Tanzania Under five Mortality Reduced by a Quarter: Why??

1. Tanzania Under five Mortality Reduced by a Quarter: Why?? Countdown to 2015 Child Survival Dr. Theopista John, WHO Country Office - Tanzania London , 13-14 Dec 2005 United Republic of Tanzania Ministry of Health

2. Outline • 3 Key Messages and supporting evidences • Conclusions • Challenges • Implications for universal access to Child survival interventions

3. Key message 1 Child survival in Tanzania has improved substantially in the past few years.

4. Evidence for recent child survival gainsNational DHS -24% -31% Source: URT Measure DHS An improvement of 24% in under 5 mortality represents 39,200 fewer child deaths per year in Tanzania

5. Key message 2 Child survival is improving because of better access to higher quality essential health services for children.

6. Evidence for coverage gains

7. Evidence from MCE-IMCI • Key messages from Multi Country Evaluation of IMCI • Improved quality of care for sick children • IMCI cost less per child managed correctly ($4.02) compared to routine care ($ 25.70) • Contribution to Child mortality reduction by 13% • Significant reduction in stunting

8. Evidence from MCE-IMCI… Quality of child care in first level facilities Difference in mortality between IMCI and comparisons districts Mortality was 13% lower in IMCI districts

9. IMCI improves quality of care Sick children managed correctly in IMCI and comparison facilities

10. Cost per child managed correctly in Tanzania

11. Evidence for recent child survival gainsRufiji District Sentinel surveillance (RDSS) -48% -60% Source: MOH TEHIP / NSS

12. Key message 3 Better access to quality health services as a result of policies and investments supporting the Tanzanian Health System.

13. 1960 1970 1970 1980 1990 1990 2000 Evolution of health sector in Tanzania Strong Investment in Rural Health Infrastructure & Primary Health care Health Sector Reforms Essential health interventions & Sector wide Approach Structural adjustment and Debt Crisis

14. Aligning budgets with priorities • 1996-97 • Before basket funding and planning tools……….. • 2000-01 • After basket funding and planning tools………..

15. Challenges • Sustaining the observed child health gains • Inadequate coverage of interventions and tools e.g District burden-of-disease planning tool & health budget mapping tools • HIV/AIDS pandemic threatening to reverse the gains • Co-ordination at national, district and community level

16. Conclusions • Tanzania has a comparative advantage for Child Survival • Good access & utilization of health facilities • Health sector reform • Poverty Reduction Strategy- PRSP II (NSGRP) • Potential for achieving the child survival ; • Mobilizing available resources for child health interventions • Scaling up of and universal access to effective interventions • Strengthening Partnership at all levels e.g. Maternal, Newborn and Child Health Partnership

17. Implications for universal coverage • National Health Sector Strategic plan and Development frameworks to support Child survival • Increasing resource allocation for scaling up of child survival delivery interventions and strategies • Decentralization at district including; • capacity building for planning and budgeting • Use of data for decision making and resource allocation e.g. DHA, BOD,SHM • Prioritization of essential interventions • Harmonization and convergence of partners throughNational Partnerships e.g. Maternal Newborn and Child Survival Partnership

18. It is never too late to invest in developing sustainable health systems that provide evidence based, cost effective and high impact interventions with high coverage and quality. Implications for Universal Coverage

19. Thank you