Freedom to choose : Women's possibility to take reproductive decisions in Babati, Tanzania

This thesis study women’s possibility to take reproductive decisions in Babati, Tanzania. Tanzania has one of the highest total fertility rates in Sub-Saharan Africa and hence a high child- and maternal mortality rate. Family planning service can help individuals to reach their reproductive goals but it is not always available or accessible. The purpose is to see what socioeconomic factors affect women’s ability to influence family planning, make a comparison between urban and rural settings, and see if women perceive themselves to have the freedom to choose. A field work in Babati was conducted during three weeks in the spring of 2009. The research questions were answered through a qualitative study with semi structured group interviews, mainly done with women but also with health personnel. The result was analysed through the concepts of gender, power and education. The respondents expressed that the husband is the main obstacle for their possibility to decide over their own fertility. Urban women generally felt free to take reproductive decisions, but rural women did not. The difference between the two settings is explained by women’s negotiating skills that depend on their status within the family and the society. Urban women are more often educated and therefore have more status and more power to influence decision-making, including reproductive decisions. Other problems in rural areas are that family planning services are less accessible and facilities sometimes lack resources. Rural health workers do not always keep statistics which makes it difficult for health planners to know what needs to be improved. The Ministry of Health and other actors need to promote women’s access to the facilities. Further recommendations suggest programs that empower women and educate men in family planning issues