The Trends in Adolescent and Youth Well-being in the United Republic of Tanzania Harnessing the Potential of Adolescents and Youth in Tanzania THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING THE UNITED REPUBLIC OF TANZANIA Harnessing the Potential of Adolescents and Youth in Tanzania World Bank June 23, 2023 TABLE OF CONTENTS EXECUTIVE SUMMARY 01 ACKNOWLEDGMENTS 09 CHAPTER 1: INTRODUCTION 10 NATIONAL PLANS, POLICIES AND VISION FOR ADOLESCENTS 14 AND YOUTH CHAPTER 2: METHODOLOGY 16 DEFINING ADOLESCENTS AND YOUTH 17 QUANTITATIVE AND QUALITATIVE DATA ANALYSIS 17 CHAPTER 3: THE GROWING POPULATION OF ADOLESCENTS 20 AND YOUTH CHAPTER 4: TRENDS IN ADOLESCENT AND YOUTH WELL-BEING 24 25 EDUCATION AND LEARNING BODILY INTEGRITY (OR AUTONOMY) AND SEXUAL AND 33 REPRODUCTIVE HEALTH 38 HEALTH AND NUTRITION PSYCHOSOCIAL WELL-BEING 41 VOICE AND AGENCY 43 ECONOMIC EMPOWERMENT AND SKILLS 43 CHAPTER 5: EVIDENCE OF GOOD INTERVENTIONS FOR ADOLESCENT AND YOUTH WELL-BEING AND POTENTIAL 48 INVESTMENT AREAS REDUCING THE DROPOUT RATE AND USING EARLY WARNING SYSTEMS 49 TECHNOLOGY AS A TOOL TO ENCOURAGE ADOLESCENT AND 50 YOUTH VOICES 51 SUPPORTING THE TRANSITION TO DECENT WORK OR LABOR ENSURING THE PROVISION OF LIFE SKILLS FOR EMPOWERMENT 52 INVESTING IN FOUNDATIONAL SKILLS AND UPSKILLING FOR 53 AGRICULTURE CHAPTER 6: THE WAY FORWARD AND POLICY 54 RECOMMENDATIONS ANNEXES 59 REFERENCES 70 1 EXECUTIVE SUMMARY Adolescent and youth account for one-third of and is a composite of multiple aspects that affect the population in the United Republic of Tanza- the life one lives and the quality of that life. In nia (URT).1 The population of adolescents, ages many ways, how to live a “good” life and whether 10–19, and youth, ages 20–24,2 is estimated to one is living this “good” life has been a key ques- increase from 14.8 million (2013) to 28.2 million tion asked across countries, and there are multi- (2035). This cohort accounts for 32 percent of ple frameworks that have been used to measure the population, however, there has been neither well-being. For the purposes of this study, six do- a systematic review on the quality of their lives mains of well-being are recognized: (1) education nor an assessment on the extent to which their and learning, (2) bodily integrity, (3) health, (4) psy- well-being has been changing over time. In 2021, chological well-being (peace), (5) voice and agen- the Government of Tanzania, under the auspic- cy, and (6) economic empowerment and skills. es of the Ministry of Health, Community Devel- These domains are interconnected, and, also opment, Gender, Elderly and Children (MoHC- considered is the idea of peace of mind, without DGEC), released the National Accelerated Action which, there is no wellness. As the adolescents and Investment Agenda for Adolescent Health and youth in Zanzibar have noted: and Well-being (NAIA-AHW) aimed at highlighting the challenges faced by adolescents (ages 10–19) “Well-being is something that and defining the strategy for investment (MoHC- gives you joy and peace.” DEC 2021). However, youth (ages 20–24) are not Adolescent girl Mjini Magharibi, a part of this action plan. As this cohort continues Zanzibar to grow in number, it remains crucial to ensure they are being supported to reach their maximum potential. To highlight how best to harness the po- tential of adolescents and youth in the URT, the “To me well-being is a state World Bank has prepared a three-part series.3 whereby I have peace of mind to perform different functions. In the This report focuses on the trends of adolescent absence of this calmness in mind and youth well-being in Tanzania, identifying nothing will be done systemati- cally.” how and why well-being has or has not changed Youth boy from Ubungo, over time. The report conceptualizes well-being Dar es Salaam holistically. Well-being can be defined as one’s ability and opportunity to learn, make decisions, live a healthy life (physically and mentally), be “Having well-being means to be well-nourished, express agency, have peace of in free environment filled with mind, and ultimately be economically empow- peace.” Adolescent from Temeke, ered. Well-being can be accumulated over time Dar es Salaam 1  The United Republic of Tanzania includes the mainland and the semi-autonomous region of Zanzibar. 2  The team uses an adapted definition of adolescence and youth. The United Nations defines youth as ages 15–24. In Tanza- nia, adolescents are defined as ages 10–19 and youth as ages 15–35. The team combines these definitions, but in recognizing the importance of distinguishing early adolescence and adolescence (GAGE 2017), three distinct age groups are referred to: early adolescents ages 10–14; adolescents ages 15–19; and youth (or young adults) ages 20–24. 3  The two other policy notes in the series focus on (1) improving basic education learning outcomes, and (2) Technical Educa- tion and Vocational Training (TVET) and skills. THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 2 The report uses a mixed-method approach to er attended and 8 percent had dropped out). This provide evidence on the status of adolescents figure declined to 41 percent for adolescents ages and youth that include the following: (1) how ad- 15–19 (10 percent had never attended and 49 per- olescent and youth well-being has changed over cent had previously attended). In Zanzibar the lat- the last five years; (2) the emerging challenges to est data (2019/20) shows that after one year of future progress of their well-being; (3) successful the FBEP,5 95 percent of adolescents ages 10–14 interventions and activities that would help im- were attending school (1 percent had never at- prove their well-being in Tanzania; and (4) how tended and 3 percent had dropped out). For ad- strengthening information and monitoring and olescents ages 15–19 this declines to 61 percent evaluation (M&E) systems can better measure, attending school (2 percent had never attended track, and assess the main dimensions of their and 37 percent had dropped out). However, this well-being. The report combines primary and rise in access should be viewed in comparison to secondary data to ensure that the voices of ado- completion rates. In Mainland Tanzania, 22 per- lescent and youth are reflected and to better un- cent of students ages 10–24 had completed lower derstand how the trends of well-being in Tanzania secondary, and in Zanzibar (2019/20) 19 percent are changing. Primary data include focus group of students ages 10–24 had completed lower discussions (FGDs) and a survey with adoles- secondary. These completion rates vary across cents and young adults from Mainland Tanzania location (rural/urban), gender (male/female), and and Zanzibar. Secondary data include analyses of economic status (poor/non-poor), see section 3.1. household data surveys and sector-specific data. In Mainland Tanzania, there is a 30-percentile point (pp) difference in completion between rural The report raises concerns about the unrealized (11 percent) and urban (41 percent) households potential of adolescent and youth well-being and a 14-pp difference between poor (12 percent) with respect to basic education. Over the past and non-poor (26 percent) households. In Zanzi- 10 years progress has been made to improve bar, the lower secondary completion rate ranges adolescent and youth well-being; however, the from 15 percent in urban areas and 8 percent in potential of adolescents and youth has not been rural locations, declining further to 7 percent for fully maximized. More adolescents and youth poor households. Between 2011/12 and 2017/18 are accessing education and health care, delay- the lower secondary completion for adolescents ing early marriage and pregnancy, and feeling ages 18–20-years increased by 9 pp for boys and satisfied with life. However, the promise of basic 10 pp for girls. In Zanzibar, males from poor house- education for all has not yet been fully realized, holds have the lowest completion rate for lower learning outcomes are low, and the possibility of secondary in both Mainland Tanzania (10 percent) getting a decent job is still constrained. and Zanzibar (7 percent). Finally, completion of While more adolescents and youth are access- lower secondary is low due to high dropout rates ing education, completion of lower secondary correlated with the age of the individual, age and continues to lag. As per the Household Budget education of the head of household; relationship Survey (HBS) data, in Mainland Tanzania (2017/18), to the head of household; and location in specific after two years of the Fee-Free Basic Education zones, for Mainland Tanzania. In 2017/18, learners Policy (FBEP),4 84 percent of adolescents ages ages 15–19 was 5.7 times more likely to drop out 10–14 were attending school (8 percent had nev- compared to learners ages 10–14, see section 3.1. 4  FBEP in Mainland Tanzania has four phases: (a) post-independence fee-free education was rolled out (seven years) but no capitation grants were provided to schools; (b) in 2001 universal primary education was introduced (seven years) with capita- tion grants provided to primary then secondary schools in 2005, however, voluntary contributions were enforced to families; (c) in 2015 (implemented 2016) the FBE policy for basic education extended the FBEP through preprimary, primary and lower secondary (12 years). During the final phase capitation grants are released and voluntary contributions are encouraged but not mandatory; and (d) in 2022 the government extended the policy to remove formal fees for two years of upper secondary level, thus covering 14 years in total. 5  FBEP in Zanzibar has two phases: (a) in 2015 the Government abolished school fees in pre-primary and primary schools; and (2) in 2018 this was extended to secondary schools. EXECUTIVE SUMMARY 3 Higher priority could be given to protecting worried about whether they would get enough bodily autonomy and integrity among adoles- food to eat during the week, and 31 percent faced cents and youth, with respect to issues such as a situation where there was no food at some point gender-based-violence (GBV), early marriage, in 2020/21. early pregnancy, access to health care and sex- The report also found that adolescents and ual and reproductive health (SRH) services, and youth are concerned about economic empow- other related issues. The prevalence of early erment, employment, and finances. In 2020/21, marriage has decreased from 1.7 percent to 0.4 28 percent were satisfied with their finances, 64 percent for learners ages 10–14 and 10.2 percent percent with housing, 55 percent with their job, to 8.6 percent for learners ages 15–19 in Mainland 64 percent with health care, 58 percent with edu- Tanzania between 2011/12 and 2017/18, poten- cation, 81 percent with the level of protection, and tially because of improved access to education. 68 percent with transportation. Satisfaction levels However, early marriage prevalence in Zanzibar for finances and education are below the aver- shows a slight rise for both age groups between age score for life satisfaction (57 percent). Na- 2014/15 and 2019/20. Early marriage among tional data on adolescents and youth show that learners ages 10–14-year-olds increased from 0.7 between 2014/15 and 2020/21 there have been percent to 0.8 percent and 3.4 to 3.9 percent for changes in employment patterns across Mainland learners ages 15–19. In both Mainland and Zan- Tanzania and Zanzibar. By 2020/21, the propor- zibar, the rate of marriage among girls is consis- tion of employment by key sector remained the tently higher compared to boys of the same age. same (agriculture 60 percent, manufacturing 9 In Mainland Tanzania a girl was nearly three times percent, and services 31 percent)6 although there more likely to be married than a boy, and in Zan- was an increase in employment by 2 pp. However, zibar the probability increases to over 4 times. as per the National Panel Survey (NPS) (2020/21), Multiple factors were correlated to early marriage 11 percent of adolescents and youth (ages 15–24) including being female, being above the age of were neither in education nor employed (7 per- 15, and living in a rural area or the Southern and cent of males and 14 percent of females); and the Eastern Zones. majority of 15–24-year-olds were self-employed More attention could be given to basic needs or working in unpaid agriculture. In 2021/22, own such as nutrition. The study found that most ado- account workers or self-employed increased from lescents and youths expressed that they were not 47 percent to 54 percent (NBS 2022). Four out of well-equipped to manage adulthood or the tran- 10 adolescents and youth (43 percent) engaged sition to adulthood, as they are not able to meet in unpaid (agricultural) family work as their main their basic needs through nutrition. A third of economic activity. As findings from the study adolescents and youth remained worried about show, adolescent and youths are having to nav- having enough food to eat. In 2014/15, across igate a reality of limited jobs and engage in eco- Tanzania 69 percent of adolescent and youth nomic activity (paid or unpaid) from a young age, population were eating three or more meals per and while they are also trying to attend school. To day (68 percent of those attending school and 73 manage these stresses, adolescents and youth percent for out of school). By 2020/21, the per- are seeking assistance to find peace of mind. centage of those eating three or more meals a Adolescents and youth reported that they have day declined slightly reaching 60 percent (60 more to give, especially in leadership roles. Ad- percent in school, and 62 percent out of school). olescents and youth explained that they feel en- In 2020/21, there remained 1 percent of adoles- gaged but there is limited scope for leadership cents and youth who had eaten zero meals per as “age” continues to be perceived as a criterion day. Within that same period, 33 percent were for leadership. Youth and adolescent reported to 6  In 2014/15 the proportion of employment by sector was 59 percent (agriculture), 11 percent (manufacturing) and 31 percent (services) (NPS 2022). THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 4 THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 5 not being given the opportunity to lead or hold from a low-income household. The evidence pre- a leadership position because they were not yet sented in this report shows that the adolescent old enough (Restless Development 2023b). and youth well-being should not be viewed in isolation to their parents and household, as drop- The study concludes that addressing ado- out rates, employment, and early marriage were lescent and youth well-being must be done found to be correlated to certain household char- through an intersectional lens, and that more acteristics. The age and education of the head attention needs to be given to the bottom quar- of household, and the relationship to the head tile who are most at-risk of being overlooked. of household contribute to the risk of dropout Multiple barriers restrict adolescents and youth, and based on the Integrated Labor Force Survey and these obstacles are compounded by geo- (ILFS) (2019/20), the possibility of being employed graphic and sociodemographic factors. Evidence was associated with gender and location of resi- suggests that while gender disparities are closing dence, but also household economic status and in terms of education access, other inequities re- size and the head of household education and main unaddressed and in need of targeted atten- gender. Youth in larger households (with six and tion, such as completion and learning outcomes, above members) and of low-income were less which vary by age, economic status, and location. likely to be employed. Adolescent and youth from Gender impacts access and completion when female-headed households were less likely to be connected with the socioeconomic status or loca- employed (twice as much as those in male-head- tion of a household. The same pattern is found for ed households). If the head of household had indicators such as early marriage, GBV, SRH, and secondary or higher education, the likelihood of employment, where gender disparities are large adolescent and youth employment increased. but made worse when compounded by being Table 0: Summary of recommendations for adolescent and youth well-being in Tanzania Domain Age Short Term Recommendations • Build capacities of teachers and heads of school to implement the Safe School Program and ensure schools provide holistic support to the child, i.e. psycho-social, SRH, family planning, life skills, parent-teacher partnerships. • Make schools a space for adolescents to practice leadership. Education • Target interventions for vulnerable adolescents to reduce dropout rates and learning 10-19 and ensure compulsory basic education. • Engage parents and communities through awareness campaigns to communicate the benefits of education complemented with testimonies from young people who have succeeded. • Establish a campaign encouraging use of internships or work experi- ence opportunities to be used during the long-wait time as an adoles- cent is transiting from Form 4 to Form 5. • Parliament to approve the amendment to the Law of Marriage (1971) Bodily 10-19 increasing the legal marrying age to the age of 18. integrity • Start an awareness/education campaign targeting parents and religious leaders to accept changes to the marriage law. • Improving awareness of and access to health insurance benefits, as well Health 10-24 as service delivery targeted at adolescents’ health needs. (and nutrition) • Engage the community in school nutrition programs. THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 6 Recommendations in this study focus on how to ensure Tanzania maximizes the potential of its adolescents and youth. Research has shown investing in adolescents and youth improves adult productivity and outcomes; and the holistic approach used in this study shows how well-being is inter- connected across all six domains. The table below presents the recommendations across the six well-being domains (table 0). An addi- tional domain of crosscutting is also present- ed as a recommendation. Medium to Long Term Recommendations Responsible Agency • Strengthen public-private partnerships to provide work experience oppor- tunities upon graduation of lower secondary, upper secondary, TVET and university. MoEST • Establish national poverty data base including poor and vulnerable youth PO-RALG • Adopt a cross-sectoral strategy to ensure targeting to vulnerable house- holds. • Ensure access to SRH and family planning to the most vulnerable – rural, MoCDGWSG boys and girls, and those in school – by removing the barriers in accessing MoH the knowledge and service. MoEST PO-RALG MoCDGWSG • Improve school nutrition initiatives for adolescent and youth in school MoH MoEST PO-RALG EXECUTIVE SUMMARY 7 Domain Age Short Term Recommendations • Strengthen gender desk at the LGA-level to ensure grievances ad- Voice dressed. and agency 10-24 • Build youth leaders, adopting programs where strong youths are high- lighted in the community. • Continue to strengthen support relationships that youth use and facili- Psychological 10-24 tate the growth of new ones with fathers. well-being • Strengthen provision of safe spaces in schools and communities for youth and adolescent to seek counsel (and avoid negative behaviors). • Strengthen quality education provision and short programs to ensure graduates can transition to work and self-employment (meeting the sup- ply and demand needs and closing the mismatch between what employ- Economic ers want and students have). empower- • Strengthen agri-skills and opportunities to ensure the majority of adoles- ment and 10-24 cent and youth are not left behind, this should focus on those in and out skills of school, recognizing the prevalence of agricultural work (paid and/or unpaid). • Develop funds/initiatives to support the transition to self-employment with initial business capital, improve the business environment (tax re- duction), and be ready to offer youth friendly business loans. • Raise parental awareness about education, drop-out rates, SRH, early marriage, pregnancy. • Target investments, especially among the poor/rural households which lag to ensure they can support the provision of basic needs. Cross-cutting 10-19 • Strengthen NAIA-AHW to act as an advocate and conduct M&E of ado- lescent and youth over time. • Improve data systems and granularity for adolescents and youth ages 10–24. Note: Detailed recommendations for improving learning in basic education are provided in the World Bank (2023) policy note for basic education; and improved recommendations for TVET are provided in the TVET policy note. THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 8 Medium to Long Term Recommendations Responsible Agency MoCDGWSG MoEST PO-RALG MoCDGWSG • Provide financial security programs for adolescent and youth. MoEST PO-RALG • Promote English fluency as a key to enter the formal labor market. • Support market analysis/business skills as two examples for self-em- ployment. MoCDGWSG • Create a job-selection system which can match graduates (secondary, MoEST TVET and university) to open job positions or spaces in formal employ- PO-RALG ment, and identify upcoming self-employment opportunities. • Develop a harmonized household survey that will collect data across MoCDGWSG variables and be comparable MoH • Ensure adolescent and youth well-being needs are reflected across all MoEST sectors and key ministries. PO-RALG EXECUTIVE SUMMARY 9 ACKNOWLEDGEMENTS This report was prepared by a World Bank team thanks to counterparts from the Government of from the Education Global practice, led by Gem- Tanzania for consultations during the preparation ma Todd (Education Specialist), with advice and of the report as well as for providing useful feed- inputs from Samer Al-Samarrai (Senior Econo- back. The report was prepared in consultation mist), and Xiaoyan Liang (Lead Education Spe- with the Ministry of Education Science and Tech- cialist). The team was assisted by consultants nology (MoEST); Prime Minister’s Office–Policy, including Neema Mosha (Data Consultant), Kojo Parliamentary Affairs, Labour, Youth, Employment Justine (Mapping Consultant), George Senyoni and Persons with Disability (PMO-LYED); Minis- (Consultant) and from the Restless Development try of Health, Community Development, Gender, Tanzania: Linus Katonto, Nassor Kikumbih, Colet- Women and Special Groups (MoCDGWSG); and ta Komutonzi Mutagwaba, Ridhione Juma, Farida Ministry of Health, Community Development, Makame, and Timothy Robertson, who led the fo- Gender, Elders and Children (MoHCDGEC). We cus group discussions and phone survey. Com- would also like to thank Arne Hoel, Hendri Lom- ments were provided from core team members bard, KwaPamoja Limited, Rob Beechey, Rohan and reviewers including Huma Waheed (Senior Reddy/Unsplash (basketball game photo on cov- Education Specialist), Kaboko Nkahiga (Senior er) and Sarah Farhat for their outstanding photog- Education Specialist), Innocent Mulindwa (Senior raphy that have enriched the visual content of this Education Specialist), Tanya Savrimootoo (Senior report. We would also like to acknowledge Mkuki Education Economist), Ruth Karimi Charo (Se- na Nyota Publishers for the beautiful design and nior Education Specialist, HAEE2), Alys Willman printing of this report. (Consultant, HGNDR), Laura Gregory (Senior Ed- This report builds on analytical work prepared ucation Specialist, HEDGE), and Federica Saliola by the World Bank including: (1) Strengthening (Manager, HSPJB). Basic Education System and Improving Learning The team would like to express its gratitude for Outcomes in Mainland Tanzania (2023); (2) Devel- the guidance received from Nathan Belete (Coun- oping Skills for Tanzania Youth through Dynam- try Director, AECE1); Safaa El Tayeb El-Kogali ic Technical Education and Vocational Training (Practice Manager, HAEE1); Preeti Arora (Manager, (TVET) (2023), both part of this deliverable, (3) Operations, AECE1); and Aneesa Arur (Program Tanzania Gender Assessment (2022); (4) Tanza- Leader, HAEDR), as well as the administrative nia Gender Based Violence Assessment: Scope, support provided by Caroline Kingu (AECE1), Celia Programming, Gaps and Entry Points (2022); and Faias (HAEE1), and Yvonne Mwenewanda (AECE1). (5) Tanzania Education Sector Institutional and The team would also like to express our sincere Governance Assessment (2021). THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 10 CHAPTER 01 INTRODUCTION THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 11 CHAPTER 01: INTRODUCTION This report provides a comprehensive picture on the status of adolescent and youth well-being, of the lives and well-being of adolescents and and a better understanding of the challenges this youth in the United Republic of Tanzania (URT). age group faces, policies and programs are likely The report provides evidence on how adoles- to be more effective. cent and youth well-being has changed over the Tanzania’s forthcoming Systematic Country Di- last five years; the emerging challenges to future agnostic (SCD)8 highlights the country’s strong progress in their well-being; successful inter- economic growth since 2017, but more needs ventions and activities that would help improve to be done to ensure growth is inclusive. Since well-being; and how strengthening information 2017, the annual economic growth, as measured and monitoring and evaluation (M&E) systems by the real Gross Domestic Product (GDP) growth can better measure, track, and assess the main rate averages 4.9 percent and remains above dimensions of their well-being in Tanzania (Main- the Sub-Saharan African average. Access to key land Tanzania and Zanzibar). This report is one of services — education, electricity, transport, and a three-part series prepared by the World Bank information communications and technology (ICT) Group focused on harnessing adolescent and — has increased (see figure 1). However, Tanzania youth potential in Tanzania. Specifically, this re- continues to lag in key areas of human develop- port complements the findings of the two policy ment which hinder the achievement of inclusive notes that focused on the context of learning out- economic growth. In 2020, Tanzania scored 0.39 comes and skills provision in Tanzania, by adding on the Human Capital Index (HCI), which quan- evidence to show the state of adolescent and tifies the contribution of health and education to youth well-being in a holistic way.7 The evidence the productivity of the next generation of work- presented in this report can provide input into the ers. This means that on average, an 18-year-old updating of the World Bank Country Partnership in Tanzania is expected to be about 39 percent Framework (CPF) and the ongoing dialogue with as productive as they could have been had they the Government of Tanzania to identify quick wins completed education and enjoyed full health. This and investment areas for the large population co- is below the Sub-Saharan African average of 0.40 hort of adolescents and youth ages 10–24. and global average of 0.57. Tanzania’s low HCI Adolescents and youth ages 10–24 account for is largely driven by low learning outcomes. The one-third of Tanzania’s population and are key quality of health and education services in Tanza- drivers in Tanzania’s quest for greater economic nia also needs improvements, and there is a need and social development. Understanding the lives to close the rural-urban gaps in service delivery. of adolescents and youth is important because Gender inequalities also persist. The gender gap the investments made during this period of their index, which measures gender gaps across four lives are predictive of future life outcomes. Invest- dimensions: economic opportunities, education, ing in adolescent and youth well-being is increas- health, and political leadership, was 0.72 in 2022. ingly seen as a critical element to accelerate prog- This means that females were 28 percent less ress on poverty reduction and reducing inequality likely to have the same opportunities than males (Camilleti and Banati 2018). With good information in Tanzania (World Bank, forthcoming). Finally, 7  The two other policy notes focus on (1) improving basic education learning outcomes, and (2) Technical Education and Voca- tional Training (TVET) and skills. This report combines primary and secondary data: the data used in this report includes house- hold surveys, literature, focus group discussions in Dar es Salaam and Zanzibar, and a survey across select regions in Mainland Tanzania and Zanzibar. 8  The SCD is the foundation for updating the Country Partnership Framework. THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 12 following the coronavirus pandemic (COVID-19), urban areas where poverty rose from 16 percent Tanzania saw an increase in the population liv- in 2012 to 23 percent in 2021 (World Bank 2022). ing below the national poverty line, particularly in Figure 1: Change in progress for key services in Tanzania Source: World Bank, forthcoming. Data used from WDI 2021. THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 13 Economic growth has not translated into more accumulated human capital. The study relies on or better jobs. The move away from the agri- a conceptual framework to define adolescent and culture sector has been slow and has failed to a youth well-being. The conceptual framework tap into the higher value chains of production. of the study builds on the National Accelerated The proportion of labor with a wage job has not Action and Investment Agenda for Adolescent changed. Every year 800,000 young people enter Health and Well-being (NAIA-AHW) (MOHCDGEC the labor market but with low academic qualifica- 2021) and international literature (Guglielmi, Neu- tions and a mismatch between the skills supplied meister and Jones 2021; Ross et al. 2020; Organ- and required. This has resulted in an increase in isation for Economic Co-operation and Develop- youth unemployment rates from 14 percent to 15 ment (OECD) 2011). The factors that affect human percent between 2014 and 2021 (National Bureau capital accumulation and well-being during the of Statistics (NBS) 2022); and 70 percent of youth period of adolescence and youth are shown in are working in the informal industry (NBS 2022). figure 2. Six domains have been used to create a well-being framework for Tanzania. Interestingly This report adds to the evidence on adolescent following engagement with youth, “peace” was and youth well-being in Tanzania,9 and looks defined as the key foundation of well-being. holistically at their well-being by including fac- tors that affect their quality of life and their Figure 2: Conceptual framework for adolescent and youth well-being Source: Authors’ own. 9  This policy note is part of a three-part series prepared by the World Bank Group, which focuses on harnessing adolescent and youth potential. The two other policy notes focus on (1) improving basic education learning outcomes, and (2) Technical Education and Vocational Training (TVET) and skills. THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 14 NATIONAL PLANS, POLICIES AND VISION FOR ADOLESCENTS AND YOUTH The Government of Tanzania developed a set of Adolescents and youth are provided with ser- policies and strategies to improve the well-be- vices through multiple ministries, departments, ing of adolescents and youth, recognizing ado- and agencies (MDAs) in Mainland Tanzania and lescents and youth as Tanzania’s demographic Zanzibar. Box 1 describes the different MDAs re- dividend. Over the past 15 years, the Government sponsible for policies and programs for adoles- of Tanzania has set up plans across key ministries cents and youth. All the ministries in Mainland to guide investments for improved service de- Tanzania are part of the National Steering Com- livery. Annex A table A.1 provides a summary of mittee for NAIA-AHW. plans supporting youth and adolescents, across Mainland Tanzania and Zanzibar. Box 1: MDAs responsible for adolescent and youth service delivery, policy, and programs in Tanzania Mainland Tanzania Zanzibar 1. Prime Minister’s Office–Policy, Parliamentary Affairs, La- 1. Ministry of Health, Community De- bour, Youth, Employment and Persons with Disability velopment, Gender, Elders and Chil- (PMO-LYED) focuses on labor market policies, employment dren (MOHCDGEC) is responsible for services, and labor market analysis and standard. overall technical guidelines, policies 2. Ministry of Health, Community Development, Gender, and regulations related to gender, Women and Special Groups (MOHCDGWSG) is responsi- community, family, women, men, and ble for overall technical guidelines, and policies and regu- special groups. lations related to gender, community, family, women, men, 2. Ministry of Education and Vocation and special groups. Trainings (MOEVT) sets the policies, 3. Ministry of Education, Science and Technology (MOEST) guidelines and regulations on the sets the policies, guidelines, and regulations on education education and learning standards. and learning standards with contributions from relevant de- Relevant departments and institutions partments and institutions, such as Tanzania Commission also support the agenda, i.e., the Ex- of Universities (TCU), Tanzania Institute of Education (TIE), aminations Council and Zanzibar In- National Examination Council of Tanzania (NECTA), National stitute of Education (ZIE). Council for Technical and Vocational Education and Training 3. Ministry of Health (MOH) sets the (NACTVET). policies, guidelines, and regulations 4. Ministry of Health (MOH) sets the policies, guidelines, and on the health (preventative and cura- regulations on the health (preventative and curative) ser- tive) services, family planning, med- vices, family planning, medical supplies, and so forth. Rel- ical supplies, and so forth. Relevant evant departments and Institutions within this ministry are departments and Institutions within crucial. this ministry are crucial. 5. President’s Office–Regional and Local Government (PO- 4. Cross-cutting ministries include the RALG) is responsible for service delivery and implementa- Ministries of Water and Energy; Infor- tion of all policies in health, education, community, and so mation, Youth and Culture; Finance forth. Implementation happens through decentralized units. and Planning; Agriculture, Irrigation 6. Cross-cutting ministries include the Ministries of Water and Livestock; Trade and Industrial and Irrigation; Information, Communications and Informa- Development; Tourism and Antiqui- tion Technology; Finance and Planning; Agriculture; Natural ties Resources and Tourism; Culture, Arts and Sports; Trade and 5. International/nongovernment orga- Industries; and Energy. nizations (I/NGOs), and civil society, 7. International/nongovernment organizations (I/NGOs), and the private sector are also in- civil society, and private sector are also involved. volved. Source: Authors’ own. INTRODUCTION 15 In 2021, the government strived to adopt a ho- and youth). These stakeholders are comprised of listic approach for adolescent and youth de- members from multiple ministries and specialties. velopment through the NAIA-AHW, a visionary Implementation of NAIA-AHW is designated to multisector framework. The NAIA-AHW offers PO-RALG and therefore utilizes a decentralized a key agenda and holistic call to action, recog- governance structure with planning and imple- nizing health, education, social protection, jobs, mentation oversight provided by the Village Exec- safety, and access to quality services, as crucial utive Officer (VEO), Ward Executive Officer (WEO), for investing in adolescents in Mainland Tanzania. District Executive Officer (DEO), and Regional Ad- The NAIA-AHW is a multisectoral, four-year plan ministration Secretary (RAS). that aims to guide investments through an inte- However, challenges remain in implementing grated approach to improve adolescent health NAIA-AHW and in targeting effective interven- and well-being (MOHCDGEC 2020) (see annex A tions to harness the full potential of adolescents figure A.2). The interventions to address adoles- and youth. Implementation of the NAIA-AHW cent well-being are cross-cutting and organized plan has been slow10 and stakeholder consulta- around six interconnected pillars: (a) to prevent tions have revealed several constraints to accel- HIV, (b) to prevent teenage pregnancy, (c) to pre- erating improvements in adolescent and youth vent sexual, physical, and emotional violence, (d) well-being. Specifically, there are few programs to improve nutrition, (e) to keep boys and girls in targeting adolescents and youth, and the exist- school, and (f) to develop skills for meaningful ing programs have limited financing and informa- economic opportunities (see annex A figure A.2). tion on impact, making it difficult to scale up the Targets have been set for each domain with co- programs or to implement best practices. There ordination structures put in place to govern the are also questions about the effectiveness of tar- agenda moving forward. NAIA-AHW is expected geting in the projects as they do not always op- to cost TSh 1.4 trillion ( US$592 million) to im- erate where the need is greatest. The existing plement over the next four years. Furthermore, data systems that track the well-being of adoles- NAIA-AHW estimates that investing in the six pil- cents (ages 10–19) are limited in scope and not lars for adolescents ages 10–19 the country will well-connected, which hampers efforts to build achieve a demographic dividend of US$3,877 per a comprehensive picture of adolescent well-be- capita (more than triple the current GDP). ing and monitor progress. There is also a lack of NAIA-AHW is governed by a multisectoral team, coordination across MDAs and stakeholders. The under the leadership of the Prime Minister’s Of- implementation of NAIA-AHW has also been hin- fice (PMO), and implementation continues to be dered because of limited data, poor monitoring decentralized through PO-RALG. NAIA-AHW sits of impact, and lack of coordination. Early consul- within the PMO, with decision-making led by the tations with the government identified the need National Minister’s Forum, multiple committees to prioritize the focus on economic empowerment (National Steering Committee and National Tech- and skills (Mainland Tanzania) as well as tourism, nical Committee), a national secretariat, working skills, and income generation (Zanzibar). The skills groups (on adolescent and reproductive health; gap was also identified as lagging. Neither Main- safe schools and life skills; prevention and control land Tanzania nor Zanzibar has a clear agenda in of micronutrient deficiencies; response and sup- place for how, where, or which program domains port services; water, sanitation and hygiene ser- to prioritize. vices in schools; and technical and quality edu- cation), and a stakeholder group (on adolescents 10  Implementation of NAIA-AHW is ongoing and the plan has set forth targets to be achieved over four years across all do- mains. However, no report has been released on implementation to date and financial disbursement to the plan is unclear. THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 16 CHAPTER 02 METHODOLOGY THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 17 CHAPTER 02: METHODOLOGY DEFINING ADOLESCENTS AND YOUTH In this report, the World Bank team uses an of distinguishing early adolescence and adoles- adapted definition of adolescence and youth. cence (GAGE 2017). Three distinct age groups The United Nations defines youth as ages 15–24. are referred to in this report: early adolescents, In Tanzania, adolescents are defined as ages 10– ages 10–14; adolescents, ages 15–19; and youth 19 and youth as ages 15–35. The team combines (or young adults), ages 20–24. these definitions, but recognizes the importance QUANTITATIVE AND QUALITATIVE DATA ANALYSIS To understand trends over time secondary data All prevalence estimates were weighted to ac- have been analyzed from national datasets. The count for the complex sample design of all national datasets cover a period of over 10 years surveys, i.e., clustering and stratification. Fur- from 2011/12 to 2021/22 inclusively and include thermore, bivariate, multivariate, and logistic re- the Household Budget Survey (HBS) of 2011/12, gression models were built to determine factors 2014/15, 2017/18 and 2019/20,11 Living Standards correlated with marriage among adolescents, Measurement Survey (LSMS) or National Pan- while multinomial logistic regression models were el Survey (NPS) of 2020/21,12 Demographic and used to determine the adjusted and unadjusted Health Survey (DHS) of 2014/15 and 2021/22,13 odds ratio (with 95 percent confidence intervals) Labor Force Survey (LFS) of 2019/20,14 and sec- associated with employment among adolescents tor specific data from the Basic Education Man- ages 10–19 and youth ages 20–24 compared agement Information System (BEMIS) of Mainland to unemployed groups. Annex A includes more Tanzania, Statistical Abstract of Zanzibar, and the details on the data, definitions of variables con- examination data from the National Examination structed, and the weights applied. Council of Tanzania (NECTA). 11  The HBS is performed by the Office of the Chief Government Statistician (OCGS) in Zanzibar and National Bureau of Statis- tics (NBS) in Mainland Tanzania approximately once every 3–5 years. It is the singular source of poverty figures in Tanzania and a main input into the CPI basket weighting process. 12  NPS is stratified, multistage cluster sample design. The survey is conducted over Mainland Tanzania and Zanzibar. 13  The DHS survey is conducted by NBS and OCGS in collaboration with MOH and other international organizations with the objective of collecting information on health indicators that helps to assess the progress made in improving the living standards of the people. 14  The main objective of the LFS is to collect information on the labor market and other sociodemographic data focusing on United Nations Sustainable Development Goal (SDG) 8, which aims at promoting sustainable economic growth and decent work. Currently there are five surveys of this form done in Zanzibar and Mainland Tanzania. THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 18 THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 19 To complement the national datasets and sur- school status, gender, income, and locations).16 veys, qualitative data were collected specifical- Restless Development conducted a primary sur- ly on adolescents and youth and a literature re- vey of 1,000 adolescents and youth across URT. view on well-being in URT was conducted. The The findings of the primary research conducted World Bank partnered with Restless Development by Restless Development are presented in the to conduct focus group discussions (FGDs) and a annexes. Table 1 highlights the different second- survey with adolescents and youth ages 10–24. ary data sets used for Mainland Tanzania and The FGDs were conducted in Dar es Salaam and Zanzibar. This report provides a desk review of Zanzibar15 in May 2023 and included a represen- literature (including governmental and nongov- tative sample of adolescents and youth to ensure ernmental reports and academic literature). a range of voices were heard (different ages, Table 1: National datasets used for Mainland Tanzania and Zanzibar Education Bodily Health, SRH Psychological Voice and Economic and Learning Integrity and Nutrition Well-being Agency Empowerment and Skills 1 HBS HBS DHS DHS FGD and HBS Survey 2 BEMIS DHS FGD and FGD and LFH Survey Survey 3 National LFS NPS Examination Data 4 NPS FGD and FGD and Survey Survey 5 FGD and survey Source: Authors’ own. Note: Household Budget Surveys (HBS) refers to data from 2011/12 and 2017/18 for Mainland Tanzania and 2014/15 and 2019/20 for Zanzibar. Basic Education Management Information System (BEMIS) refers to data between 2013 and 2022 for Mainland Tanzania and Zanzibar. Demographic and Health Survey (DHS) refers to data from 2015/16 and 2021/22. The 2022 DHS has not yet been released in full therefore some indicators were not available for comparative analysis. Labor Force Survey (LFS) refers to data from 2020. National Panel Survey (NPS) (or Living Standards Measurement Survey) refers to 2020/21 data. Challenges were found as not all datasets measure the same variables, or use different definitions, making comparison over time and place difficult. Focus group discussions (FGD) and survey were conducted in May 2023. None of the surveys measured indicators related to voice and agency. 15  This study was conducted in both Mainland Tanzania and Zanzibar, whereby in Mainland data were collected in the Dar es Salaam region, covering the districts of Temeke, Ubungo and Kinondoni. In Zanzibar the team reached out to young people residing in Urban west region covering the districts of Urban, West “A” and West “B”. All located data were collected by youth. In total 10 FGDs were conducted (5 in Mainland and 5 in Zanzibar). 16  Within the target group (ages 10–24), there were additional criteria to select participants for the FGD, which included gen- der and education status. FGDs were conducted with similar genders, to ensure female participation. Each FGD was attended by no less than six participants and included those who have never been to school, completed grade 7, or finished secondary education. THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 20 CHAPTER 03 THE GROWING POPULATION OF ADOLESCENTS AND YOUTH THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 21 CHAPTER 03: THE GROWING POPULATION OF ADOLESCENTS AND YOUTH With an annual population growth rate of 3.2 percent. In Zanzibar, population growth rate is 3.8 percent, Tanzania is expected to have a popu- percent. Adolescents and youth ages 10–24 ac- lation of 140 million by 2050. According to Tan- count for 32.0 percent of the total population, and zania’s 2022 national census, the total popula- across urban and rural areas. tion has reached 61.7 million. The population in Based on the 2012 census projections17 for 2035, Mainland Tanzania has reached 59.9 million (49.0 the population of adolescents and youth in Tan- percent men; 51.0 percent women) and 1.9 mil- zania is expected to double. The official projec- lion in Zanzibar (48.0 percent men; 52.0 percent tions estimate the population of adolescents and women). These figures show that between 2012 youth ages 10–24 will increase from 14.8 million and 2022 overall, Tanzania’s population has seen to 28.2 million between 2013 and 2035. In both a 3.2 percent growth rate per year, making Tan- 2013 and 2035, adolescents and youth account zania’s population growth rate the third highest for 32 percent of the population. Figure 3 shows worldwide (See the Tanzania Economic Update, the change in adolescent and youth population World Bank 2023), and it is above the Sub-Saha- over time for Mainland Tanzania and Zanzibar. ran African average population growth rate of 2.6 17  A national census and DHS were conducted in August 2022 however, the full reports have not yet been released. The Gov- ernment has released an overview of census data on the NBS website and preliminary report highlighting key indicators from the DHS. The report includes findings on fertility, teenage pregnancy, family planning, early childhood mortality, maternal care, early childhood development index, infant and youth feeding, malaria, and HIV. THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 22 The population growth, specifically the rise in Investment in human capital and provision of adolescent and youth numbers, will have re- opportunities for decent jobs is crucial for eco- percussions for service delivery in Tanzania. In nomic growth. Recent estimates of poverty show Mainland Tanzania, the Education Sector Devel- that the country’s progress to eradicate poverty opment Plan (ESDP) 2022–2026 estimates that has been slow (World Bank 2023). Between 2019 the school-age population will increase by 5 pp by and early 2021, poverty rates rose from 26.2 per- 2026.18 Between 2020 and 2026, the number of cent to 27.0 percent, indicating COVID-19 only children ages 6–24 is estimated to increase from modestly impacted the persistent and preexis- 42.9 to 43.1 million, with the greatest increase in tence of poverty in the country. In late 2022, pov- children ages 7–13, rising from 17.6 million to 18.6 erty rates declined slightly to 26.8 percent but million. remained above pre-pandemic levels. It is esti- mated the number of people living in poverty will continue to increase by 450,000 due to popula- tion growth. Investment in Tanzania’s human cap- ital is vital to address the country’s poverty rate.19 Figure 3: Population projections for adolescents and youth ages 10–24, 2013 to 2035 Source: URT 2018 (National Population Projections, NBS Tanzania and Office of the Chief Government Statistician Zanzibar). Investing in adolescents has been shown to reap demographic dividends and improve out- 18  As of June 2023, these projections are being updated with the national census of 2022 and in light of the ongoing educa- tion policy and curriculum reforms. Revised estimates are expected by the end of 2023. 19  On May 19, 2023, the Government of the United Republic of Tanzania declared its commitment to invest in human capital. THE GROWING POPULATION OF ADOLESCENTS AND YOUTH 23 comes over time, especially considering the pop- from 42.0 percent (no education) to 26.1 per- ulation increase among adolescents and youth. It cent (incomplete primary education), 27.1 percent is a pivotal moment to investment in adolescents (complete primary), and 7.5 percent (complete and youth (ages 10–24) as they transition to adult- secondary education or more) (Al-Samarrai and hood. Research estimates Tanzania’s demograph- Tamagnan 2018). When comparing the 2015/16 ic changes will account for 0.4 percentage points with the 2022 TDHS the impact of the level of ed- of average annual real GDP per capita growth ucation seems to have declined slightly, although (Ahmed et al. 2014). In Mainland Tanzania, invest- there is still a 34 percentile-point (pp) difference ment in adolescents alone is estimated to achieve between teenage fertility based on the least and a demographic dividend of US$3,877 per capita, highest educated (Global Financing Facility (GFF) more than triple the current GDP (NAIA-AHW 2023). Teenage fertility rate drops from 41.0 per- 2021). Research has shown investing in adoles- cent (no education) to 19.0 percent (incomplete cents and youth improves adult productivity and primary), 26.0 percent (complete primary), and 7.0 outcomes, and there are studies indicating how percent (complete secondary education or more). improved access to education by adolescents A similar decrease occurs for youth ages 20–24, has positive health outcomes (Al-Samarrai and whereby the completion of secondary education Tamagnan 2019). Regression analysis conducted or more reduces by two-thirds the likelihood of on the 2015/16 DHS shows how completion of being married by age 17. Finally, research on fe- higher levels of education reduces the Total Fer- male-genital mutilation (FGM) shows that the tility Rate (TFR) by up to two fewer births, delays experience of FGM impacts later life outcomes: the possibility of early marriage by over 40.0 per- women who have experienced FGM are more cent, and improves health outcomes for children. likely to be in domestically abusive relationships Teenage fertility for 15- to 19-year-olds drops (Todd and Shabani 2018). THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 24 CHAPTER 04 TRENDS IN ADOLESCENT AND YOUTH WELL-BEING THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 25 CHAPTER 04: TRENDS IN ADOLESCENT AND YOUTH WELL-BEING Findings for adolescent and youth well-being are chological well-being (peace), (5), voice and agen- presented as per the six domains: (1) education cy, and (6) economic empowerment and skills. and learning, (2) bodily integrity, (3) health, (4) psy- EDUCATION AND LEARNING While Tanzania has made significant progress With these efforts for improved access, basic in expanding access to basic education, learn- education has not been realized with 19 percent ing outcomes are still low, largely due to an in- to 30 percent of adolescents ages 10–19 either adequate supply of qualified teachers, the per- having never attending or no longer attending sisting gap between infrastructure and teaching school in Zanzibar and Mainland, respective- and learning materials, the challenges of educa- ly.20 The proportion of out-of-school (OOS) ado- tion governance through a decentralized system lescents and youth has declined because of the with multiple stakeholders, and the challenges rollout of the Fee-Free Basic Education Policy of limited public financing (World Bank 2023). A (FBEP).21 Table 2 shows a small (and declining) forthcoming World Bank policy note identifies the percentage of adolescents who have never at- multitude of challenges affecting access to, and tended school, the higher percentage of OOS quality of, basic education in Mainland Tanzania adolescents in Mainland Tanzania than Zanzibar, that provides a fuller analysis of the need for more and the percentage increase of adolescents ages efficient and effective investments in education. 15–19. (The education structure is shown in annex B.) Table 2: Adolescent education status (ages 10–19 years) in Mainland Tanzania and Zanzibar Ages 10–14 Ages 15–19 Adolescent Mainland Zanzibar Mainland Zanzibar Education status 2011/12 2017/18 2014/15 2019/20 2014/15 2019/20 2014/15 2019/20 Currently attending 81% 84% 92% 95% 44% 41% 59% 61% school Never attended school 11% 8% 3% 1% 10% 10% 3% 2% Attended but no longer 8% 8% 5% 3% 46% 49% 38% 37% attended (dropped) Source: Authors’ estimations from HBS Mainland Tanzania (2011/12 and 2017/18); Zanzibar (2014/15 and 2019/20). 20  The Education Sector Analysis (ESA) 2021 reports 3.2 million school-age children were out of school and 1.2 million had never attended school. 21  FBEP in Mainland Tanzania has four phases: (a) post-independence fee-free education was rolled out (seven years) but no capitation grants were provided to schools; (b) in 2001 universal primary education was introduced (seven years) with capitation grants provided to primary then secondary schools in 2005, however, voluntary contributions were enforced to families; (c) in 2015 (implemented 2016) the FBEP for basic education was made extending FBEP through preprimary, primary and lower secondary (12 years). During the final phase capitation grants are released and voluntary contributions are encouraged but not mandatory; (d) in 2022 the government extended the policy to remove formal fees for two years of upper secondary level, thus covering 14 years in total. THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 26 Equity and inclusion of the most vulnerable ad- Furthermore, the NER in lower secondary for ages olescents and youth need careful consideration 14–17 varies across regions, with the lowest at 11 as access for late adolescents and youth contin- percent for girls in Geita region and 13 percent ue to lag. Figure 4 and 5 show trends in the gross for girls and boys in Katavi region, compared to enrollment across education (preprimary, primary, an NER of 64 percent for boys in Dar es Salaam secondary, and postsecondary) using HBS data. and 62 percent for girls in Kilimanjaro. In Zanzibar, (Annex table A.1 provides enrollment rates over the NER in lower secondary for ages 12–15 rang- time from different datasets). Figures 4 and 5 high- es from 25 percent in Michweni to 56 percent in light two key trends: (a) there are more children, Magharibi West B. Greater efforts are required to adolescents, and youth accessing education; and improve access to post basic education (upper (b) when adolescents turn 13, their enrollment secondary, TVET, and higher education) which in education rapidly declines. Across Mainland continues to lag. In Mainland Tanzania, the gross Tanzania and Zanzibar improved access to ed- enrollment rate (GER) for 2017/18 drops from 99 ucation has been observed for adolescents and percent (primary) to 8 percent (upper secondary). youth from poor and rural households. However, In Zanzibar, the GER for 2019/20 drops from 111 disparities remain between rural-urban and poor- percent (primary) to 8 percent (upper secondary). non-poor households, as well as across regions. National data reported in the Annual Education In the case of Mainland Tanzania, the HBS 2017/18 Sector Performance Report (AESPR) (URT 2021) data show that after five years, the number of ad- shows that the number of adolescents and youth olescents ages 14–17 enrolled in lower secondary enrolled in TVET22 increased by 52 pp between was still 27 percentile points (pp) lower for rural 2016/17 and 2020/21. The number of students in- compared to urban households and 14 pp lower creased from 264,937 to 553,200, with 43 per- for the poor compared to non-poor households. cent females. Vocational education continues In 2017/18, a girl from a poor household in Main- to hold the largest share of students enrolled in land Tanzania had a net enrollment rate (NER), for TVET, accounting for 69 percent of the students adolescents ages 14–17, of 21 percent, compared in 2021. But this number is still low compared to to a non-poor girl (37 percent) and non-poor boy the number dropping out of school. (35 percent). Figure 4: Enrollment in education (preprimary, primary, secondary, and postsecondary) by poverty (left) and location (right) for Mainland Tanzania, both genders (%) Source: Authors’ estimations from HBS Mainland Tanzania (2011/12 and 2017/18); Zanzibar (2014/15 and 2019/20). 22  TVET includes education includes alternative education opportunities after primary, ordinary secondary, and advanced level secondary, or upon the failure to complete primary. TVET encompasses a formal stream including government and non- governmental providers and a nonformal stream which is mainly prevocational, such as the integrated postprimary education. TRENDS IN ADOLESCENT AND YOUTH WELL-BEING 27 Figure 5: Enrollment in education (preprimary, primary, secondary, and postsecondary) by poverty (left) and location (right) for Zanzibar, both genders (%) Source: Authors’ estimations from HBS (2011/12 and 2017/18 Mainland Tanzania; and 2014/15 and 2019/20 Zanzibar). See World Bank, forthcoming. Household data show only 2 in 10 adolescents ban (41 percent) households and a 14-percentile and youth in Mainland Tanzania and 1 in 10 in point difference between poor (12 percent) and Zanzibar complete lower secondary education. non-poor (26 percent) households. In Zanzibar, There have been some improvements to the com- the primary completion rate between rural and pletion and progression rates as per household urban areas has a 22-pp difference (27 percent data (figure 6). In Mainland Tanzania, completion and 45 percent, respectively); and for lower sec- has risen from 50 to 59 percent (primary), 19 to ondary the completion rate declines to 11 percent 30 percent (Form 2), 12 to 22 percent (lower sec- in total (15 percent for urban areas and 8 percent ondary), and 4 percent to 7 percent (upper sec- for rural). Completion of lower secondary declines ondary) between 2011/12 and 2017/18. Yet the further for poor households, reaching 7 percent in challenge remains in ensuring completion for stu- 2019/20. Males from poor households have the dents across all locations and income statuses. lowest completion rate for lower secondary in In the case of lower secondary completion rates both Mainland Tanzania (10 percent) and Zanzibar for Mainland Tanzania, there is a 30-pp difference (7 percent). in completion between rural (11 percent) and ur- Figure 6: Variation in completion rates, by region, Mainland Tanzania (left) and Zanzibar (right) Source: Map on left shows Mainland Tanzania HBS 2017/18; Zanzibar HBS 2019/20. Note: Darker shades of blue represent regions with higher completion rates and lighter color represents regions with lower completion rates. THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 28 The findings match the primary data collected useless or uninteresting; 11 percent dropped out from adolescent and youth. Of the respondents, at this age for being unwell. For adolescents that 77.5 percent stated it “was easier to access basic have completed Standard 7 (primary) but did not education,” and they stated that this education progress to lower secondary, 74 percent of ado- was crucial for their well-being, acquiring skills lescents ages 14–16 and 75 percent ages 16–18 and getting a job, and 70 percent of adolescents believed that they had completed their educa- and youths reported that they did not feel the ed- tion, while 17 percent (ages 14–16) and 15 percent ucation system was doing enough to support vul- (ages 16–18) failed their exam. Among adoles- nerable groups (Restless Development 2023b). cents ages 18–20 not enrolled in Form 4 (the final year of lower secondary), 35 percent felt they had High dropout and low completion rates are completed their education, 19 percent failed an linked to several factors, with a correlation exam, and 14 percent could not afford to continue found between dropout rates and the age of the school. student and the head of household’s education level. Box 2 identifies the main reasons for drop- Three key areas to address to improve comple- ping out of school in Mainland Tanzania and Zan- tion include reducing truancy to ensure regular zibar. Box 3 shows the results of the multivariate attendance, changing perceptions of the low analysis to identify factors positively correlated value in education, and improving learning out- with dropping out. It is important to note that the comes in primary to ensure completion of basic reason for dropping out changes throughout ado- education (see box 2). Of the respondents sur- lescence (World Bank, forthcoming). Forty-seven veyed, 62 percent of the adolescents and youths percent of 14- to 16-year-olds who dropped out explained that they dropped out due to reasons between Standards 1–6 (not completing primary) “beyond their control.” dropped out due to school being perceived as THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 29 Box 2: Factors linked to low post-basic education and completion of education in Mainland Tanzania and Zanzibar The national BEMIS reports the main reason for discontinuing school to be truancy (AESPR 2021). Not attend- ing school for 90 days consecutively is grounds for expulsion. In 2021 the government approved and issued a reentry circular clarifying that a student who has dropped out of formal education, for various reasons, is allowed to return. Implementation of the reentry policy for girls and boys to return to school is proceeding well with 1,907 (54 percent girls) students returning to formal secondary schools in 2022; and another 4,106 enrolled in the Al- ternative Education Pathway (AEP) program. Irregular attendance is linked to multiple reasons including distance and infrastructure, informal fees and indirect costs associated with education, and working while in school. The 2022 NPS provides evidence that 93 percent of primary students in Mainland Tanzania and 88 percent of primary students in Zanzibar travel to primary school by foot.23 The average distance (in minutes) for children walking to school has increased in Main- land Tanzania by 2.6 minutes, but decreased by 3.8 minutes in Zanzibar. The 2020/21 NPS estimates on average children spends on average of 30 minutes travelling to primary school. Limited infrastructure and access to pit latrines also hinder attendance (Joshi and Gaddis 2015). Poor class attendance during menstruation is common due to not being able to purchase menstrual materials, pain during menstruation, cultural taboos that girls should remain home during menstruation, doubt on the durability on the menstrual health and hygiene materials (MHH), and fear or shame of stigmatization at school (National Institute of Medical Research (NIMR) 2021). In addition, the government has extended the Fee-Free Based Education Policy (FBEP) for 14 years in Mainland Tanzania and 13 years in Zanzibar, however, informal fees are still required. Informal fees may include contributions for school maintenance, non-teaching staff, food, running school-based assessments and more. The cost of educa- tion becomes a stronger reason for dropping out as an adolescent gets older and if they are from a poor or rural household. For example, the 2017/18 HBS shows 17 (rural) and 23 (poor) percent of 18–20-year-olds were not in school due to costs, compared to 10 percent in the urban and non-poor counterparts. The final contributing fac- tor to irregular attendance is that about 25 percent of adolescents and youth are working while attending school (see section 4.6). There are 26 percent of adolescents ages 10–14, 29 percent of adolescents ages 15–19, and 18 percent of youth ages 20–24 engaged in employment while attending school. Perceived low value on continuing education contribute to the out-of-school rate, despite a general per- ception that education is satisfactory. Analysis on the Mainland Tanzania 2017/18 HBS shows that progression through education is low as children/adolescents become satisfied with the level of education obtained. In 2017/18, 74 percent of 14–16-year-olds and 75 percent of 16–18-year-olds did not progress to lower secondary as they stated they had completed school (World Bank, forthcoming). The same pattern is found for both girls and boys. Furthermore, the 2020/21 NPS shows that 36 percent of children/adolescents in rural areas and 41 percent in urban areas are not attending schools as they were satisfied with the level of education obtained and 23 per- cent in rural areas (25 percent in urban) were looking for work or has started work. This low perception, however, could be more a reflection of parents and communities, and the value they place on education. FGD results from Restless Development (2023) show young people identify education to help make decisions, acquire technical and life skills, and avoid illicit behaviors. However, the young people highlighted the main reasons for drop-out were (1) parents failing to seek a school transfer, (2) use of alcohol or drugs by youth, or (3) lack of community awareness on the benefit of education, existence of irresponsible parents, cultural aspects (i.e. unyago, see section 3.4) and poverty among girls. 23  The percentage of students travelling by foot decreases in urban areas (NPS 2022). THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 30 Long wait time between completion of lower secondary and transition affect progression to upper second- ary. In total students wait eight months before transitioning from Form 4 to Form 5. In 2020, 373,958 students passed the Form 4 exam while 96,862 (26 percent) enrolled in Form 5 the following year (2021) (BEMIS 2022). The Government has now digitized the Form 5 selection system in the hope to reduce the wait time. Passing the primary school leaving examination (PSLE) is a factor in adolescents and youth schooling deci- sions. There is a correlation between dropping out (low progression) and failure in the primary education exam (World Bank, forthcoming). To transition to secondary education the student is required to pass the PSLE. Howev- er, there are some regions that go against this trend, for example, a student may pass the PSLE but not continue into lower secondary education suggesting there may be sociocultural and gender factors at play. Source: AESPR 2021. Box 3: Factors correlated to adolescent and youth dropouts in Mainland Tanzania only Evidence shows an increase in adolescent and youth dropouts in Mainland Tanzania (2017/18) due to the following factors: (a) age, with the dropout rate rising to 5.7 times higher for adolescents ages 15–19, and 8.6 times higher for youth ages 20–24, compared to adolescents ages 10–14; (b) age and education of the head of household, with the dropout rate declining for adolescents and youth living within households headed by older age groups, and if the head of household had a primary education or above. The risk of an adolescent or youth dropping out declined by 60 percent if the head of household had secondary education or above; and (c) rela- tionship to the head of household, with the risk of the dropout rate declining for adolescents and youth if they were children of or biologically related to the head of household (although it is not statistically significant). The risk of dropout rate increases by 3.7 times when the adolescent or youth is not related or a servant. Zonal variations persist in the correlations for dropout rates among adolescents and youth. The risk of drop- ping out for adolescents and youth in the Northern and Central Zone was lower in comparison to the Western Zone, while the dropout rate increased in the Southern Zone (by 1.9 times) and Lake Zone (by 1.7 times) com- pared to the Western Zone. See annex C table C.2 for full details. Source: HBS 2017/18. Student pass rates in key national examinations the scores on examinations at Standard 6, Form exhibit an increasing trend until 2020; however, 2, Form 4, and Form 6 in Zanzibar. It also shows more than 20 percent of students fail the end of 20 percent of students failed the PSLE in Main- primary exam, and failure rates of mathematics, land Tanzania in 2022 and 20 percent failed the science, and English are high across all national Form 2 national exam in Zanzibar in 2020. In ad- examinations (World Bank 2023). Table 2 shows dition, for the CSEE, 12 percent failed the exam national pass rates for the Standard Four Na- in Mainland Tanzania in 2022, but it is important tional Assessment (SFNA), Primary School Leav- to note that of the 87 percent who passed, over ing Examination (PSLE), Certificate of Secondary 50 percent of these students were just passing Education Examination (CSEE), and Advanced with Division 4.24 In Mainland Tanzania, in 2022, CSEE (ACSEE) for Mainland Tanzania and shows 51 percent of candidates taking the CSEE scored 24  Division 1 = Excellent scoring 80–100 marks; Division 2 = Very Good scoring 70–79 marks; Division 3 = Good scoring 60–69 marks; Division 4 = Average scoring 50–59 marks; and Division 5–7 = Satisfactory, Subsidiary, and Fail. TRENDS IN ADOLESCENT AND YOUTH WELL-BEING 31 a Division 4 overall and only 7 percent scored Di- In Mainland Tanzania, 74 percent of ages 10–14, vision 1. Furthermore, the results for mathematics, 77 percent of ages 15–19, and 77 percent of ages science, and English are key caveats in the low 20–24 could read a full sentence. In the case of performance. Figures 7 and 8 show the PSLE (offi- Mainland Tanzania, literacy increases by 22 pp if cial age 13) and CSEE (official age 17) examination an adolescent or youth has completed preprima- outcomes by subject for Mainland Tanzania. The ry education versus upper secondary education. figures show the subjects that adolescents and Figure 9 shows the variation in literacy by regions. youth poorly performed in, which include English, However, when measuring literacy in English (typ- mathematics, and sciences. Learning outcomes ically a student’s second or third language), less for TVET are reflected in the second policy note than 10 percent of adolescents and youth in Main- by the World Bank (2023a). land Tanzania can read a complete sentence in English. If the adolescent or youth is from a poor Household data provides evidence that over 66 household, the ability to read a complete sen- percent of adolescents and youth in Mainland tence in English declines further by more than Tanzania and Zanzibar can read a complete sen- half, reaching only 3 percent, and 6 percent if the tence; but proficiency in English continues to be adolescent or youth is from a rural household. a challenge. Household data on literacy rates, as This should be compared to 11 percent of adoles- measured by the ability to read a full sentence, cents and youth from a non-poor household, or 16 shows 60 percent of early adolescents ages percent of adolescents and youth from an urban 10–14, 58 percent of late adolescents ages 15–19, household, being able to read a full sentence in and 60 percent of youth ages 20–24 could read English. a complete sentence in Zanzibar (HBS 2020/21). Table 2: National assessment and examination pass rates (total), 2013–2022 (Mainland Tanzania and Zanzibar) Mainland Tanzania Zanzibar SFNA PSLE FTNA CSEE ACSEE Std. 6 Form 2 Form 4 Form 6 2013 – 51.0 – – – – – – – 2014 – 56.9 – 69.8 – – – – – 2015 88.8 67.8 – 68.0 – – – – – 2016 93.4 70.3 – 70.4 97.9 – – – – 2017 93.8 72.2 – 77.6 98.1 95.9 73.7 67.3 29.5 2018 93.2 76.5 – 79.3 98.7 95.9 73.3 69.6 34.9 2019 91.9 81.5 – 80.7 99.1 97.3 76.8 66.7 38.3 2020 – 82.7 92.0 85.8 99.5 98.1 78.7 56.1 35.6 2021 – 81.9 85.2 86.3 – – – – – 2022 86.3 79.6 – 87.1 – – – – – Source: National Examination Council of Tanzania (NECTA) 2022a and 2022b; Office of the Chief Government Statistician (OCGC) 2021. Focus on examinations conducted by adolescents and youth (ages 10–24). Note: Primary School Leaving Examination (PSLE); Standard Four National Assessment (SFNA); Form Two National Assessment (FTNA); Certificate for Secondary Education Examination (CSEE); and Advanced Certificate for Secondary Education Examination (ACSEE). ACSEE for 2022 is yet to be disclosed and will be announced July 2023. THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 32 Figure 7: National assessment and examination scores for PSLE (left) (total, A–C pass) and distri- bution of grades for students who passed (grades A–C) in 2022 (right), Mainland Tanzania only between 2018–2022 Source: National Examination Council of Tanzania (NECTA) (2022); AESPR 2021. Figure 8: National Assessment and Examination scores for CSEE (left) (total, A–D pass) and dis- tribution of grades for students who passed (grades A–D) in 2022 (right), Mainland Tanzania only between 2018–2022 Source: National Examination Council of Tanzania (NECTA) 2022b); AESPR. Figure 9: Adolescents and youth (ages 10–24) able to read a complete sentence in Mainland Tan- zania (left) and Zanzibar (right) Source: HBS 2017/18 (Mainland Tanzania); HBS 2019/20 (Zanzibar). Note: Darker shades of blue represent regions where greater percentage of youth (ages 10–24) can read a complete sentence. TRENDS IN ADOLESCENT AND YOUTH WELL-BEING 33 BODILY INTEGRITY (OR AUTONOMY) AND SEXUAL AND REPRODUCTIVE HEALTH In 2015/16, 44 percent of girls ages 15–24 com- (11.8 percent as per the LFS of 2019/20) compared pared to 17 percent of boys the same age who to 5.9 percent (2017/18) or 6.7 percent in (2019/20) were married. As of 2019, the legal age of mar- in urban areas. In Zanzibar, the difference is not riage is 18 for boys and 15 for girls in Tanzania. In as large but still visible. In 2019/20 in Zanzibar, 2015/16, the median age at first marriage for wom- 7.5 percent of adolescents and youth in rural lo- en is age 19 and age 24 for men in both Mainland cations were married compared to 5.6 percent in Tanzania and Zanzibar (DHS 2015/16). During the urban locations. previous 2015/16 DHS, 14 percent of adolescent Evidence suggests that over the last 10 years girls ages 15–19 and 30 percent of young girls marriage among adolescents has been de- ages 20–24 were married compared to 1 percent layed, potentially because of improved access of boys and 16 percent of male youth. to education (see section 4.1). When comparing Over the last 10 years the prevalence of ado- marriage prevalence across age groups, the de- lescent and youth marriage25 has decreased in cline in marriage prevalence is happening earli- Mainland Tanzania and Zanzibar, but the rate er at ages 10–14 and ages 15–19 (early marriage), of marriage among girls is consistently higher while rising for ages 20–24. These results are for compared to boys. There is large variation in the both Mainland Tanzania and Zanzibar. Youth en- prevalence of early marriage depending on which gaged in the FGDs explained that child marriage dataset is used. Despite the variations, patterns was influenced by (1) a desire for money from par- can be found (figure 10). There is a prevalence ents, (2) having a hard life at home, (3) parents’ of marriage for 10–24-year-olds has decreased. irresponsibility, and (4) religious support (Restless For Mainland Tanzania, the analysis shows the Development 2023). The parental role in early prevalence of marriage has decreased from 14.8 marriage was strongly emphasized. Furthermore, percent (2011/12) to 10.8 percent (2017/18). In Zan- youth explained that if a girl-child married early zibar, adolescent and youth marriage has also they were more likely to face GBV as they are not declined but at a slower rate from 6.8 percent knowledgeable about married life and pregnan- (2014/15) to 6.7 percent (2019/20). In both Main- cy. However, adolescents and youth surveyed land Tanzania and Zanzibar, a girl was more likely also explained that they see the prevalence of to be married compared to a boy of the same age. early marriage and teenage pregnancy to have In Mainland Tanzania, a girl was three times more declined (Restless Development 2023). Among likely to be married than a boy of the same age the respondents, 92 percent explained that child and in Zanzibar the probability increases to over marriage was not acceptable under cultural val- 4 times. Marriage prevalence of adolescents and ues and norms, and 77 percent of the adolescents youth is higher in Tanzania compared to Zanzi- and youth interviewed explained they were able bar. Girls and boys in rural areas were more likely to decide who they marry. This suggests the suc- to be married compared to their urban counter- cess of community intervention campaigns. parts. In Mainland Tanzania, 12.8 percent of rural adolescents and youth were married in 2017/18 25  Child marriage is defined as marriage among children ages 10–14; teenage marriage is defined as marriage among teenag- ers ages 15–19. Youth marriage is defined as marriage among youth ages 20 –24. As of 2019, the minimum age of legal marriage is 18 for boys and girls in Tanzania following the High Court which increased the minimum age of marriage for girls and boys is age 14 and age 15, respectively (World Bank, 2022). However, these changes are still pending Parliament approval. The Law of Marriage Act of 1971 previously permitted child marriage for girls age 14 with parental consent, acting in contradiction to the Law of the Child. THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 34 Figure 10: Prevalence of married adolescents and youth in Mainland Tanzania (blue) and Zanzibar (green) Source: HBS 2011/12; HBS 2017/18; HBS 2014/15; HBS 2019/20; LFS 2019/20; NPS 2020/21. Note: The NPS 2020/21 is represented for Mainland Tanzania only as the NPS does not provide a distinction between Zanzibar rural and urban, in 2020/21 marriage prevalence for Zanzibar was 5 percent in total for ages 10–24. The results show a lot of variation depending on the dataset used, and the HBS tends to show higher prevalence compared to NPS. In Mainland Tanzania and Zanzibar, there are adolescents ages 15–19 the HBS shows the high- several regions and zones where adolescents est prevalence of marriage resides in the Lake and youth are more likely to be married.26 Zone while the LFS shows the Western Zone; Comparing marriage prevalence by age groups and (c) for youth ages 20–24, the HBS shows across the latest HBS and LFS data the following marriage rates are highest in the Southwest High- is found: (a) for adolescents ages 10–14, the HBS lands Zone while the LFS suggests the Western shows highest prevalence of marriage in Lake Zone. For regional variations of early marriage by and Central Zones (no comparison for LFS); (b) for age see figure 11. Figure 11: Geographical variation in early marriage of females (ages 10–24 only), Mainland Tanzania and Zanzibar Source: HBS 2017/18 (Mainland Tanzania); HBS 2019/20 (Zanzibar). Note: Darker shades of blue represent region with high rate of marriage among females (ages 10–24) while lighter shades rep- resent areas with lower occurrences. 26  The identification of these regions depends on the data used. Interestingly when comparing the geographical variations for marriage of adolescents and youth estimations vary between the HBS and LFS data for Mainland Tanzania (see annex 3 table 3). TRENDS IN ADOLESCENT AND YOUTH WELL-BEING 35 Box 4: Factors correlated to adolescent and youth marriage Evidence shows marriage prevalence for adolescents and youth in Mainland Tanzania (2017/18) increases with the following factors: (a) gender, with females twice more likely to be married as an adolescent or youth compared to males (2.029 OR and significant 0.000); (b) age, with the risk of marriage increasing from the age of 15. Adolescents aged 15–19 are 14.7 times more likely to be married compared to adolescents age 10–14, and youth age 20–24 were 82 more times more likely to be married; (c) location of residence, with marriage among adolescent and youth reducing in urban location (0.376 and significant 0.000). This result, that marriage declines in urban areas, may not necessarily depict increased freedom from early marriage in urban areas but rather indicates improved access to contraception and different cultural traditions or pressures in urban areas27. (d) the age of the head of household, with adolescents and youth more likely to be married if living within a head of the household who was age 50–65 (1.804). There was an increase in likelihood of marriage for adolescents and youth in female headed households, and with larger households with eight plus children, but the correlation was not significant. Zonal variations persist in the correlations for marriage among adolescents and youth. The risk of marriage for adolescents and youth in the Southern and Eastern Zone was lower in comparison to the Western Zone. While marriage increased in the Lake Zone compared to the Western Zone. See annex C table C.2 for full de- tails. Source: HBS 2017/18. Teenage pregnancy28 in Tanzania has declined regions with a substantial proportion of adoles- from 27 percent to 22 percent between 2015/16 cents and youth not using contraceptive meth- and 2022. Teenage pregnancy remains more ods(see figure 13). It is important to note the common for adolescents in urban areas (25 per- total fertility rate (TFR) for women ages 15–49 cent), with no education (53 percent), among has declined, although slowly. In 1999 on av- the lowest wealth quintile group (35 percent), erage women would give birth to 5.6 children and among those aged 19 (46 percent). Fig- compared to 4.8 children in 2022. This decline ure 12 shows the regional variations in teenage is led by decreasing fertility in rural areas from pregnancy for Mainland Tanzania and Zanzibar 6.5 children (1999) to 5.5 children (2022). The and access to modern sexual and reproductive TFR in urban areas has increased slightly from health (SRH) in 2022. Access to SRH is explained 3.2 children (1999) to 3.6 children (2022).29 It is further in section 4.3. In 2022, the regions of important to note the decline has been slow, es- Songwe and Katavi had the highest prevalence pecially when comparing Mainland Tanzania to of teenage pregnancy; and they are among the Kenya and Zanzibar, and Tanzania’s TFR remains higher than the Sub-Saharan Africa average. 27  A National Survey conducted in 2017 on the drivers and consequences of child marriage showed that adolescent girls are facing many challenges related to traditions, cultural, family-related, and external factors linked to early marriage in Shinyanga, Tabora, Mara, Dodoma, Manyara, Mtwara, Lindi, Pwani, Dar es Salaam, and Iringa (MOHCDGEC and CDF 2017). The reasons var- ied by location, for example in Shinyanga lack of school, traditional dances, and parental force were key, while in Dar es Salaam and Pwani affordability of secondary education and unyago (traditional rituals that teaching girls how to have sex) were identified as key drivers. Push factors identified for early marriage were tradition, completion of primary education, peer pressure, parental influence, and financial reasons. 28  Teenage pregnancy is defined as adolescent girls between the ages of 15 and 19 who have become pregnant. 29  A study by the Global Financing Facility (GFF) (2023) identifies regional variations in the types of early pregnancy, based on the 2015/16 DHS data. The study shows the regional occurrences of four types of teenage pregnancies: (1) low-moderate premarital teenage sex (before age 20) and low pregnancy (before age 17) (in the regions of Mjini Magharibi and Kigoma); (2) low-moderate premarital teenage sex with high levels of teenage pregnancy (in the region of Kaskazini Pemba); (3) moder- ate-high premarital sex and teenage pregnancy (in the regions of Katavi, Rukwa, Mwanza and Geita); and (4) moderate-high premarital sex and low pregnancy (in the regions of Iringa, Njombe, Kilimanjaro and Tanga). Most youth ages 20–24 in 2015/16 were type 3 (in the regions of Katavi, Rukwa, Mwanza and Geita) . THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 36 Figure 12: Teenage pregnancy (left) and access to SRH (right), by region, Mainland Tanzania and Zanzibar Source: TDHS 2022. Note: Darker shades of blue represents regions with greater percentage of teenage pregrenancy (left)/ higher access to SRH (right). Figure 13: Trend in age-specific fertility rates (left); and percent of girls who had sex, got married, or had birth between ages 8 to 19 (right) Source: UNPD WPP 2019 from GFF 2023; DHS (2015/16) from GFF 2023. Adolescents and youth are susceptible to gen- often close to the victim. Figure 14 shows the der-based violence (GBV) in Tanzania and Zan- experience of violence among late adolescents zibar. The 2015/16 DHS data show that GBV is (ages 15–19) in Tanzania and how the experienc- prevalent in different forms across the country. es compare to the minimum, maximum and range Forty percent of women ages 15–49 had experi- of violence found in the other 54 DHS countries. enced physical violence; 17 percent of women of The figure shows Tanzania scores higher than the same age had experienced sexual violence; the average across the 54 DHS countries in three 44 percent of the women had experienced inti- types of violence experienced by adolescents mate-partner violence; under 30 percent of girls ages 15–19: sexual violence, emotional violence, experienced sexual violence before the age of 18; and physical violence. The experience of violence and 58 percent of women (40 percent of men) be- increases when the adolescent is married. On av- lieved a husband is justified in beating their wife erage, adolescents seek help. However, for those under certain circumstances. The DHS findings deciding to seek help, it depends on the violence highlighted the prevalence of GBV, its occurrence experienced. Many do not seek help. from a young age, and that perpetrators were TRENDS IN ADOLESCENT AND YOUTH WELL-BEING 37 A recent GBV assessment conducted by the urban areas, using public transportation, were World Bank (2022) identified that there are more at risk of GBV or sexual harassment com- some groups more at risk of GBV due to inter- pared to older women; and adolescent girls re- sectional factors, such as poverty, education, main susceptible to traditional practices, such sexuality, gender, and age. One of the high-risk as bukwilima, mkole, vigodoro, mbina or samba groups identified was adolescent girls and young (UNICEF Tanzania 2017; World Bank 2022b).30 women. For example, women ages 18–25 in Figure 14: Experience of violence and seeking help for adolescents ages 15–19, across the 54 DHS countries Source: GFF 2023. Note: The averages, minimum, and maximum, experiences of violence by adolescents are shown across 54 DHS countries, including Tanzania. Violence against children, adolescents, and ported psychological violence and 37 percent youth happens in multiple spaces, including the reporting sexual violence. For female secondary home and school. A study showed that multiple school students, fear and lack of knowledge of forms of violence were prominent within and be- how to report were the most common reasons for yond the school setting (Haki Elimu 2020). Primary not reporting. A UNICEF Tanzania report (2017) and secondary students experience physical vio- included mapping where the violence happened. lence at school on a regular basis; approximately The domains with perceived risks include schools 9 percent of the students had experienced sexual (14 percent), being far from home (11 percent), the violence in the last six months, with the incidence home (21 percent), and city streets (34 percent). increasing by 6 percentile points for secondary Children with disabilities, working children, chil- school girls and 2 percentile points for secondary dren living with HIV/AIDS, orphans, children living school boys. Among the students’ respondents of with stepparents, and street children were iden- the study, a third of secondary students reported tified as groups at high risk of experiencing vio- having experienced psychological violence over lence. the last six months. The study also showed how many cases of violence were unreported in school with about 50 percent of the students having re- 30  These are traditional practices in specific areas of Tanzania. For example, mkole is practiced by the Zaramo tribe and involves sexual violence on girls during traditional dances and ceremonies. Mbina is practiced by the Sukuma tribe. Vigodoro ceremonies are described as “weekend parties”, or initiation ceremonies, practiced in Temeke (Dar es Salaam) and Kisarawe (Pwani). Such parties may involve girls dancing half-naked and sexual activities or rape. Bukwilima is practiced in Shinyanga, part of the harvest festival, and involves girls being forced to choose a boy to sleep with. Samba also is the traditional practice where girls are taken to the witchdoctor to prepare for marriage. (UNICEF 2017; World Bank 2022b). THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 38 About 1 in 10 women have experienced female ucation, and girls from a poor household as well genital mutilation (FGM), with 51 percent of as girls from Manyara, Dodoma, Arusha, Singida, these experiences happening before adoles- Mara and Tanga (TDHS 2015/16). The experience cence. Eleven percent of women had experienced of FGM is found to impact life circumstances. female genital mutilation (FGM) in 2015/16 (TDHS Analysis shows that women who have experi- 2015/16). From those who responded, 51 percent enced FGM are more likely to be in a domestically experienced FGM at the time of the circumcision abusive relationship. The GBV assessment by the when they were eight years old; 38 percent were World Bank (2022b) describes the structures, leg- ages 9–15, and 8 percent were ages 16–22 (Todd islation, and policies related to GBV prevention and Shabani 2018). The odds-ratio of experienc- and response in Tanzania. ing FGM was higher for rural girls, girls with no ed- HEALTH AND NUTRITION Only 10 percent of adolescents and youth in Tan- were accessing and utilizing health care services zania have access to health care services.31 Ac- in urban areas compared to 7 percent of males in cess to health care is lower for males compared to rural areas.32 Reasons for low utilization of general females, especially in rural areas. In 2016, 11 per- health care services by adolescents is described cent of adolescents and youth (9 percent of males below in box 5. In Mainland Tanzania, 8 percent of and 12 percent of females) had access to health adolescents and youth were living in a household care in Mainland Tanzania. Access to health care that had health insurance. In Zanzibar, only 3 per- declines among the rural population. Only 9 per- cent of adolescents and youth had health insur- cent of adolescents and youth (7 percent of males ance. The low levels of adolescents and youth with and 10 percent of females) were able to access active health insurance may be due to the require- health care services in rural areas compared to 15 ment for making contributions to the fund, and percent in urban areas (15 percent of males and 15 thus need for a regular income.33 Utilization of in- percent of females). In Zanzibar, access declines surance by youths is also low due to limited aware- further to 9 percent overall (8 percent of males ness of the insurance fund benefits, long delays in and 10 percent of females). When comparing by receiving out-of-pocket reimbursements, and dis- location and gender, access increases in urban satisfaction in the treatments provided in health areas to 9 percent of females but urban females facilities, i.e., how treatments are provided or the are less likely to access health care compared distance needed to travel to receive treatments.34 to rural females, whereas 10 percent of males 31  Satisfaction in health care services has increased over time. The NPS shows that satisfaction in health care services in- creased by 8.5 pp in Mainland Tanzania between 2014/15 to 2020/21, with the largest increase found in Dar es Salaam (21.2 percent); and by 7.7 pp in Zanzibar. Overall, the satisfaction in health care has risen at a higher rate among men (9 pp) compared to women (8.2 pp). For respondents who were dissatisfied with the services, long waiting times was the most common reason, followed by cost and lack of medicine. 32  The question is phrased: “In the last four weeks, have you received care from a health care provider?” 33  The National Health Insurance Fund (NHIF) annual report (2020/21) shows the total number of beneficiaries of the fund has increased from 4,403,581 (2019/20) to 4,550,207 (2020/21). The number of contributing members (to the fund) also increased from 1,055,555 (2019/20) to 1,212,519 (2020/21). A total of 95 percent. However, when analyzing where the members come from the following is found: 39 percent of contributing membership are public employees (48.7 percent), students (24.4 percent), Toto Afya (13.0 percent) and private employees (9.3 percent).. 34  Katerengabo (2020) assessed the utilization of the NHIF students’ health scheme, finding students were complaining about having limited knowledge about what the NHIF can cover, but also experiencing poor treatment or customer care within the accredited health facilities, which limited their utilization. TRENDS IN ADOLESCENT AND YOUTH WELL-BEING 39 Box 5: Barrier’s adolescents face in accessing and utilizing health services In assessing accessibility of adolescents to sexual and reproductive health (SRH), HIV care and treatment, and voluntary medical male circumcision (VMMC) the following were found: 1. Low availability of skilled human resources. Due to heavy workload and competing priorities the quality of services to adolescents is not attained. 2. Commodities for adolescent SRH services are not always available at health facilities, including free contraceptives and antiretroviral (ARV) drugs. This sometimes leads adolescents to purchase family planning commodities from private health facilities at a higher price. A lack of finances thus hin- ders the purchasing ability to access services for these adolescents. 3. Long distances to health facilities are also a barrier to services, especially among those in rural areas who report incurring transport costs to reach facilities. 4. Long queues at health facilities before being attended (long wait times) is another barrier that hinder access to quality health services. 5. Poor service delivery, such as health workers’ attitudes, hinder adolescents from seeking information that could improve their health. For example, adolescent girls face difficulties when seeking contracep- tive commodities from health care workers as they fear to be seen prostitutes. 6. Myths and misconceptions continue to exist around SRH and HIV prevention services. Some ad- olescents expressed their disbelief in the safety and efficacy of condoms, while others associated circumcision with superstitious practices. Furthermore, stigma and discrimination can necessitate ad- olescents living with HIV to be registered at a distant clinic, as parents do not want them to be known by providers at nearby facilities. The underserved adolescent boys face two key barriers: (1) lack of tailored SRH services unlike their female counterparts who can access them through RCH clinics; and (2) early adolescent boys (less than age 18) need parental consent when seek for VMMC services; and older adolescent boys who feel mature find it difficult to interact with female service providers when accessing VMMC services and prefer male providers. Parents and healthcare workers were identified as a bottleneck for younger adolescent girls who want to get information and commodities related to family planning and reproductive health. Barriers faced by adolescents in school include the timing of RCH service delivery. RCH services are mainly provided during weekdays at the same time as school. Furthermore, health workers are reluctant to provide RCH services in school for adolescent girls, especially when they are seeking for contraceptives. Adolescents with HIV must seek permission from their teachers to attend clinics which disclose their status and could lead to their stigmatization among teachers and students. Finally, barriers facing rural adolescents include long dis- tance travel and transport costs incurred to reach health facilities, coupled with long wait times before accessing health services and shortage of commodities/drugs makes harder for rural adolescents to access RCH services and VMMS. Source: World Health Organization (WHO) and URT 2022. The number of female adolescents (ages 15– any method of contraceptive, and 13 percent of 19) using modern contraceptive methods has married female adolescents and 29.9 percent of increased, but 85 percent still are not access- youth were using a modern method of contra- ing modern SRH methods. 2015/16, 15 percent ception (DHS 2015/16).35 By 2022, the use of all of married female adolescents (ages 15–19) and contraceptive methods increased to 18 percent 67 percent of youth (ages 20–24) were using of adolescents and 34 percent of youth, and 15 35  Thirty-nine percent of sexually active female adolescents (ages 15–19) and 67 percent of youth (ages 20–24) were using THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 40 percent of adolescents and 30 percent of youth adolescents face multiple barriers in accessing for modern contraceptive methods (DHS 2022). health care services in Tanzania. The WHO and Also in 2022, 49 percent of urban women and 42 MoH (2019) report emphasize how adolescents percent of rural women (ages 15–49), who were have limited access to SRH services, HIV care and sexually active and unmarried, were using a con- treatment, and voluntary male circumcision due to traceptive method (35 percent and 38 percent limited availability, accessibility, acceptability, and were using modern methods).36 The use of mod- effective coverage. ern methods continues to lag compared to tradi- In 2020/21, 40 percent of adolescents and youth tional contraceptive methods; however, the latter were not having three or more meals a day and 1 method is increasing. percent had eaten no meals for a day. The DHS More adolescent and youth females in Zanzi- 2016 estimates 63 percent of adolescents and bar are accessing clinics during their pregnan- youth in Mainland Tanzania, and 59 percent in cy. In Zanzibar, access to (utilization of service) a Zanzibar were eating three or more meals a day.37 clinic during pregnancy rose from 94 percent in The NPS data estimates are similar (see figure 15). 2014/14 to 100 percent in 2020/21. The increase In 2014/15, across Tanzania 69 percent of the ad- was found across all age groups. In the case of olescent and youth population were eating three Mainland Tanzania, fewer female adolescents and or more meals per day. Sixty-eight percent of youth attended a clinic during their pregnancy in those attending school had three meals or more 2020/21. Access declined from 94 percent to 91 a day (73 percent for out of school). By 2020/21, percent (2014/15 to 2020/21), with 10–14-year-olds the percentage eating three or more meals a day having the lowest access (74 percent), followed declined slightly reaching 60 percent (60 per- by 15–19-year-olds (75 percent) and 20–24-year- cent in school and 62 percent out of school). One olds (83 percent). When looking at where adoles- percent had eaten no meals for a day. It is also cents and youth deliver their babies, there has important to be critical of the quality of meals pro- been a decline in deliveries in hospitals/ materni- vided (or accessed). The DHS data (2015/16) show ty wards, and a rise of deliveries in clinics, health that 46 percent of females in Mainland Tanzania facilities and dispensaries. In Mainland Tanzania and 63 percent of females in Zanzibar had ane- in 2014/15, 49 percent of adolescents and youth mia, reflecting a deficiency in the nutritional value had a baby delivered in a hospital, followed by of meals eaten. 15 percent in health clinics, 34 percent at home, About 33 percent of adolescents and youth re- and 2 percent at other locations. By 2020/21, the main worried about whether they will get food number of hospital deliveries declined to 36 per- to eat, even though the proportion declined cent and at home deliveries declined to 17 per- from 34 percent to 30 percent between 2015 cent, while health clinics and dispensaries rose to and 2021. Furthermore, 31 percent in Mainland 46 percent. In Zanzibar, delivery in a hospital re- Tanzania and 12 percent in Zanzibar experienced mains the most predominant location for delivery, a situation when they had no food at some point and this has risen from 56 percent in 2014/15 to 71 during 2020/21.38 Figure 15 shows the variation of percent in 2020/21. Delivery in health care facility zero meals per day by age group (right), and the and dispensaries also increased from 4 percent percentage who faced a situation where they did to 10 percent over the same time frame. Beyond not have food in 2020/21 (left). delivery and access to clinics during pregnancy, any method of contraceptive, and 33 percent of sexually active female adolescents and 54 percent of youth were using a mod- ern method of contraception (DHS 2015/16). 36  These findings match the primary data collected by Restless Development (2023b) which showed that 50 percent of ado- lescents and youth found it easy to access SRH while the remaining 50 percent do not. 37  The data also show that there is (1) minimal difference between the number of meals for males and females, (2) more ad- olescents and youth in urban areas were eating at least three meals a day, and (3) more adolescents and youth in school were having three or more meals a day. 38  The main reason was lack of finances, followed by inadequate household stocks due to drought. TRENDS IN ADOLESCENT AND YOUTH WELL-BEING 41 Figure 15: Adolescents and youth who faced a situation where no food was available at some point during 2020/21 (left) and distribution number of meals eaten by adolescents and youth (in school and out of school) (right) Source: NPS 2020/21. Household data estimate that between 2.2 per- spectively. For Zanzibar, the HBS data estimates cent to 5.6 percent of adolescents and youth in 3.2 percent disability for ages 10–14, 4.4 percent Mainland Tanzania and 3.8 percent in Zanzibar for ages 15–19, and 4.1 percent for ages 20–24. In had some form of disability.39 In 2017/18 the num- both Mainland Tanzania and Zanzibar, comparing ber of adolescents and youth with a disability is the HBS data over time suggest the prevalence estimated to be 4.7 percent (ages 10–14), 6.0 per- of disability, across all age groups, to have in- cent (ages 15–19) and 6.7 percent (ages 20–24), creased, potentially due to improved diagnosis, for Mainland Tanzania (HBS 2017/18). In 2019/20, assessment, and community acceptance to dis- prevalence of disability by age group was estimat- ability. ed at 2.5 percent, 1.9 percent, and 2.4 percent, re- PSYCHOSOCIAL WELL-BEING Within the FGDs, many youths defined peace fied as reasons limiting confidence in adolescent of mind as a compulsory part of well-being. As and youth ability to transition into adulthood. one youth boy from Ubungo, Dar es Salaam ex- plains: “To me well-being is a state whereby I have “Well-being is something that peace of mind to perform different functions. In gives you joy and peace” the absence of this calmness in mind nothing will Adolescent girl Mjini Magharibi, be done systematically.” However, many of the Zanzibar respondents identified that their peace was chal- lenged in different ways, including exam stresses or pressures from studies, and the search for em- ployment and a regular income. Most adolescents “Having well-being means to be in a free environment filled (ages 10–19) felt they were not well-equipped to with peace” manage adulthood as they were currently not Adolescent from Temeke, able to meet their basic needs. Limited education, Dar es Salaam somewhere to stay, and lacking a job were identi 39  Six questions were asked to understand the ability of (1) vision, (2) hearing, (3) mobility, (4) cognition, (5) self-care and (6) communication. Through this a yes/no binary variable with “yes” indicated if the respondent had some difficulties, a lot of difficul- ties, or could not do any of them; and “no” disability if the respondent had none, not at all, or no with assistive services. Albinism was not included in the disability definition because this report is informed by the Washington Group on Disability Statistics, and its definition of disability does not include albinism (Madans, Loeb and Altman 2011). THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 42 Adolescent and youth satisfaction with life has Adolescents and youth have defined behaviors increased from 44 percent to 57 percent since to seek assistance when stressed or psychoso- 2014/15. The NPS includes questions to the pop- cially challenged. Within the FGDs, participants ulation on the level of satisfaction in health, fi- explained they have places and people that pro- nances, housing, job, health care, education, pro- vide peace of mind. Participants explained that tection, and life in general. Overall, in 2014/15, 44 when they were stressed, they seek assistance percent of adolescents and youth were very satis- from their mother, aunties, sister, brother, grand- fied, satisfied or somewhat satisfied with their life. mother, and friends. Assistance from their father Fifty-two percent were very dissatisfied, dissatis- was low or not specified (Restless Development fied, or somewhat dissatisfied. In 2020/21, overall 2023), possibly indicating limitations on the type satisfaction increased to 57 percent while 41 per- of conversations one can have with the father. cent were dissatisfied with life. The distribution of Furthermore, the participants explained how the responses is shown in figure 16. In 2020/21, 85 beach, gym, drinking alcohol, religious houses, percent were very satisfied, satisfied or somewhat and dancing to music at a club, as key locations satisfied with their health, 28 percent with their to reduce stress. finances, 64 percent with housing, 55 percent with their jobs, 64 percent with health care, 58 percent with education, 81 percent with the level of protection, and 68 percent with transportation. Figure 16: Adolescent and youth responses to the level of satisfaction in their life (2014/15, left; 2020/21, right) Source: NPS 2014/15 and 2020/21. Note: Data present results for both Mainland Tanzania and Zanzibar. The HBS (2019/20) survey shows that 16 per- percent for ages 20–24). Exercise was four times cent of adolescents and youth were engaging higher for males (26 percent of males engaged in in frequent exercise in Zanzibar (18 percent in exercise compared to 6 percent of females), and urban areas, 14 percent in rural, 18 percent of non- highest in South Unguja (40 percent of males and poor, and 11 percent of poor). Exercise was more 6 percent of females). Approximately 1 percent common for late adolescents and youth where of adolescents and youth in Zanzibar smoked. the percentage increased from 9 percent for Smoking was only identified among males, and ages 10–14 to 19 percent for ages 15–19 and 24 most common in South Unguja (2 percent). TRENDS IN ADOLESCENT AND YOUTH WELL-BEING 43 VOICE AND AGENCY No indicators were available in the national they see something is not going well. However, datasets on voice and agency for adolescents they recognized the use of gender-desks in LGAs and youth. There is however an overlap with the and how these had given attention to some of bodily integrity indicators, such as indicators on the issues they face. Generally, youth in Zanzibar the prevalence of adolescent and youth marriage, and Mainland Tanzania feel they are given atten- violence, and access to SRH (see section 4.2). tion, listened to, and provided the opportunity to Further findings on voice and agency from the contribute to the youth political wings, especial- qualitative data analysis and literature review are ly the leading Chama cha Mapinduzi, CCM party; presented in chapter 5. at youth-led organizations; and at the LGA level. Youth in Temeke were also confident to be in po- Results from the FGD and survey suggest that sition to make future decisions about their life at although platforms for raising their voices are household level. limited, in general adolescent and youth are satisfied with the mechanisms available. The However, involvement and engagement are FGD explored voice and agency at different lev- not leading to youth leadership opportunities els: family, school, community, and district level as “age” is perceived to criteria for leadership (Restless Development 2023). At the family level, by many. From the leadership perspective, youth participants felt they were receiving some atten- and adolescent reported not being given the op- tion by parents, and felt listened to at home and portunity to lead especially at LGA levels. It was school. A few youths reported their opinion mat- explained that there continues to be norms about ters at the household and community-level deci- what makes a good leader, and that to hold a sion-making. However, at the local government leadership position you need to be of a certain authority (LGA) district-level in Temeke and Ubun- age, usually precluding representation from ado- go districts (Mainland Tanzania), youth reported lescents and youth. an absence of platforms to raise their issues when ECONOMIC EMPOWERMENT AND SKILLS While skills are acquired across the education and concerns were raised about weak English lan- subsectors, only a small portion of adolescents guage and a lack of work experience for job po- and youths are acquiring skills through Technical sitions. However, enrollment in TVET has expand- and Vocational Education and Training (TVET). ed, with annual enrollment growing by 10 percent The World Bank (2023a) report on skills in Tan- per year. In 2022, 530,000 enrolled in public and zania describes the challenges and opportunities private TVET institutions. Annually graduates are within Technical and Vocational Education and entering the labor market with primary, second- Training (TVET) in Mainland Tanzania. The report ary, TVET, or higher education certifications, highlights the TVET education system; the TVET which raises concerns about whether the skills employment structure and labor participation; ac- graduates have acquired meet the needs of the cess to, and the quality of, TVET, specifically the job market. skills mismatch between skills acquired and skills Employment patterns show that opportunities demanded by employers; and improvements that for work are mainly in agriculture, manufactur- could be made to strengthen skills development ing, and services; employment in the informal for youth. Furthermore, FGDs with adolescent and sector is rising; and self-employment is the youth identified a different set of skills were per- norm. The NPS data shows the three major eco- ceived to be needed to enter the labor market, THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 44 nomic sectors in Tanzania include agriculture, cive for long term success. Self-employment was manufacturing, and services. In 2014/15 the pro- identified to be limited in empowering the youth portion of employment by sector was 59.0 per- and adolescent due to poor market opportunities cent in agriculture, 11.0 percent in manufacturing, for products and lack of start-up capital (Restless and 31.0 percent in services. By 2021/22, agricul- Development 2023b). The World Bank (2023a) ture accounted for 60.0 percent, manufacturing TVET policy note provides results from tracer 9.0 percent, and services 31.0 percent, of the total studies showing how a high number of graduates labor force in 2020/21. In 2020/21 in the poorest move into self-employment and have low job sat- households, 8 out of 10 individuals worked in ag- isfaction. riculture compared to 3 out of 10 in the wealthi- est household. Employment in the service sector is more common for wealthier households (NPS “It is so difficult to secure formal employment in an institution 2022). Although there was an increase in employ- (public or private) even if you ment by 2 pp (NPS 2022), employment trends have all the qualifications” show youth unemployment rose from 13.7 percent Adolescent boy, Ubungo, to 14.7 percent and youth employment in the in- Dar es Salaam formal sector has also risen from 61.5 percent to 62.0 percent since 2014/15. Finally, most of the Four out of 10 adolescents and youth engage in youth remain to be self-employed. In 2022, for unpaid family work (agricultural work) as their workers ages 15 and above, own account work- main economic activity, although the prevalence ers, or self-employed category has increased sig- of this declined in 2020/21. Figure 17 shows the nificantly from 47.0 percent to 54.0 percent (NBS change in economic activity (or employment type) 2022). trend between 2014/15 and 2020/21. It is import- ant to note the percentage of youth engaged in Improved education attainment has not trans- paid (wage) employment has stayed the same (9 lated to more skilled jobs as the share of em- percent in 2014/15 with 8 percent of males and ployment in highly skills occupations declined. 9 percent of females, and 8 percent in 2020/21 Tracer studies conducted with graduates of TVET and 8 percent across males and females respec- who get a job indicate that there is a weak link tively). Another important factor to consider is the between TVET and industry jobs as there is no engagement of adolescents and youth in unpaid guaranteed employment and the skills obtained family work (agricultural), which remains the main in studies are not the most prioritized by indus- economic activity, although there has been a 14- try,40 salaries are low (with 87 percent paid less pp decline between 2014/15 and 2020/21. As of than a million T Sh a month), and job satisfaction is 2020/21, 43 percent of adolescents and youth low. The TVET report highlights the need for TVET stated unpaid family work (agricultural) to be their studies to be more demand-driven and decentral- main economic activity (45 percent of males and ized. During the FGDs youth and adolescents ex- 41 percent of females). Moreover, since 2014/15, pressed a consensus that (s) it was difficult to get there has been an increase in self-employment a job41; and (b) the main solution was to employ (nonagricultural), apprenticeships (paid and un- yourself, even though conditions are not condu- 40  TVET training needs to be better aligned to the industry, and this issue is examined in a recent report from the Tanzania Private Sector Foundation (TPSF) which analyzed the extent of the skills mismatch between what employers want (demand) and what they receive (supply) across six sectors of Tanzania. Across the six sectors, training institutes are not equipping youth with the skills that employers need and want (TPSF 2021). Taking the example of agribusiness and agroprocessing sector, the highest skills demanded by teachers’ staff (and taught in training institutions) is farming technology, while the most in-demand skill by employers of agribusiness and agroprocessing is farming practices. In the tourism and hospitality sector, the most demanded skills for teaching staff are customer care while employees place the greatest value on a graduate having good communication skills and being able to speak multiple languages. This skills mismatch is a recurring concern across all the sectors including construction, ICT, and transport and logistics. 41  During the FGDs there was a consensus that you must know someone in an institution even if you have all the job qualifi- cations (nepotism); and for young girls sexual corruption (sextortion) is widely mentioned to be associated with employment in many institutions (Restless Development 2023a). TRENDS IN ADOLESCENT AND YOUTH WELL-BEING 45 Figure 17: Adolescent and youth employment (total (left), male (middle), and female (right)) (2014/15 to 2020/21) Source: NPS 2014/15 and 2020/21. Note: Data present results for both Mainland Tanzania and Zanzibar. paid), unpaid family work (nonagricultural), and cate how youth have to multitask or work while in ownership of a farm, especially for females. How- education. Employment of adolescents and youth ever, these increments are marginal. Farm own- in school was higher in rural areas (see table 3). ership increased from 25 percent to 27 percent, Being employed while studying was higher for largely because of increases in farm ownership boys compared to girls. Although the difference by females rising from 24 percent to 29 percent for employment of boys and girls in school ages (males remained steady rising slightly from 25 10–14 was small, approximately 1 pp. percent to 26 percent). Employment is common while attending ed- The joint status of being employed and attend- ucation.42 When disaggregating employment ing school was highest in Rukwa region. Figure for adolescents based on enrollment status, the 18 shows the variation in employment of adoles- 2019/20 LFS data show employment rates are cents (ages 10–19) who are attending school and higher for adolescents (ages 10–19) not enrolled out of school.43 Rukwa, Lindi and Kagera have in education. However, many adolescents are the highest percentage of adolescents and youth working while in school, especially those in rural who are employed or engaging in economic ac- areas. About 26.6 percent of adolescents (27.8 tivity while studying. Out-of-school adolescents percent of males and 25.4 percent of females) en- and youth who were employed reached as high rolled in education were engaged in some type as 95 percent in Rukwa (94 percent of females of economic activity, compared to 75.4 percent of and 96 percent of males) and as low as 40 per- adolescents (79.8 percent of males and 71.0 per- cent in Dar es Salaam (37 percent of females and cent of females) were not enrolled in education. It 60 percent of males). should be noted that education for 20–24-year- olds is not compulsory; however, the findings indi- 42  Although post lower secondary education is not compulsory, this study highlights the prevalence of employment while in education. Further disaggregation will be provided focusing on employment in school for learners ages 10–19 only. 43  Recent research by Shule Bora (FCDO) shows that the seasonality of work matters. Regions and LGAs have seasonal pat- terns of employment for children attending school. Therefore, the seasonality of when families and children were asked these questions in the survey needs to be considered. (not published) THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 46 Figure 18: Variations in employment for adolescents (10-19 years only) in education (left) and out of education (right), by region for Mainland Tanzania only Source: LFS 2019/20. Note: Darker shades of blue represent regions with higher percentage of adolescents employed while in education (left)/ while out of education (right). Employment for adolescents and youth increas- and 75 percent of youth ages 20–24 were em- es with age and is consistently higher for males ployed (81 percent of males and 70 percent of and in rural locations, compared to the counter- females), not differentiating those in and out of parts. Overall, in the LFS 2019/20, 30 percent of school. The LFS for 2019/20 shows more males adolescents ages 10–14 were employed (32 per- are employed compared to females, and em- cent of males and 28 percent of females); 53 per- ployment is double (or three) times higher in rural cent of adolescents aged 15–19 were employed compared to urban areas. (55 percent of males and 51 percent of females); Table 3: Employment of adolescents and youth, by age, location, and enrollment status Ages 10–14 Ages 15–19 Ages 20–24 In school Out of school In school Out of school In school Out of school Rural 30.5 67.6 34.5 83.6 27.1 86.3 Urban 11.2 36.1 15.7 58.6 10.7 65.1 Total 25.7 64.5 28.7 78.6 17.5 80.2 Source: LFS 2019/20. Regardless of whether attending school or not, agriculture declines if out of school (65 percent), most adolescents and youth were engaged in out of school in urban areas (20 percent), and by agriculture. As shown from the NPS, the LFS sur- age (the percentage employed in agriculture if vey identifies agriculture to be the main employ- out of school declines from 76 percent for ages ment activity for adolescents and youth, irrespec- 10–14 to 59 percent for ages 20–24.44 Agricultur- tive of attending school or not (see figure 19). The al employment is more common for adolescents dominance of employment in agriculture persists (ages 10–19), compared to youth (ages 20–24). when looking at the total in school from urban Engagement or employment in household activi- and rural locations (55 percent and 81 percent, re- ties and the private sector become more common spectively). However, the proportion engaged in if the adolescent or youth is not attending school 44  Seventy-six percent of 10–14-year-olds out of school worked in agriculture compared to 78 percent of those in school; 70 percent of 15–19-year-olds out of school compared to 77 percent in school; and 59 percent of 20–24-year-olds out of school compared to 60 percent of those in school. TRENDS IN ADOLESCENT AND YOUTH WELL-BEING 47 and if they are of an older age. The proportion of in household activities doubled if in urban areas male and female employed in household activi- (29 percent out of school in urban areas com- ties was similar for those in school, but for adoles- pared to 15 percent in rural areas). Finally, private cents and youth out of school more females were sector employment was occupied by 17 percent employed in this sector (22 percent) compared of adolescents and youth out of school but only 5 to males (14 percent). For both adolescents and percent of those in school. youth in and out of school the number employed Figure 19: Employment of adolescents and youth, by age, gender, and enrollment status Source: LFS 2019/20. Adolescents and youth explained how self-em- ness loan or capital. For those who were lucky ployment is not by choice, but rather due to to access a loan, over 50 percent had difficulties difficulties in finding jobs, which suggests a finding a potential market for their products. The skills-mismatch across the board (Restless De- adolescent and youth surveys explained 44 per- velopment, 2023ab). Of the respondents of the cent did not have access to entrepreneurial skills survey, 83 percent of adolescents and youth ex- required for self-employment and for those em- plained they had difficulties finding a job, and 82 ployed, 37 percent confessed to not having the percent explained it was difficult to access a busi- skills required by the employer. Box 6: Factors correlated to adolescents and youth employment and unemployment Evidence shows employment among adolescents and youth in Mainland Tanzania (2017/18) increases with the following factors: (1) gender, with females ages 10–19 and ages 20–24 are more likely to be employed com- pared to their males (1.324 (ages 10–19) and 1.442 (ages 20–24); (2) residence, with urban adolescents and youth four times more likely to be employed (significance 0.000); (3) the size of the households, with youth in larger households, with 6 and above members, less likely to be employed; (4) income, non-poor adolescents and youth were more likely to be employed; (5) the gender of the head of household, with adolescents and youth from fe- male headed households twice as unlikely to be employed; and (6) education of the head of household, in which adolescents and youth from households where the head of household had secondary or higher education were 11 percent (ages 10–19) and 12 percent (ages 20–24) more likely to be employed. See annex C table C.4 for full results on the correlations. The evidence also shows zonal variations in the prevalence of employment. Adolescents (ages 10–19) from the Lake Zone were 2.8 times more likely to be employed compared to those from the Western Zone. Youth (ages 20–24) from the Lake Zone were 4.4 times more likely to be employed, and from the Northern Zone 4.3 times more likely to be employed, compared to those from the Western Zone. These zonal variations in employ- ment correlates show that regional and zonal employment opportunities vary across Mainland Tanzania. Source: HBS 2017/18. THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 48 CHAPTER 05 EVIDENCE OF GOOD INTERVENTIONS FOR ADOLESCENT AND YOUTH WELL-BEING AND POTENTIAL INVESTMENT AREAS THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 49 CHAPTER 05: EVIDENCE OF GOOD INTERVENTIONS FOR ADOLESCENT AND YOUTH WELL-BEING AND POTENTIAL INVESTMENT AREAS REDUCING THE DROPOUT RATE AND USING EARLY WARNING SYSTEMS Tanzania has continued to invest in improving of an early warning dropout system (EWS). EWS equitable access to quality basic education, has been shown to be effective across many ed- and this vision is being operationalized through ucation systems to reduce or prevent dropouts several programs, including World Bank pro- by enabling the school and education authorities grams, such as the Education Program for Results to identify at-risk students and intervene early, as (EPforR), Boosting Student Learning Outcomes appropriate (see UNICEF 2016).45 Through the (BOOST), Secondary Education Quality Improve- SSP the Government is building the capacity of ment Project (SEQUIP), and Zanzibar Improving teachers and heads of school to ensure schools Quality of Basic Education Project (ZIQUE); as well are a safe space, enabling a child to access key as programs from development partners, NGOs, services (beyond education) such as SRH, leader- and CSOs. Through these programs the govern- ship, life-skills, and family planning. Furthermore, ment is scaling up interventions to improve access the holistic approach and engagement of multi- to, and quality of, education. There are also spe- ple stakeholders used in the SSP are crucial as cific interventions focused on reducing the drop- research shows improved effectiveness when out rate and identifying earlier students at risk of knowledge on violence, protection, and punish- dropping out. In Mainland Tanzania, the govern- ment is provided to children, adolescents, and ment is rolling out a Safe School Program (SSP) stakeholders (Lees and Devries 2018). However, for primary and secondary schools, which focus- evidence also shows that EWS tends to be more es on provision of life skills training for students, suitable in contexts where the dropout rate is low capacity building of guidance and counselling (below 10 percent).46 In addition, East Asian coun- teachers at the school level, improved awareness tries highlight how building social narratives and of teachers’ code of conduct and pedagogical norms on the importance or value of education skills to ensure teaching is inclusive, the strength- are key to ensure completion and motivation to ening of community engagement, and the rollout learn (see box 7) 45  Lee and Chung (2019) explore the use of machine learning to predict dropout rates through EWS. 46  In Mainland Tanzania, studies will be conducted to follow up on the impact of the SSP and EWS. THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 50 Box 7: The case of China and building the value of education and importance of learning Shanghai has strong embedded social norms that place a high value on education. The methods used by Shanghai to score as one of the top education systems worldwide include four traditional factors that include the following: (1) high expectations or value on education, (2) belief in hard work and diligence to bring change at the individual and family level, (3) trust and respect in teachers, and (4) identification of examinations as a safe- guarding mechanism that validates education as something to be respected and valued. This traditional value system helps parents see the importance of their child attending and completing school. Source: Zhang 2023. TECHNOLOGY AS A TOOL TO ENCOURAGE ADOLESCENT AND YOUTH VOICES Adolescents and youth have raised their voice and adolescents, (4) inconsistent budget alloca- to demand action on the key challenges they tion, (5) traditional systems for delivering educa- face. The Tanzania Youth Manifesto (TYM) (2020– tion, and (6) inadequate utilization of technology. 2025), prepared and launched by sixteen civil-so- In the case of health, especially health services, ciety organization (CSOs) in Tanzania following TYM raised concerns that SRH centers are not ad- the national elections in 2020. The TYM identified olescent- or youth-friendly, and health insurance six key priority areas for improvement: education is not accessible, leaving adolescents and youth for all; health; jobs; inclusion, voice and agency; at risk. In the case of jobs, TYM stated that they and access to information. TYM identifies the main have limited access to financial services, decent gaps and demands for each priority area (Tanza- jobs, entrepreneurship knowledge and necessary nia Youth Coalition (TYC) 2021). For example, in skills; they described the resistance in the busi- the case of education for all, the youth identified ness environment to startups and the exclusivity the following challenges faced for youth educa- of new, emerging industries, such as the creative tion: (1) a mismatch between the formal education industry, which left them feeling ill-equipped to and twenty-first century skills, (2) high illiteracy enter or navigate within. rates, (3) the high school dropout rates of youth EVIDENCE OF GOOD INTERVENTIONS FOR ADOLESCENT AND YOUTH WELL-BEING AND POTENTIAL INVESTMENT AREAS 51 With nearly 90 percent of adolescents and ages 15–19; and 89 percent of households with youth with access to a mobile phone within youth ages 20–24, accessed a mobile phone. their household, technology has the potential Access to a mobile phone in the household in- for improving effective participation in civic en- creases by 3 pp if there are youth ages 20–24 gagement and economic development. The ILFS in the household. Box 8 identifies a possible low- (2019/20) reported that 87 percent (87 percent of cost intervention that can be improved for better males and 88 percent of females) of households engagement of adolescents and youth. U-Report with adolescents and youth ages 10–24 were is a free SMS platform engaging the population able to access a mobile phone. Ownership was 10 to share their opinion on different issues. U-Re- pp higher in urban areas at 95 percent. When dis- port was launched in 2017 in Mainland Tanzania aggregating by age groups within the household, and 2018 in Zanzibar by UNICEF (UNICEF, n.d.). 86 percent of households with adolescents ages To date 260,760 subscribers have joined the plat- 10–14; 87 percent of households with adolescents form; and the subscribers are age 0 to over 35. Box 8: Using technology to ensure adolescents and youth participate The U-Report platform sends (free) SMS to subscribed users on different topics, however, response rates are quite low. In a recent opinion poll on corporal punishment to discipline students in schools, 13 percent of subscribers responded (10,896 males and 6,259 females). The main responders were from Dar es Salaam. The responses received were mixed in opinions. For example, 49 percent believed teachers should be able to use corporal punishment to discipline students, while 51 percent disagreed, and 64 percent did not believe corporal punishment changed a student’s behavior. When asked whether corporal punishment should be banned 45 percent agreed, 46 percent disagreed, and 9 percent did not know. However, the poll provides useful infor- mation on who administers corporal punishment in school, with 76 percent confirming any teachers does so. For policy makers this provides evidence that the policy for corporal punishment is not being adhered to at the school level. The policy currently allows for corporal punishment although guidance is provided on how it is to be administered only by one designated teacher in the school. In addition, platforms like FEMINA-Hip magazines enable youth engagement on key topics. Social media is also a key area to explore how to engage youths on topics. The FGDs expressed how social media was frequently used. Source: UNICEF, n.d.; FEMINA-Hip, 2023. SUPPORTING THE TRANSITION TO DECENT WORK OR LABOR It is important to support the transition to work tive Jobs (ESPJ). Buni and GENEmpower have and decent jobs through consideration of men- provided internships and mentorships to students torship or startup kits for adolescents and youth starting a business, while ESPJ has focused on seeking work. To help bridge the gap between tracer studies to identify where graduates go and school and work for adolescents and youth there the conditions of work. However, more could be are NGOs such as Buni and Empower and pro- done to support adolescents and youth who are grams such as the Youth Entrepreneurship Facility looking to start a business, since many must rely (ILO) supported by Kazi Nje Nje (Work Outside) or on own-funding or informal funding sources, such the World Bank Education and Skills for Produc- as funding from family (Tanzania Startup Associa- THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 52 tion (TSA) 2022). The establishment of start-ups for self-employment. Youth also encouraged the and a strong ecosystem for startups has been Government to support the growth of key indus- limited due to lack of access to local funding op- tries including the tourism industry, mineral sec- portunities. tor, and harbor development. These sectors were identified as opportunities for casual labor and Youth encouraged the Government to invest skilled labor opportunities, hence potentially re- in strengthening good language skills for im- ducing unemployment rates. proved opportunities of employment, and busi- ness skills and market analysis for improved entrepreneurialism. Addressing these skills “Skills on how to self-employ and gaps is key for youths to make the transition practical skills to make products to work. English fluency was identified as a key such as cake, baskets, etc. is barrier to entering the formal labor market and missing to youth” Narrated a young boy (20-24) market analysis/ business skills are two examples from Kinondoni ENSURING THE PROVISION OF LIFE SKILLS FOR EMPOWERMENT Evidence shows connecting microfinance ser- vulnerable adolescents were targeted through vices with empowerment interventions for the intervention. The TASAF program provides a adolescents leads to improved participation maximum transfer of US$17 (38,000 T Sh) month- and results for adolescents. A study comparing ly to poor households, depending on whether the outcomes of the Empowerment and Liveli- the household has a child under age 5 or age 18, hood for Adolescents (ELA) program by BRAC in or a child enrolled in school (the fixed amount is Uganda and Tanzania shows that microfinancing US$4.50 or 10,000 T Sh). The cash-plus program improves adolescent participation in life-skills complements TASAF with livelihood enhance- clubs or saving groups (Beuhren et al. 2017). ment interventions, focused on life-skill develop- Microfinance services, linked to empowerment ment, including savings promotion and training to (life-skills), also worked to increase participation access productive opportunities, links to services of adolescents not enrolled in the ELA program. for SRH and HIV (and life-skills training), and small With these findings, the UNICEF-funded cash-plus grants to support safe economic activities (TSAF, intervention is an important program to highlight. TACAIDS and UNICEF 2020). The program has Cash-plus was developed as an intervention for been rolled out in two phases: a three-month ed- vulnerable adolescents, going beyond cash pro- ucation program (mid-line) and a nine-month men- vision. UNICEF coordinated with Tanzania Social torship. The cash-plus intervention has recorded Action Fund (TASAF), which supports 1.1 million improving health, education and empowerment, poor households in Tanzania, to ensure the most outcomes and of adolescent well-being through EVIDENCE OF GOOD INTERVENTIONS FOR ADOLESCENT AND YOUTH WELL-BEING AND POTENTIAL INVESTMENT AREAS 53 connecting the ‘livelihood enhancement’ inter- lescents living within the most vulnerable house- ventions with conditional cash transfers to ado- holds (box 9). Box 9: Cash-plus intervention for vulnerable adolescents The cash-plus targeted adolescents ages 14–19 living within a household. The baseline assessment report shows that adolescents living in a household supported by TASAF remain vulnerable as the household is la- bor-constrained, has large numbers of children and adolescents and few working-age adults, and is likely to be headed by the elderly, with an average age of 60. The findings show that the cash-plus intervention has a positive impact on: (a) adolescent’s aspirations to own a business, (b) participation in economic activity, (c) mental health, (d) self-esteem, (e) entrepreneurial attitudes, (f) gender equitable attitudes, (g) contraceptive and HIV prevention knowledge, (h) HIV testing, (i) increase in visits to health facilities, and ( j) reduction in sexual violence, delays in sexual debut, and decreases in perpetration of violence. However, there was a negative unintended impact on schooling whereby the dropout rate of older female adolescents increased. Source: TASAF, Tanzania Commission for AIDS (TACAIDS), and UNICEF 2020. INVESTING IN FOUNDATIONAL SKILLS AND UPSKILLING FOR AGRICULTURE There is a need to invest in foundational skills, benefiting from, agriculture: access to land as an especially to ensure youth progress up the ag- entry barrier and access to knowledge (improved riculture value chain. Evidence suggests invest- technologies) as key for improving productivity ments in TVET, or higher education do not always (URT 2022b). The initiative started in 2022 and pay off, especially for students with weak pros- will close in 2030. However, youth can only ef- pects of employment or a lack of foundational fectively benefit from agribusiness if six principal skills (World Bank 2019), although the returns vary challenges are addressed. These include access depending on the course studied. In Ghana, the to the following: (a) knowledge, information, and ratio in relative returns for students studying ag- education (including agricultural training and ed- riculture, health and welfare courses ranged from ucation to ensure the graduates can meet the 1 to 11 times the earnings of a typical worker who demands of the market); (b) land; (c) financial ser- has completed secondary education. This shows vices; (d) specialized skills on-the-job, i.e., skills the need to improve the quality of the skills cours- for green jobs; (e) markets to sell goods; and (f) es being delivered but also an opportunity for in- involvement in policy dialogue (see FAO 2014). vesting in agriculture courses. Several countries The interventions need to be seen as a holistic have invested in strengthening foundational liter- package to be effective. acy and numeracy skills for out-of-school youth Youth and adolescents participating in the FGDs and adults to improve agriculture productivity. suggested the Government should improve ru- More guidance and improved policies are re- ral roads (for improved connectivity to trade quired to show how agriculture can generate markets) and the availability of agricultural in- higher profits. The Ministry of Agriculture has puts (tractors, fertilizer, irrigation schemes) to recently established the Building a Better Tomor- attract youth to stay in rural areas, and benefit row: Youth Initiative for Agribusiness (BBT-YIA) fo- from those opportunities. Otherwise, migration to cused on addressing two main problems that hin- urban areas will continue. der youth (and women) from participation in, and THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 54 CHAPTER 06 THE WAY FORWARD AND POLICY RECOMMENDATIONS THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 55 CHAPTER 06: THE WAY FORWARD AND POLICY RECOMMENDATIONS More progress can be made in improving ado- government could utilize a holistic approach and lescent and youth well-being, especially for the consider the following recommendations: (a) en- bottom income quartile. Figure 20 summarizes sure the most vulnerable are reached; (b) all ado- the risks adolescents and youth face as they tran- lescents and youths are supported to get the skills sition into adulthood. It maps the risks against data they need to get, or make, the decent jobs; and on enrollment in education (preprimary, primary, (c) peace of mind is sustained. Recommendations secondary, and TVET). To ensure the potential of are provided below and highlighted in table 4. adolescents and youth is better harnessed the Figure 20: Transition of adolescents and youth and the barriers faced in Mainland Tanzania and Zanzibar Source: URT 2022a (Mainland Tanzania); URT 2021 (Zanzibar). Note: Figure shows enrollment across subsectors and key aspects affecting adolescents and youth over time. TVET shows data from 2021. THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 56 Make more effective use of a household-based training, and (3) informal education or short cours- approach to target adolescent and youth es to adolescent and youth. These skills should well-being. Evidence shows that the adolescent be supported by a package, including financing and youth should not be viewed in isolation to for agricultural start-up and land, to help harness their household. Dropout rates, employment, and the full potential of youth and adolescents in this marriage in combination with household structure field. This recommendation should be viewed and dynamics play important roles in adolescent with consideration of the ongoing curriculum re- and youth well-being. The age and education forms due to be implemented from January 2024, of the head of household and the adolescent or whereby the curriculum will introduce a flexible youth relationship to the head of household can education system (vocational stream and gener- also contribute to increasing the risk of dropouts. al education stream) following the completion of Interventions such as the cash-plus TASAF are Standard 6 (primary school). thus well-designed as they not only target the in- Operationalize the multisectoral coordination dividual adolescent or youth but the whole house- unit of NAIA-AHW for advocacy and monitoring, hold. Engagement of parents and communities while also continuing to support line ministries has also been identified as a cross-cutting issue. to ensure adolescents and youth are included in Focus on the bottom quartile adolescents and relevant service delivery. It remains important to youth across all sectors and provide foundation- equip the multisectoral NAIA-AHW to operate as al and digital skills for all. Research shows invest- an advocate for adolescents, however, it should ing in foundational skills such as literacy increas- not take the role of service delivery. Line minis- es lifelong earnings by 18 percent to 25 percent.47 tries should remain in charge of adolescents and Foundational and digital skills are necessary for youth in their services, and they should ensure all adolescents and youth to effectively engage any special needs are catered to or targeted. NA- in the labor and job market, and more attention IA-AHW should act as advocacy secretariat and needs to be paid to the bottom quartile. As shown potentially a (external) joint monitoring platform in Section 3, 20 percent adolescents and youth would be able to identify the priority areas for ad- in Mainland Tanzania and 10 percent in Zanzibar olescents and youth. A similar secretariat can be complete lower secondary education. See figure establishment in Zanzibar. 20, which shows the bottom 22 percent are still Harmonize national survey and data tools to getting pregnant, 7 percent to 11 percent are get- ensure comparison is available over time and ting married, and 15 percent to 30 percent are not across domains. This study highlights the wealth accessing SRH. There is a need to focus on the of data available through national surveys, how- bottom quartile to ensure such risks are reduced. ever, it also shows the inconsistencies and vari- Investing in agriculture skills for improved diver- ations in the data based on which questions are sification and the informal job market to better asked and what methodology, weights, and tools connect to industry needs. The prevalence of are used. There is a need to consider having one employment in agriculture by adolescents and national survey conducted regularly (every 2 to 3 youth identifies the need for investing in the years) that can encompass all data required. Im- right skills for productive engagement in this in- provements in the categorization of employment dustry. There is as described above the need for is also needed to ensure greater accuracy in the (1) foundational skills through formal education, type of jobs. (2) upskilling through internships and on-the job 47  The skills minimum proficiency is defined as basic foundational skills, socioemotional skills, higher order cognitive skills, and specialized skills. Early years to secondary should ensure foundational, socioemotional, and higher order cognitive skills are well-built (Hanushek et al. 2013). THE WAY FORWARD AND POLICY RECOMMENDATIONS 57 Table 4: Summary of recommendations for adolescent and youth well-being in Tanzania Domain Age Short Term Recommendations • Build capacities of teachers and heads of school to implement the Safe School Program and ensure schools provide holistic support to the child, i.e. psycho-so- cial, SRH, family planning, life skills, parent-teacher partnerships. • Make schools a space for adolescents to practice leadership. • Target interventions for vulnerable adolescents to reduce dropout rates and Education and 10-19 ensure compulsory basic education. learning • Engage parents and communities through awareness campaigns to commu- nicate the benefits of education complemented with testimonies from young people who have succeeded. • Establish a campaign encouraging use of internships or work experience oppor- tunities to be used during the long-wait time as an adolescent is transiting from Form 4 to Form 5. • Parliament to approve the amendment to the Law of Marriage (1971) increasing Bodily integrity 10-19 the legal marrying age to the age of 18. • Start an awareness/education campaign targeting parents and religious leaders to accept changes to the marriage law. • Improving awareness of and access to health insurance benefits, as well as Health 10-24 service delivery targeted at adolescents’ health needs. (and nutrition) • Engage the community in school nutrition programs. Voice and • Strengthen gender desk at the LGA-level to ensure grievances addressed. agency 10-24 • Build youth leaders, adopting programs where strong youths are highlighted in the community. • Continue to strengthen support relationships that youth use and facilitate the Psychological 10-24 growth of new ones with fathers. well-being • Strengthen provision of safe spaces in schools and communities for youth and adolescent to seek counsel (and avoid negative behaviors). • Strengthen quality education provision and short programs to ensure graduates can transition to work and self-employment (meeting the supply and demand needs and closing the mismatch between what employers want and students Economic have). empowerment 10-24 • Strengthen agri-skills and opportunities to ensure the majority of adolescent and and skills youth are not left behind, this should focus on those in and out of school, recog- nizing the prevalence of agricultural work (paid and/or unpaid). • Develop funds/initiatives to support the transition to self-employment with initial business capital, improve the business environment (tax reduction), and be ready to offer youth friendly business loans. • Strengthen quality education provision and short programs to ensure graduates can transition to work and self-employment (meeting the supply and demand needs and closing the mismatch between what employers want and students have). Cross-cutting 10-24 • Strengthen agri-skills and opportunities to ensure the majority of adolescent and youth are not left behind, this should focus on those in and out of school, recog- nizing the prevalence of agricultural work (paid and/or unpaid). • Develop funds/initiatives to support the transition to self-employment with initial business capital, improve the business environment (tax reduction), and be ready to offer youth friendly business loans. Note: Detailed recommendations for improving learning in basic education are provided in the World Bank (2023) policy note for basic education; and improved recommendations for TVET are provided in the TVET policy note. THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 58 Medium to Long Term Recommendations Responsible Agency • Strengthen public-private partnerships to provide work experience opportunities upon graduation of lower secondary, upper secondary, TVET and university. MoEST • Establish national poverty data base including poor and vulnerable youth PO-RALG • Adopt a cross-sectoral strategy to ensure targeting to vulnerable households. • Ensure access to SRH and family planning to the most vulnerable – rural, boys and MoCDGWSG girls, and those in school – by removing the barriers in accessing the knowledge MoH and service. MoEST PO-RALG MoCDGWSG • Improve school nutrition initiatives for adolescent and youth in school MoH MoEST PO-RALG MoCDGWSG MoEST PO-RALG • Provide financial security programs for adolescent and youth. MoEST PO-RALG • Promote English fluency as a key to enter the formal labor market. • Support market analysis/business skills as two examples for self-employment. MoEST • Create a job-selection system which can match graduates (secondary, TVET and PO-RALG university) to open job positions or spaces in formal employment and identify up- PMO-LYED coming self-employment opportunities. • Develop a harmonized household survey that will collect data across variables and MoEST be comparable MoCDGWSG • Ensure adolescent and youth well-being needs are reflected across all sectors and PO-RALG key ministries. PMO-LYED THE WAY FORWARD AND POLICY RECOMMENDATIONS 59 ANNEXES ANNEX A: CONTEXT OF ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA Table A.1: Summary of GOT plans and visions to improve adolescent and youth well-being Plan Year Coverage Constitution of the United Republic of Tanzania 1977 Mainland, Zanzibar Tanzania Development Vision (TDV) 2025 1995 Mainland, Zanzibar National Five-Year Development Plan III (FYDP) 2021–2026 Mainland, Zanzibar National Youth Development Policy 2007 Mainland, Zanzibar National Youth Council Act 2015 Mainland Health Health Sector Strategic Plan V 2021–2026 Mainland National Adolescent Health and Development Strategy 2018–2022 Mainland Zanzibar Reproductive, Maternal, Newborn, Child and Adolescent Health 2019–2023 Zanzibar Strategic Plan National Road Map Strategic Plan to Improve Reproductive, Maternal, 2016–2020 Mainland Newborn, Child & Adolescent Health in Tanzania; Strategic and Action Plan for the Prevention and Control of Non-Communicable Diseases; Human Resource for Health and Social Welfare Strategic Plan; Health Financing Strategy 2016–2020 2014–2019 Education Education and Training Policy (ETP) 2014 Mainland Education Sector Development Plan III (ESDP) 2022–2026 Mainland Education Policy 2006 Zanzibar Zanzibar Education Development Plan II (ZEDP) 2017–2022 Zanzibar School feeding guidelines for primary and secondary 2019; 2022 Mainland Guidelines for Implementing HIV/AIDS and Life Skills Education Pro- 2004 Mainland gram in Schools Safe School Program (Primary and Secondary) 2022 & 2023 Mainland & Zanzibar Multi-sectoral National Accelerated Action and Investment Agenda for Adolescent 2021–2025 Mainland Health and Wellbeing (NAIA-AHW) THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 60 Objective Impact to Ages 10–24 National constitution defining the rights and duties of citizens and role Rights of adolescents and youth are of the state. defined within. Defined the society Tanzania visioned by 2025. Three goals defined: Principals for adolescents and youth achieving quality and good life for all; good governance and rule of still applicable today. law; and strong and resilient economy. Multisectoral plan to achieve the goals defined in the TDV. Skills, education, business, employ- ment, and inclusion in the economy. Defines youth in Tanzania and the key policy issues to empower Addresses development issues for youth. youth (ages 15–24). Describes the structure and function of Youth council at different lev- Not applicable els. Defines a multiyear plan target across health outcomes. Adolescent health is included as a pri- ority. Develops a strategy that enables the government to work on ADHD. Not applicable Not applicable Not applicable Not applicable Not applicable Defines the vision and mission of education in Tanzania. The ETP de- Recipients of formal and non-formal fines the principles, structure, and process of education. education. A multiyear plan defining targets across sub-sectors of education from Recipients of formal and non-formal pre-primary, primary, secondary, technical, vocational, and higher ed- education. The ESDP also identifies ucation. Guides the implementation of the ETP. targeted programs for out-of-school adolescents and youth. Defines the vision and mission of education in Zanzibar. Defines the Recipients of formal and non-formal principles, structure, and process of education. education. A multiyear plan defining targets across sub-sectors of education Recipients of formal and non-formal from pre-primary, primary, secondary, technical, vocational, and high- education. The ZEDP also identifies er education. Guides the implementation of the Policy. adolescent health and life skills as a key target. Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Multisectoral agenda aiming to address the key challenges facing ad- Prioritize implementation for adoles- olescent health and well-being (ages 10–19). Identifies six pillars for cents in Geita, Katavi, Kigoma, Lindi, intervention and prioritizes 13 regions (targeted). Mara, Mbeya, Mwanza, Rukwa, Shin- yanga, Simiyu, Songwe, Tanga, Tabo- ra. ANNEXES 61 Figure A.1: Population pyramid for Tanzania (Mainland and Zanzibar) total (top), urban (middle) and rural (bottom) 80+ 246,373 389,289 75-79 166,357 207,937 70-74 288,954 337,913 65-69 329,847 374,238 60-64 555,227 595,847 55-59 616,939 636,403 50-54 906,162 947,236 45-49 1,121,993 1,168,071 40-44 1,315,193 1,396,308 35-39 1,532,164 1,676,186 30-34 1,902,825 2,053,133 25-29 2,220,568 2,507,604 20-24 2,560,797 3,005,179 15-19 3,096,582 3,185,807 10-14 4,035,586 3,961,652 5-9 4,434,204 4,484,375 0-4 4,723,359 4,760,812 Male Female 80+ 54,281 95,755 75-79 42,868 53,813 70-74 80,517 92,420 65-69 101,497 110,027 60-64 171,289 182,355 55-59 204,211 204,606 50-54 317,041 314,061 45-49 419,540 419,858 40-44 523,371 541,273 35-39 635,170 681,230 30-34 817,904 881,704 25-29 967,785 1,107,584 20-24 1,044,277 1,274,661 15-19 1,035,102 1,221,172 10-14 1,156,374 1,224,752 5-9 1,313,444 1,349,838 0-4 1,449,008 1,455,835 Male Female 80+ 192,092 293,534 75-79 123,489 154,124 70-74 208,437 245,493 65-69 228,350 264,211 60-64 383,938 413,492 55-59 412,728 431,797 50-54 589,121 633,175 45-49 702,453 748,213 40-44 791,822 855,035 35-39 896,994 994,956 30-34 1,084,921 1,171,429 25-29 1,252,783 1,400,020 20-24 1,516,520 1,730,518 15-19 2,061,480 1,964,635 10-14 2,879,212 2,736,900 5-9 3,120,760 3,134,537 0-4 3,274,351 3,304,977 Male Female Source: National Bureau of Statistics (NBS); Dashboard on the National Census 2022. THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 62 Figure A.2: NAIA-AHW framework (2021–2025) Source: MOHCDEC, URT. 2021. ANNEXES 63 63 ANNEX B: DESCRIPTION OF THE VARIABLES AND WEIGHTS Survey weights are mainly used to adjust the selection that is primary sampling units (Eas) imbalances between the survey sample and and households sampled from the PSU’s. The the population. For surveys studies the com- weight considered information of segmented mon types of weight used are design weights PSUs and also number of households that ac- or non-response weights. Similarly, in this analy- tually responded to the survey in each of the sis design weights were used to compensate for PSUs. The design weight was then adjusted oversampling or under-sampling of the specific at individual level to equate population results cases. A simple interpretation of weights is it indi- from the sample to respective projected popu- cates how much each case will count in statistical lations with regard to sex and age distribution procedure, for example for a weight of 107 that from 2021 census (URT 2022c). means each case sample will count as 107 cases • Demographic Health Survey (DHS). Like other including itself in the study. Below is a summary designs multistage sampling was used; the first of how survey weights were calculated (obtained step involved selecting sample points (clusters) from the documents shared accompanying the which consists of EA identified from the 2012 datasets) as: Tanzania population and housing census. The • All Household Budget Surveys (HBS). Mul- second stage involved obtaining the household tistage sampling strategy was used; the first from the clusters using systematic sampling stage was to select the Enumerative Areas (EA) strategy. In this survey, two weights are used: as Primary Sampling Units defined from the household weights and individual weights. The census enumerations. Then stratification based household weight is the inverse of its house- on residence (rural/urban) status. Weights were hold selection probability multiplied by the calculated using Horwitz-Thompson estimator inverse of the household response rate of its which consist of multiplying the observed from household response rate group. The individual the sampled units by the inverse of their selec- weight of a respondent’s case is the household 1 tion probabilities. = . This is an unbiased weight multiplied by the inverse of the individu- estimator and provides good estimates in the al response rate of her individual response rate absence of auxiliary information. Here wi is the group. Response rate groups are groups of weight for the sampled unit/individual i in the cases for which response rates are calculated cluster/ EA. Individual weights are the combi- for example household response rate equals nation of cluster weight, in-cluster weight, and to number of household with completed HH in- non-response adjustment weight. Finally, over- terview over sum of number of household with all population weight was obtained by multiply- a completed household interviews + dwelling ing household size and individual weight. with no competent respondent + household with postponed/no competent respondent and • Integrated Labour Force Survey (ILFS). The household which dwelling was not found. design weight was computed by multiplying inverse of probabilities at the two stages of THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 64 Table B.1: Summary of the distribution and summary statistics of weights from each dataset used in analysis Total Weighted Data Source Weights Summary Statistics Sample Sample Mean Median Minimum Maximum (SD) Household Budget Popweight= 6718.1 4036.4 107.5 78010.4 14,827 89,892,470 Survey 2011 – Main- hhweight*hhsize (7645.1) land Household Budget Popweight= 7558.2 5860.0 153.2 86707.2 14,272 107,859,678 Survey 2018 – Main- hhweight*hhsize (6485.1) land Household Budget Popweight= 434.9 397.8 36.5 3229.3 8,100 2,944,838 Survey 2014 – Zan- hhweight*hhsize (238.0) zibar Household Budget Popweight= 802.9 693.7 42.4 3563.1 4,697 3,770,242 Survey 2019 –Zan- hhweight*hhsize (482.3) zibar Labour Force Survey weight 1115.8 1038.5 114.5 7709.1 15,971 17,821,651 2020 – Mainland (782.5) Source: Author Own. ANNEX C: STRUCTURE OF EDUCATION Figure C.1: Structure of education in Tanzania. Source: Author’s own. Note: The correct school age for Mainland Tanzania refers to preprimary ages 5–6 (two years, one year is compulsory), primary ages 7–13 (seven years of compulsory), lower secondary ages 14–17 (four years compulsory), and upper secondary ages 18–19 (two years). Basic education consists of 12 (2+7+4) years. While the Education and Training Policy (ETP) 2014 defines only one year of preprimary, of which is reflected in the curriculum, the ETP 1995 technically applies and it defines two years of preprimary, ages 3–4 (socialization) and ages 5–6 (primary school readiness). For the purposes of this study, preprimary is defined as ages 5–6, skills ages 10–24, and higher education ages 20–24. For Zanzibar the official age are ages 4–5 for preprimary (two years compulsory), primary ages 6–11 (six years compulsory), lower secondary ages 12–15 (four years compulsory), and upper second- ary ages 16–17 (two years). FBE is 14 years in Mainland Tanzania (1+7+4+2) and 13 years in Zanzibar (2+7+4+2). ANNEXES 65 65 ANNEX D: OUTPUTS FROM THE DATA ANALYSIS Table D.1: GER, NER, and Completion Rates Mainland Zanzibar 2011/12 2017/18 2021/22* 2014/15 2019/20 2020/21* GER Preprimary 35 55 84 54 90 85 Primary 97 99 109 116 113 123 Lower Secondary 42 43 48 58 91 77 Upper Secondary 5.8 7.7 7.6 7.1 10 5.6 Skills 0.9 0.2 0.8 0.8 0.9 — Higher Education 1.7 0.9 — 2.2 4.1 7,110 NER Preprimary 23 40 37 23 60 65 Primary 74 82 94 66 78 97 Lower Secondary 27 31 38 10 34 45 Upper Secondary 1 2 4 0 1 48 Skills 1 0 — 1 1 — Higher Education 2 0 — 2 3 — Completion Primary 50 59 — 14 35 — Form 2 19 30 — — — — Lower Secondary 12 22 — 5 11 — Upper Secondary 4 7 — 2 4 — Source: HBS (2011/12 and 2017/18 Mainland; and 2014/15 and 2019/20 Zanzibar). Calculations: Authors’ own (Mainland) and Al-Samarrai (2022) (Zanzibar). Note: It is important to recognize slight variations in the GER and NER reported in different data sources and reports. For ex- ample, the National Panel Survey (NPS) 2022 provides evidence that the NER has risen at a slower pace reaching 35 percent (preprimary), 82 percent (primary), 38 percent (lower secondary) and 6 percent (higher education) in Mainland Tanzania and 55 percent (preprimary), 88 percent (primary), 65 percent (lower secondary), and 7 percent (higher education) in Zanzibar. Data reported for 2021/22 is from the Government Basic Education Management Information System (BEMIS). The correct school age for Mainland Tanzania refers to preprimary ages 5–6 (one year compulsory), primary ages 7–13 (seven years compulsory), lower secondary ages 14–17 (four years compulsory), upper secondary ages 18–19 (two years), skills ages 10–24, and higher education ages 20–24. Basic education consists of 12 (1+7+4) years. While the Education and Training Policy (ETP) 2014 defines only one year of preprimary, of which is reflected in the curriculum, the ETP 1995 technically applies and it defines two years of pre-prima- ry, ages of 3–4 (socialization) and ages 5–6 (primary school readiness). This study focuses on ages 5–6. THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 66 Table D.2: Drop-out multivariate correlates for Mainland Tanzania (2017/18) 95% Confidence Interval Covariates Adjusted OR Low Limit Upper Limit P-Value Age in categories 10–14 1.000 — — — 15–19 5.744 4.740 6.961 0.000 20–24 8.591 6.889 10.715 0.000 Marriage official No 1.000 — — — Yes 1.204 0.938 1.545 0.145 Geographic zones Western 1.000 — — — Northern Z 1.365 0.953 1.956 0.090 Central Z 1.209 0.856 1.709 0.281 Southern Highlands 1.375 0.960 1.969 0.082 Southern 1.925 1.191 3.112 0.007 Southwest Highlands 1.508 1.068 2.129 0.020 Lake 1.687 1.265 2.249 0.000 Eastern 1.517 1.049 2.193 0.027 Household head, age in categories <30 1.000 — — — 30–39 0.857 0.620 1.184 0.349 40–49 0.688 0.490 0.965 0.030 50–65 0.674 0.485 0.938 0.019 66+ 0.806 0.546 1.189 0.276 Household Head, gender Male 1.000 — — — Female 1.157 0.974 1.375 0.097 Household head employment status Unemployed 1.000 — — — Employed 1.205 0.850 1.709 0.294 Self employed 0.865 0.646 1.157 0.327 Unpaid family helper/own a farm 1.090 0.854 1.390 0.489 Household head, education level No education/Incomplete primary 1.000 — — — Complete primary 0.630 0.536 0.739 0.000 Secondary or higher 0.442 0.331 0.591 0.000 Household size category 1–3 1.000 — — — 4–5 0.825 0.649 1.048 0.114 6–7 0.935 0.727 1.204 0.604 8+ 0.958 0.735 1.249 0.751 Relationship to the head of the family Head/Spouse 1.000 — — — Children 0.887 0.602 1.305 0.542 Biological related 0.941 0.610 1.451 0.783 Other relationship 1.160 0.795 1.692 0.442 Non-related/Servant 3.686 2.120 6.406 0.000 Source: HBS 2017/18. ANNEXES 67 67 Table D.3: Marriage multivariate correlates for Mainland Tanzania (2017/18) 95% Confidence Interval Covariates Adjusted OR Low Limit Upper Limit P-Value Gender Male 1.000 — — — Female 2.029 1.665 2.472 0.000 Age in categories 10–14 1.000 — — — 15–19 14.655 9.511 22.579 0.000 20–24 82.028 52.488 128.193 0.000 Poverty status Non-poor 1.000 — — — Poor 1.023 0.824 1.269 0.840 Rural-urban residence Rural 1.000 — — — Urban 0.376 0.277 0.512 0.000 Geographic zones Western 1.000 — — — Northern 0.386 0.243 0.613 0.000 Central 0.504 0.326 0.780 0.002 Southern Highlands 0.386 0.239 0.623 0.000 Southern 0.228 0.105 0.499 0.000 Southwest Highlands 0.895 0.606 1.322 0.576 Lake 1.068 0.779 1.465 0.682 Eastern Zone 0.295 0.169 0.515 0.000 Household head, age in categories <30 1.000 — — — 30–39 1.401 0.838 2.344 0.198 40–49 1.163 0.691 1.956 0.570 50–65 1.804 1.090 2.986 0.022 66+ 1.314 0.749 2.307 0.341 Household head, gender Male 1.000 — — — Female 1.303 0.945 1.798 0.106 Household head, employment status Unemployed 1.000 — — — Employed 0.576 0.329 1.011 0.054 Self-employed 0.665 0.445 0.994 0.047 Unpaid family helper/own a farm 0.894 0.648 1.234 0.497 Household head, education level No education/Incomplete primary 1.000 — — — Complete primary 0.524 0.417 0.659 0.000 Secondary or higher 0.439 0.284 0.677 0.000 Household size category 1–3 1.000 — — — 4–5 0.649 0.417 1.009 0.055 6–7 0.689 0.426 1.114 0.129 8+ 1.409 0.890 2.231 0.144 THE TRENDS IN ADOLESCENT AND YOUTH WELL-BEING IN TANZANIA 68 Covariates Adjusted OR Low Limit Upper Limit P-Value Household head, marital status Never married 1.000 — — — Married/Living together 16.107 3.124 83.049 0.001 Separated/Divorced/Widowed 8.112 1.472 44.695 0.016 Relationship to the head of the family Head/Spouse 1.000 — — — Children 0.007 0.004 0.012 0.000 Biological related 0.009 0.005 0.016 0.000 Other relationship 0.081 0.048 0.136 0.000 Non-related/Servant 0.027 0.014 0.053 0.000 Source: HBS 2017/18. Table D.4: Employment multivariate correlates for Mainland Tanzania (2017/18) 95% Confidence Interval Covariates Adjusted OR Low Limit Upper Limit P-Value Gender Employed ages 10–19 Male 1.000 — — — Female 1.324 1.086 1.614 0.005 Employed ages 20–24 Male 1.000 — — — Female 1.442 1.010 2.058 0.044 Rural-urban residence Employed ages 10–19 Rural 1.000 — — — Urban 4.198 3.310 5.325 0.000 Employed ages 20–24 Rural 1.000 — — — Urban 4.973 3.421 7.230 0.000 Poverty status Employed ages 10–19 Non-poor 1.000 — — — Poor 0.508 0.378 0.682 0.000 Employed ages 20–24 Non-poor 1.000 — — — Poor 0.484 0.285 0.820 0.007 Household size category Employed ages 10–19 1–3 1.000 — — — 4–5 1.233 0.827 1.838 0.305 6–7 1.162 0.789 1.712 0.448 8+ 0.729 0.483 1.100 0.132 Employed ages 20–24 1–3 1.000 — — — 4–5 0.695 0.445 1.087 0.111 6–7 0.617 0.372 1.024 0.062 8+ 0.571 0.345 0.946 0.029 Geographic zone Employed ages 10–19 Western zone 1.000 — — — Northern zone 1.784 1.130 2.814 0.013 Central zone 1.718 1.021 2.890 0.041 Southern Highlands 1.677 1.020 2.758 0.042 zone Southern zone 1.919 0.997 3.692 0.051 Southwest High- 0.843 0.483 1.471 0.547 lands Lake zone 2.818 1.834 4.331 0.000 Eastern Zone 1.403 0.880 2.237 0.155 ANNEXES 69 69 Covariates Adjusted OR Low Limit Upper Limit P-Value Employed ages 20–24 Western zone 1.000 — — — Northern zone 4.312 1.797 10.346 0.001 Central zone 2.322 0.907 5.945 0.079 Southern High- 3.184 1.218 8.328 0.018 lands zone Southern zone 2.600 0.767 8.819 0.125 Southwest High- 1.376 0.534 3.544 0.508 lands Lake zone 4.474 1.864 10.742 0.001 Eastern Zone 2.982 1.230 7.230 0.016 Household head, gender Employed ages 10–19 Male 1.000 — — — Female 0.387 0.286 0.524 0.000 Male 1.000 — — — Employed ages 20–24 Female 0.470 0.289 0.762 0.002 Household head, age in categories Employed ages 10–19 <30 1.000 — — — 30–39 1.402 0.822 2.392 0.215 40–49 0.919 0.537 1.575 0.759 50–65 1.008 0.593 1.713 0.978 66+ 0.076 0.028 0.205 0.000 Employed ages 20–24 <30 1.000 — — — 30–39 0.930 0.492 1.755 0.822 40–49 0.825 0.400 1.705 0.604 50–65 1.637 0.806 3.323 0.172 66+ 0.392 0.142 1.081 0.070 Household head, education level No education/ Incom- Employed ages 10–19 1.000 — — — plete primary Complete primary 2.607 1.880 3.615 0.000 Secondary or higher 11.068 7.706 15.897 0.000 No education/Incom- Employed ages 20–24 1.000 — — — plete primary Complete primary 2.679 1.676 4.283 0.000 Secondary or higher 12.197 7.064 21.061 0.000 Household head, marital status Employed ages 10–19 Never married 1.000 — — — Married/Living to- 0.957 0.459 1.996 0.907 gether Separated/Di- 0.971 0.438 2.151 0.941 vorced/Widowed Employed ages 20 –24 Never married 1.000 — — — Married/Living to- 1.112 0.555 2.228 0.764 gether Separated/Di- 0.957 0.409 2.241 0.920 vorced/Widowed Relationship to the head of the family Employed ages 10–19 Head/Spouse 1.000 — — — Children 12.477 5.784 26.916 0.000 Biological related 13.846 6.292 30.472 0.000 Other relationship 14.528 6.650 31.739 0.000 Nonrelated/Servant 15.483 6.306 38.012 0.000 Employed ages 20–24 Head/Spouse 1.000 — — — Children 0.261 0.147 0.463 0.000 Biological related 0.344 0.166 0.714 0.004 Other relationship 0.451 0.235 0.866 0.017 Nonrelated/Servant 0.458 0.194 1.077 0.073 0.005 0.001 0.015 0.000 Source: HBS 2017/18. 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