Women’s health investment can add $1 trillion to global economy, says Pathfinder Tanzania chief

Investing in women’s health is one of the smartest economic decisions a country can make, says Dr Joseph Komwahingiro, Senior Country Director, Pathfinder Tanzania.

He notes that closing the women’s health gap could inject 1 trillion dollars annually into the global economy, and that women reinvest up to 90 percent of their income into families and communities.

ON PATHFINDER’S WORK IN TANZANIA

Q: How long has Pathfinder been working in Tanzania, and what are your main areas of focus?

A: Pathfinder has been a partner in Tanzania since 1957, working alongside the government and communities to strengthen health systems, improve maternal and child health, and advance women’s rights and leadership. Our work focuses on sexual and reproductive health by expanding access to contraception, family planning, safe delivery, and post abortion care. We also prioritise prevention of and response to gender based violence through integrated care for survivors, particularly children.

Kivule Hospital’s One Stop Center demonstrates why integration matters. Survivors often move between services and are forced to repeat painful experiences multiple times. In this model, services are coordinated so survivors can access support without being pushed into repeated retelling as they move from one service point to another.

We also invest in youth empowerment because young people are leaders who already hold solutions. That work ranges from peer education at Mtetema Primary School to youth led climate adaptation. In addition, we integrate climate and health by supporting climate resilient health systems and promoting climate smart approaches that protect health and economic security for women. We also support women’s economic empowerment through programmes like Tuungane, linking health with economic opportunities, because health services alone do not work if women cannot afford to access them.

All of this is done in partnership with the Ministry of Health, the Ministry of Community Development, Gender, Elderly, Children and Special Groups, the Prime Minister’s Office Regional Administration and Local Government, regions including Morogoro, Arusha, and Zanzibar, and community based organizations that are closest to the issues.

Q: Why should Tanzania continue investing in women’s health, what are the biggest challenges, and what gives you hope?

A: Women’s health is infrastructure. It is not separate from economic development, it is foundational to it. When women are healthy, families and communities thrive. When women access contraception and plan families, they can complete education and participate economically. When maternal mortality drops, society does not lose productive members.

The data strengthens this argument. Closing the women’s health gap could inject 1 trillion dollars annually into the global economy. Women reinvest up to 90 percent of their income into families and communities. That is why investing in women’s health is one of the smartest economic decisions a country can make.

The challenges are real and interconnected. Access gaps remain for women in rural areas, women with disabilities, adolescent girls, and those in hard to reach regions. Barriers include distance, cost, stigma, and facilities that are not disability inclusive. Health systems also face strain. Health workers are under resourced, understaffed, and under supported. When facilities lack basic supplies, even skilled providers cannot deliver quality care.

There is also a false separation of health from economic realities. Health services alone do not work if women cannot afford access, if they lack economic power to make decisions about their bodies, or if climate shocks destroy livelihoods and health at the same time. Climate change is amplifying these pressures. Floods destroy health facilities, droughts drive child marriage, heat waves complicate pregnancies, and displacement increases gender based violence.

Two things give me tremendous hope. Young people are leading peer education, demanding better services, holding systems accountable, and building community solutions. We are also seeing integration in real time, where women’s health is increasingly addressed together with economic resilience, education, and climate realities. These signals show Tanzania moving toward a model where women’s health is treated as infrastructure, communities lead, and sustainability is foundational. The challenges remain significant, but the pathway is becoming clearer, and Tanzania is demonstrating that pathway for the region.

Q: Today is the International Day of Zero Tolerance for FGM. What does this day mean for Tanzania?

A: Today is an important moment for Tanzania and for the wider global effort to end female genital mutilation. It also coincides with a major milestone for Pathfinder. We have just signed the HER Future partnership, which will reach over 380,000 young people in Morogoro and Arusha with integrated support that includes sexual and reproductive health services, prevention of gender based violence, economic opportunities, and youth leadership development.

Tanzania has made real progress. FGM prevalence has dropped from 18 percent to 8 percent over three decades. However, 2.7 million Tanzanian women and girls have still experienced FGM, and in Arusha prevalence remains at 41 percent. The last 8 percent are often the hardest to reach.

HER Future treats FGM not as an isolated issue, but as part of a broader system linked to child marriage, maternal mortality, gender based violence, and girls’ education. You cannot address one without addressing the others.

Q: Why is FGM still happening in some communities despite the laws and awareness campaigns?

A: Because it is deeply connected to beliefs about marriageability, family honor, and economic security. In communities where FGM is practised, families often believe their daughters will not be accepted for marriage without it, and marriage is seen as the only pathway to economic stability.

Awareness alone does not work. Families need economic alternatives so they can see other futures for their daughters. Male engagement is also necessary so young men pledge to marry girls who have not been cut. Religious and community leaders have a central role in shifting norms from within. Health systems must also be ready to support survivors with trauma informed care. This is why HER Future integrates health, economic empowerment, education, and community engagement. Communities have told us clearly that you cannot just tell us to stop FGM, you have to help us create different futures for our daughters.

Q: What makes the HER Future project different from past FGM programs?

A: Three things. The first is the holistic approach. We address teenage pregnancy, maternal mortality, gender based violence, youth economic empowerment, and sexual and reproductive health together, because these issues are interconnected in young people’s lives. The second is disability inclusion. Girls with disabilities face even higher rates of violence and are often excluded from services, so HER Future ensures facilities are accessible, trains providers in disability inclusive care, and engages families of children with disabilities. The third is that it is locally led. Tanzanian organisations, Pathfinder together with Amani Girls Organization, Femina Hip, and Pastoral Women’s Council, are leading this work in collaboration with government and the Norwegian Embassy. This is a multi year investment with government ownership from the start, not a short term donor project.

Q: How does FGM affect maternal and child health outcomes?

A: Severely. Women who have undergone FGM face 15 percent to 55 percent higher rates of perinatal death. They experience prolonged labour, increased caesarean sections, severe bleeding during childbirth, and higher maternal mortality risk. Survivors also experience chronic pain, infections, and psychological trauma.

These are not only individual tragedies, they are health system burdens. When FGM complications lead to emergency caesareans or prolonged hospitalisations, already strained facilities bear those costs. Health workers in Arusha and Manyara deal with these complications regularly. FGM elimination is not only a rights issue, it is a health systems issue. Prevention reduces facility burden and saves lives.

Q: What role do men and boys play in ending FGM?

A: Critical. In many communities, fathers, brothers, and potential husbands influence the decision. If marriageability is tied to FGM, young men need to publicly commit to marrying girls who have not been cut. We have seen this work in Kenya, where Maasai warriors pledged not to marry girls who have undergone FGM, and that shifted the calculation for families.

HER Future includes male engagement by working with fathers, religious leaders, traditional leaders, and young men to understand FGM’s harms and model different masculinities where being a man is not about controlling women’s bodies. That is how change takes root.

Q: How can Tanzania reduce dependency on donor funding for women’s health programs?

A: This is the critical question, and it requires multiple strategies. Government ownership and domestic resource mobilisation matter because the more Tanzania invests its own resources in women’s health, the less vulnerable programmes are to donor funding shifts. We are seeing this with m mama, where the government leads, and it has scaled nationally.

Public private partnerships can also support sustainability. m mama works because Vodafone Foundation partners meaningfully. There are opportunities for the private sector to invest in women’s health not as corporate social responsibility, but as smart business, because healthy women are productive employees, consumers, and entrepreneurs. Sustainable financing mechanisms also matter, including health insurance schemes that cover maternal care, community financing models, and social enterprises like Kenya’s FemVive where women earn income distributing health products. Integration across sectors is also essential. When health is connected to economic development, climate adaptation, and education, rather than treated as a standalone sector, it becomes easier to access different funding streams and justify investments differently.

The Women Led Innovation Roundtable we convened this week explored these questions deeply. The consensus was clear. We need to move from how do we get more donor funding to how do we build models that do not require donor funding to sustain. That is the future Tanzania is building, and it is a pathway the entire region is watching.