Examining Women’s Agency, High Fertility and Maternal and Child Health in Tanzania

Sam Maghimbi


The paper considers why reproductive health has stalled in Tanzania. The individual
woman in Tanzania gives birth to many children (TFR = 5.2). The demographic and
economic transition is slow and the most striking characteristics is poor and lowly
educated women having many children. The patterns of mortality among girls and
women (and men) are still characterized by a predominance of infectious diseases. This
makes women’s agency in bringing social and economic development so important. The
argument is advanced that child-bearing will go down to replacement level and the
wellbeing of women and children improve if women themselves become active agents of
change or the dynamic promoters of social transformations that can alter their lives and
the lives of children and men. The fundamental changes required to bring this in Tanzania
is to put emphasis on the role of women’s agency. Some decline in infant and under-five
mortality is observed in Tanzania, but it is argued that there is still much space for further
decline in infant, under-five, and maternal mortality. It is further stated that there is much
space to increase life expectancy by promoting active women’s agency.

Keywords: fertility, women’s agency, maternal and child health, Tanzania, life expectancy


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