Driving this progress is the Start Small project, implemented by MSI Tanzania in partnership with the Zanzibar Fighting Against Youth Challenges Organisation (ZAFYCO) and the Ministry of Health
Zanzibar. A quiet but significant shift is unfolding across Zanzibar as more young people and families gain access to reproductive health information and services, marking one of the most notable improvements in the islands’ public health landscape.
Driving this progress is the Start Small project, implemented by MSI Tanzania in partnership with the Zanzibar Fighting Against Youth Challenges Organisation (ZAFYCO) and the Ministry of Health.
The initiative has reached thousands of young people in communities, secondary schools and universities, helping to reduce reproductive health risks and strengthen service delivery.
The project was introduced after rising concerns about unplanned pregnancies, sexually transmitted infections and unsafe abortions among students, especially in higher learning institutions.
“This was a crucial step because the problem is more severe than people realise,” ZAFYCO executive director Abdalla Abeid said.
He added that fear, stigma and misinformation have long kept young people from seeking reproductive health services, leaving even secondary school students vulnerable.
To counter these challenges, the project adopted youth-friendly and creative approaches, encouraging open discussions on sexual and reproductive health.
Mr Abeid said misuse of emergency contraceptives was a major issue, with many young people repeatedly using emergency pills without understanding the risks.
He also noted misconceptions among married couples who believed family planning was only meant for unmarried individuals.
Start Small Project manager, Ms Domitira Masalla highlighted door-to-door outreach by community health workers and the establishment of school-based clubs, which have become safe spaces for students to discuss sensitive issues.
“We created spaces where young people could safely share their concerns,” she said. The project also provides life skills and entrepreneurship training to help the youth plan their futures while making informed decisions about their health.
At the State University of Zanzibar (SUZA), the impact is visible. Deputy Minister for Health and Environment in the student government, Thani Othman Abdulrahman, said the education “helped me understand myself and what I need to do.”
He noted that many students hesitate to seek help, with some dropping out due to violence, unhealthy relationships or early pregnancy.
The SUZA minister for Social Welfare and Student Development said young women often arrive with limited reproductive health knowledge, making them vulnerable to exploitation. “Without this education, it becomes difficult because someone offering financial help can easily take advantage of you,” she said.
The project has also improved family planning services in southern Zanzibar. South Unguja district medical officer, Dr Mohammed Mtumwa Mnyimbi, said trained nurses are providing more community-level counselling.
“Family planning is key to reducing maternal deaths and improving the mother’s health,” he said. Uptake has risen from between nine and 12 percent to 13.9 percent.
Nurse-midwife Siwangu Steven Muhagama said awareness campaigns have increased demand for long-term methods such as implants and IUDs. She now serves more than 25 clients a day, up from about 16.
For residents like Christina Ayubu Stefano from Mwela, the project has made daily life easier. She said family planning allows her to plan her future, adding: “Even when challenges arise, you are supported in a safe way.”
Zanzibar’s Reproductive and Child Health Coordinator, Saida Abuubakar Mohammed, said the project has strengthened health facilities and addressed harmful beliefs.
Maternal deaths have fallen from 89 in 2023 to 45 in 2025, while the contraceptive prevalence rate has increased from 15 to 17.5 percent. She said proper use of family planning is “one step toward reducing preventable deaths.”
