Use of family planning services and fertility transition in Tanzania

Abstract

Introduction: Under the Sustainable Development Goals (SDGs), modern contraceptive use in East Africa is expected to increase from 43 to 56 per cent between 2017 and 2030. As a result, unmet family planning needs and birth rates are expected to decline. While Tanzania has seen improvements in contraceptive access and use in recent years, the impact on fertility remains unclear. We examined contraceptive use and fertility patterns in Tanzania over the past thirty years.
Methods: Nationally representative cross-sectional data from seven Demographic and Health Surveys (DHS) conducted between 1992 and 2022 were used. The unit of analysis was women of childbearing age (15–49 years). Fertility trends, modern contraceptive use, and unmet needs were analyzed and compared using STATA version 15 for Windows. Some independent variables were included: age in 5-year groups, de jure region of residence, highest level of education, and current contraceptive use by method type.
Results: Between 1992 and 2022, 84,264 women were interviewed in the seven surveys. DHS-2022 included 29,143 eligible women of childbearing potential (mean age: 35.2 ± 8.2). Of these, 84.15% (n=24,524) lived in rural areas, and 52.85% (n=15,402) had no education. Only 38% of currently married women used contraception. The total fertility rate in Tanzania fell from 6.2 to 4.8 (-22.6%). Fertility rates varied regionally between 2.8 (Dar es Salaam) and 6.6 (Simiyu) children per woman (mean: 4.96). Of current nonusers, 23.1% expressed intention to start using contraceptives, while 66.01% did not.
Conclusion: The total fertility rate in Tanzania has fallen significantly. However, many women of childbearing age still do not use contraceptives and have no intention of doing so. Further improvements in access to modern contraceptives and education will have a positive impact on the country's rapidly growing population.