History Made: Tanzania’s Expands Parental Leave for Preemie Care

Hi Friends ,

When I founded the Doris Mollel Foundation (DMF) in 2015, it was deeply personal. Born prematurely at just 900 grams, I knew firsthand the challenges preterm infants face — and how much work needed to be done to improve their chances of survival. At the time, prematurity was an overlooked issue in Tanzania, and there was little collaboration between civil society and the government to address it, our team was less than 4 people and equipped with the belief that we can make an impact. That had to change.

Over the years, DMF became the first and only organization to work hand in hand with the Tanzanian government on preterm infant care, leading groundbreaking policy reforms that had never been done before. Today, there are just under 11 employees at DMF, with an extensive nationwide reach, covering 27 out of 30 regions, saving more than 17,000 preterm babies’ lives and directly impacting the lives of adolescents, girls, youths and women.

Group Photo: Bottom from left to right, Innocent Mungy; an advocate for preemie-related issues, United Nations Resident Coordinator and UNDP Representative; Alvaro Rodriguez, Dr. Augustine Massawe; a neonatology specialist from Muhimbili National Hospital; Dr. Ahmad Makuwani; the Director of Maternal and Child Health from the Ministry of Health, Community Development, Gender, Elderly, and Children; and Muhimbili National Hospital Nurse.

In June 2018, we took the first step. DMF convened a stakeholder workshop in Dar es Salaam to discuss the importance of increasing parental leave for parents of premature babies. Held at the Hyatt Regency, this event brought together key decision-makers, including UN Coordinator Alvaro Rodriguez, Dr. Ahmad Makuwani from the Ministry of Health, and the late Dr. Augustine Massawe, one of Tanzania’s leading neonatologists. It was the first formal call to the Tanzanian government to recognize the challenges faced by parents of preemies.

Images showing on going discussions on the maternity and paternity leave extensions at Hyatt Hotel

The discussions that day set the foundation for what would become a years-long fight to turn advocacy into law. We weren’t just raising awareness; we were demanding action. Just a few months later, in November 2018, DMF took the fight to Parliament. Addressing female Members of Parliament at the National Assembly in Dodoma, we laid out the urgent need for policy change. Premature babies, who face critical health challenges at birth, need specialized care — and parents need time to provide it. For the first time in Tanzania’s history, maternity leave reform was on the legislative agenda.

Group Photo: Doris Mollel Foundation with the Tanzania Women Parliamentary Group (2018)

By 2021, we had gained momentum, but real change still required political will. That year, DMF, in collaboration with the Social Welfare Committee of the Parliament, launched The Prematurity Agenda 2021 — a nationwide campaign pushing for three key policy reforms:

• Extending parental leave from three months to six months for mothers of premature babies and from three days to one month for fathers.
• Ensuring all health insurance providers — including the National Health Insurance Fund (NHIF) and private insurers — covered preterm medical care in maternity packages.
• Incorporating prematurity education into Tanzania’s national science and biology curriculum to ensure future generations understand neonatal care.

Pictures showing the then Speaker of the Parliament of the United Republic of Tanzania, Hon. Job Ndugai, launching the Prematurity Agenda. Alongside him are, from left to right Executive Director of DMF, and from right, the then Chairman of the Social Welfare Committee of the Parliament, Hon. Stanslaus Nyongo and the then Permanent Secretary of the Ministry of Health Dr. John Jingu.

This campaign directly engaged lawmakers and health stakeholders, making the case that Tanzania could lead Africa in maternal and neonatal policy reform. However, the discussions weren’t easy. Employers raised concerns about costs, and labor laws remained rigid. The fate of our proposal rested in the hands of Parliament’s Social Welfare Committee. Still, we persisted — because advocacy is not about convenience; it’s about conviction.

Video Interview on BBC News Focus On Africa about the Prematurity Agenda Campaign, 2021

For the first time ever, Tanzania has extended its paid maternity leave for parents of premature babies — a policy change that will impact thousands of families. During the 18th Meeting of the Fourth Session, the Parliament of the United Republic of Tanzania passed the Labor Laws Amendment Bill (NA.13) of 2024, which amended Section 33 to increase maternity leave for employees giving birth to preterm babies, allowing their maternity leave to be extended to cover the remaining weeks of the standard forty (40) weeks of pregnancy. Additionally, the approved Bill has extended paternity leave for fathers of preterm babies from three days to seven days. The current law now reads as follows:

“An employee who gives birth to a premature child is entitled to a paid maternity leave from the date of giving birth up to completion of the forty weeks of pregnancy and to maternity leave period provided under subsection (6) within the leave cycle.”

This means that if a mother gives birth to a premature baby at 24 weeks. She will be entitled to a paid maternity leave of nine months (40 weeks — 24 weeks) + the current three months. And so forth.

Advocacy is often about raising awareness, but real impact comes when policies shift, laws evolve, and lives improve. This maternity leave reform is proof of what’s possible when persistence meets purpose. It wasn’t easy — policy change never is. But by working strategically with government leaders, leveraging evidence-based advocacy, and amplifying the voices of affected families, we turned an overlooked issue into a national priority. And this isn’t the first time.

Many people think our advocacy started three years ago, but it actually didn’t. DMF started advocating for policy changes in the maternal and child health sector in 2016.

DMF Timeline:

• 2015 — DMF founded.
• 2016 — Formally introduced the case for prematurity education integration into Tanzania’s national Education Curriculum to the Ministry of Education.
• 2017 (November) — Introduced the parental leave agenda to Hon. Angellah Kairuki, the then President’s Office responsible for Public Service Management and Good Governance.
• 2018 (June) — Formally introduced the case for extended parental leave at a stakeholder workshop in Dar es Salaam with UN representatives.
• 2018 (November) — Took the issue to Parliament and addressed female MPs at the National Assembly in Dodoma.
• 2020 — Expanded collaborations with health stakeholders and its advocacy to include insurance reforms. Policy change campaigns.
• 2021 — Launched The Prematurity Agenda 2021 in partnership with the Social Welfare Committee of Parliament, pushing for: Extended parental leave (from three to six months for mothers, three days to one month for fathers); Inclusion of preterm medical care in health insurance packages; and Prematurity education integrated into Tanzania’s national Education Curriculum.
• 2021 — The Association of Tanzania Private Sector’s Insurers included preterm costs in maternity care packages for the first time. Held year round meetings with Ministries.
• 2022 — The National Health Insurance Fund (NHIF) expanded coverage to include preterm medical costs. Year meetings and year round policy change campaigns.
• 2022, 2023 — The Tanzanian government allocated $22.8 million in funding to address prematurity challenges–the largest investment of its kind in the country’s history. Held more year round meetings & updated campaigns.
• 2023 — Prematurity education is officially integrated into Tanzania’s Education curriculum. Held more meetings.
• 2024 (May) — Vice President Mpango announced on May 1st that maternity leave for mothers of premature babies should begin only after special care. More meetings and campaigns.
• 2024 (November) — The Labour Laws Act, 2024 Bill, first read in Parliament. More meetings and campaigns.
• 2025 (January) –Met with the Parliament’s Committee to amend Bill Changes. More meetings and campaigns.
• 2025 (January) & now — The Labour Laws Act, 2024 Bill, Second and Third read in Parliament. Bill passed and approved into law. Tanzania becomes the first country in Africa to extend paid leave for mothers of premature babies.

However, similar to other organizations, we know very well, no journey is without its challenges. Each of these milestones was hard-fought and hard-won — because advocacy in Africa is never easy. But Tanzania’s maternity leave reform, like the victories before it, proves that change is possible when the right people, the right strategy, and unwavering persistence come together.

The challenges that children, adolescents, girls and women face in our countries and continent today, will still persist for years to come. Systems are broken, and we can’t just complain about it.

A Heartfelt Thank You 🩵

To our partners: Thank you. Your support has been invaluable in driving this historic policy change. Advocacy is never easy, and systemic change does not happen overnight, but together, we have proven that persistence leads to progress.

Today, no other country in Africa has amended its maternity leave policies. We did it. No other organization in Africa has successfully advocated for such a policy change. We did it. For the past 10 years, no organization in Tanzania has convinced the government to amend so many laws in this area. We did it.

So what’s next?

Policy reform is just the first step. A law on paper doesn’t save lives — an effective health system does. Tanzania’s maternal and neonatal care system still faces major challenges that put mothers and babies at risk every day.

• Gaps in research leave us without the data needed to drive better policies and interventions.
• Too few trained health professionals mean that preemies and mothers often don’t get the specialized care they need.
• Insufficient education and training in neonatal care for both medical staff and parents lead to preventable deaths.
• Adolescent health, teenage pregnancies, and early marriage continue to drive high-risk births, making access to maternal care even more urgent.
• Emergency obstetric care, especially for postpartum hemorrhage, remains inadequate, making childbirth dangerously unpredictable for too many women.
• Women & girls’ empowerment advocacy is critical to breaking cycles of poor maternal health — ensuring that girls have access to education, reproductive healthcare, and opportunities that protect them from early pregnancy and forced marriage.
• A girl’s right to education is non-negotiable. In empowering and educating adolescent girls, we give them the tools to achieve their full potential and transform their families, communities, and countries.

When girls are educated, they delay pregnancy, improve health outcomes, and become the change-makers of tomorrow.

Fixing these gaps will require more than just policy — it will take investment, collaboration, and community-driven solutions to transform maternal and newborn health in Tanzania. That’s where we go from here.

The fight isn’t over. It’s just beginning.

Let’s build a future where every mother and every baby has access to the care they deserve, where every girl has the chance to shape her own future, and where communities are at the heart of lasting change.

Partner with us!

At DMF we believe it takes a collective effort to create meaningful change, and you — our friends — are important to this journey. We encourage you to put your resources where impact is — by partnering with the Doris Mollel Foundation. We invite you to collaborate with us in driving solutions that truly matter. Whether through strategic alliances, shared resources, or advocacy, your partnership fuels the transformative work we do together.

Let’s build on this momentum together.

If you’ve supported DMF before — THANK YOU. This victory is yours. If you’re new to our work and you believe in sustainable change — there’s never been a better time to join us.