Une infirmière dévouée innove avec une chanson pour amener les Tanzaniens à parler de planification familiale

16 octobre 2019


Reproduit avec la permission de Jhpiego

Sarah Simama, infirmière, assiste une cliente qui souhaite choisir une méthode de contraception pour la planification familiale après une séance clinique au centre de santé de Malamba Mawili. Photo de Zacharia Mlacha.

Des centaines de femmes assises sous deux arbres denses au centre de santé de Malamba Mawili, chantant une chanson dirigée par l'infirmière Sarah Simama. Les paroles de la chanson dépeignent une mère de nombreux enfants:

Regarde cette femme!
She is struggling with her children—
une dans sa main droite,
une à sa gauche,
un autre enveloppé devant et derrière elle
et toute une série de bambins courant devant elle.

Billboard hit … for family planning. A song unlike any other, Simama dreamed it up to deliver a message with impact that draws women from neighboring communities. They come to listen, learn and decide for themselves how to plan their pregnancies in the best interest of their families. They come to access friendly, woman-centered, high-quality health care.

When she started her program 13 months ago, Simama treated a few women per week. Today, more than 100 arrive to access the high-quality health services offered by this dedicated and dynamic nurse. For Simama, being a nurse is not just a profession; it’s her passion. A wife and mother of four, the 44-year-old uses every opportunity available to advocate for women and empower them with knowledge about reproductive health so they can have healthier families.

“I always wanted to be a nurse, ever since I was a child. I even asked my mother several times why she didn’t go for the profession. In the village where I grew up, nurses and doctors were seen as very important people in the community, especially when they saved a person’s life,” she says.

As the matron in charge at Malamba Mawili Dispensary in Ubungo municipality, Simama has led by example to ensure women in her community have access to high-quality family planning services in a warm and welcoming facility. Throughout her career, from nursing school to Iringa Referral Hospital and Njiro Health Center’s nursing and midwifery department, Simama recognized the great need among women for information about reproductive health and pregnancy spacing in an environment that put them first. While working in an integrated maternal health clinic early in her career, Simama discovered that many women waited for long periods of time to see a health provider, leaving many frustrated. Others just left the clinic.

“I used to feel so bad that women were waiting many hours in my health facility. They looked desperate. I wanted to change that and make them enjoy , especially during the family planning session to make the session more participatory,” she says.

Défi accepté

À Malamba Mawili, où elle travaille depuis juillet 2018, elle a rencontré de nombreuses femmes qui souhaitaient espacer leurs grossesses mais manquaient d'informations sur les méthodes de planification familiale. Formée en tant que prestataire de services de planification familiale et coach auprès du projet The Challenge Initiative (TCI) -Tupange Pamoja, Simama a été une championne de la sensibilisation des femmes aux services de planification familiale mis à leur disposition. Le projet dirigé par Jhpiego, financé par la Fondation Bill & Melinda Gates en collaboration avec le gouvernement tanzanien, a été mis en place dans cinq régions, dont Dar es Salaam, pour développer les services de planification familiale volontaires afin de toucher davantage de femmes et de sauver des vies. et aider à bâtir des communautés saines et résilientes.

Le gouvernement tanzanien a lancé une nouvelle initiative de planification familiale en 2012 après s'être engagé à accroître la disponibilité des méthodes de contraception modernes à tous les niveaux de son système de santé. Reconnaissant que des familles en meilleure santé conduisent à un pays plus prospère, la Tanzanie s'est engagée à augmenter ses dépenses en produits de planification familiale d'environ 20%, passant de 1 milliard 26,1 millions à 1 milliard 27,3 millions d'ici 2020.

Tanzania has engaged policymakers, strengthened outreach services, and challenged traditional norms and family sizes. With one of the highest child marriage prevalence rates in the world, the government’s commitment to reform key policies related to age of marriage, reduce teenage pregnancy and increase youth-friendly reproductive health facilities reflects its vision for a nation of healthier girls and women.

Par exemple, les services de planification familiale ont été fournis à 267 407 femmes dans la région de Dar es Salaam de juillet 2018 à juin 2019. Parmi elles, 80% a reçu une méthode réversible à longue durée d'action dans les établissements soutenus par TCI.

Simama is among those skilled, confident health providers committed to meet clients where they are and offer health messages that speak to their needs. Educating women on family planning through song was her way of conveying a strong message that women wouldn’t easily forget. Through a variety of integrated approaches and outreach, she has worked to expand family planning efforts to other service areas within her facility over the past three years, increasing acceptance and reducing missed opportunities to consider contraception.

Simama remembers one of her first clients, a 37-year-old mother who had given birth seven times. “She looked older than her age and was very desperate not to have more babies,” she says. “Unfortunately, her husband also was not well informed about modern family planning and contraception. I took her through a family planning session and asked her husband to come as well.”

After their counseling session, the couple decided voluntarily to choose a family planning method right for them. “Now they are rejuvenated,” Simama says.

Une chanson qui colle

Simama’s use of song spread quickly among government health providers who support the TCI project.

“From the first time, I saw her singing and dancing a song that has lyrics about the importance of family planning and the risks to women’s health associated with not accessing family planning, I was interested and decided to follow up,” says Rose Mnzava, who leads the TCI project in Tanzania.

TCI’s work in women’s health is making an impact.

“Women who attend family planning sessions at the facility are now increasing. They have become the champions to advocate for their partners and other women in their community,” Mnzava says. “I have never met any nurse like Sarah, who is so passionate. That song is so touching, and even when sung at home, it’s easy to pick up by other woman and even a husband because the message is powerful and tells the truth.”