 17. Arusha, Dodoma, Kilimanjaro, Manyara, Mara and Singida.

← 18. Dodoma, Katavi, Kaskazini Pemba, Kusini Pemba, Kusini Unguja, Singida and Rukwa.

← 19. Arusha, Geita, Kagera, Mbeya, Manyara, Mara, Mwanza, Njombe, Pwani, Ruvuma and Songwe.

← 20. Results are based on an OLS regression performed at the regional level on the prevalence rate of FGM/C. The share of the population declaring that FGM/C is a practice that should not be abandoned is the main independent variable. The sample of regions is restricted to Mainland Tanzania. Control variables include urbanisation rate, average age of the population, average number of children, several variables on the marriage status and the type of marriage, variables on the educational level and variables on the level of wealth in the regions. Coefficients and marginal effects of attitudes towards FGM/C are significant at a 10%-level.

← 21. Results are based on an OLS regression performed at the regional level on the prevalence rate of FGM/C. The share of the population declaring that if they have or would have a daughter, they would want her to be excised is the main independent variable. The sample of regions is restricted to Mainland Tanzania. Control variables include urbanisation rate, average age of the population, average number of children, several variables on the marriage status and the type of marriage, variables on the educational level and variables on the level of wealth in the regions. Coefficients and marginal effects of attitudes towards FGM/C are significant at 1%-level.

← 22. Dar es Salaam, Dodoma, Kaskazini Pemba, Kaskazini Unguja, Kigoma, Kusini Pemba, Kusini Unguja, Lindi, Mbeya, Mjini Magharibi, Mtwara, Mwanza, Njombe, Pwani and Songwe.

← 23. Covert contraceptive usage may be interpreted as an indicator of women’s low levels of influence in decision making over contraceptive usage, as a proxy for spousal opposition to contraceptive usage or as a manifestation of unequal levels of sexual education between women and men.

← 24. Women of reproductive age are defined as women aged between 15 and 49 years old.

← 25. Kigoma (50%), Manyara (50%), Tabora (51%), Geita (51%), Shinyanga (51%), Simiyu (59%), Mara (64%), Kaskazini Unguja (66%), Kaskazini Pemba (70%), Kusini Pemba (71%) and Mwanza (74%).

← 26. Arusha, Geita, Kaskazini Pemba, Katavi, Mbeya, Morogoro, Shinyanga, Shongwe and Tabora.

← 27. Tabora, Shinyanga, Mwanza and Kaskazini Pemba.

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