The U.S. Agency for International Development (USAID) Tulonge Afya project, which means “let’s talk about health” in Kiswahili, created opportunities for Tanzanians to improve their health status by working to transform sociocultural norms and by supporting the adoption of healthy behaviors.

Although rates of HIV, AIDS, malaria and tuberculosis, as well as sexual and reproductive health-related mortalities, have been declining in Tanzania in recent years, these concerns persist for many Tanzanians — and disproportionately affect women and young people. The five-year USAID project sought to address these issues through the application of a comprehensive, integrated social and behavior change (SBC) approach.

By addressing social and cultural norms, and SBC system needs, FHI 360:

• Improved the ability of individuals to practice healthy behaviors.
• Strengthened community support for improved health behaviors.
• Improved systems for the coordination and implementation of SBC interventions.

Through close collaboration with the government of Tanzania (GOT), local stakeholders and partners, and communities, FHI 360 designed and delivered integrated SBC platforms that contributed to SBC impacts and increased our understanding of quality integrated SBC programming. These platforms combined national-level mass media and social media with a suite of co-designed and co-delivered community-level SBC activities, provider behavior change initiatives, and digital tools and supporting toolkits.

Key project achievements include:

• Addressing the needs of pregnant women, their partners, and parents and caregivers of children under five through the Naweza (“I can” in English) platform, including contributing to increases in antenatal care attendance, facility delivery, prevention of malaria in pregnancy, and uptake of postpartum family planning.
• Addressing the sexual and reproductive health needs of adolescents and young people through the Sitetereki (“I am unshakable” in English) platform, including contributing to increases in the use of modern contraceptive methods among sexually active adolescents.
• Supporting the achievement of the national 95-95-95 HIV testing and treatment objectives through the Furaha Yangu (“My happiness” in English) campaign, which led to measurable changes in determinants of HIV testing, treatment initiation, and adherence to and retention in care.
• Supporting the SBC needs of the GOT and implementing partners across priority health areas — including family planning and reproductive health; maternal, newborn and child health; HIV and AIDS; and tuberculosis — as well as providing comprehensive risk communication and community engagement support related to COVID-19 prevention and response.

As part of its sustainability approach, FHI 360 worked with the GOT to develop an online repository of SBC materials, where all project-supported resources are publicly available for reference and use. The repository can be accessed here.