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“Using Global Health Initiative Opportunities to Strengthen Immunization Services” in Tanzania

“Using Global Health Initiative Opportunities to Strengthen Immunization Services” in Tanzania. Africa Regional Committee on Immunization Dar es salaam, Tanzania 10-12 Dec 2012. Presentation Outline. Back ground information SWAp Arrangement in TZ

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“Using Global Health Initiative Opportunities to Strengthen Immunization Services” in Tanzania

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  1. “Using Global Health Initiative Opportunities to Strengthen Immunization Services” in Tanzania Africa Regional Committee on Immunization Dar es salaam, Tanzania 10-12 Dec 2012.

  2. Presentation Outline • Back ground information • SWAp Arrangement in TZ • Opportunities to Strengthen Immunization Services • Immunization Performances in Tanzania • Challenges • way forwards

  3. Background Area = 940,000 sq km Population. = est. 45m (2012) Average growth rate = 2% MMR = 454/100,000 TANZANIA Life expectancy = 58yrs Under five Mortality =81/1000

  4. Tanzania Health System • The health sector has a referral services from primary hospital to secondary (regional) hospital and finally to tertiary (central) hospital or specialized hospital • About 50.6% of population lives within 5 km of a primary health facility • The total of staffing in the health sector stands at 42% of the actual need according to defined staffing norms.

  5. Immunization services • EPI was established in 1975 • Immunization service is provided free in both public and private health facilities, urban and rural areas • A total of 5,676 provide routine immunization services in the country - 80% in rural area • Each of rural facility provide 2-3 outreach services for immunization monthly

  6. SWAp for integrated health services delivery • The Sector Wide Approach started in 1998. • Development Partners both multilateral and bilateral participate in the SWAp arrangements • The partners include 8 bilateral who are financing through the Health Basket Fund • Those who finance the sector outside the Health Basket Fund • International NGOs • Multilateral include; WB, WHO, UNICEF, UNFPA, UNAIDs, ADB,...

  7. SWAp for integrated health services delivery 2 • The operational structures of SWAp;- • The SWAp Committee Which sit twice a year; the first sits in May and the second meeting is the Joint Annual Health Sector Review, usually sitting in September • There is a Basket Fund Committee which oversee the functions of the Health Basket Funds with its Health Basket Sub-Audit Committee

  8. Opportunities - Other support to the health sector which also support IVD programme • Health Basket Funding (HBF) immunization is a priority • UNDAP-Health and Nutrition Component has substantial allocation of funds annually • USAID Support through a number of NGO’s • CIDA-CANADA supporting the HRH though BMAF and through the HBF as well

  9. Opportunities -2 GFATM especially GFR9 is only supporting immunization services indirectly. The GFR9 HSS programme provides HSS mainly through: • Health workforce: Construction, recruitment of trainers, increase of students • Information systems: Training, supervision, surveillance, IT equipment • Medical products & technology: Warehouse construction, training, quality assurance • Leadership & Governance: Training, supervision

  10. Opportunities -3 GAVI Support • Started in 2000 and total of $ 109,368,218 received [ 87% was for vaccine support and 13% for Immunization system strengthening (ISS)]. • Hepatitis B vaccine was introduced in January 2002 in the DPT-HepB vaccine formulation. • In April 2009, Hib vaccine was introduced in the DPT-HepB-Hib (pentavalent) vaccine formulation. • Rotavirus vaccine and Pneumococcal conjugate vaccine 13 (PCV 13) will be introduced in January 2013.

  11. Opportunities of the GAVI ISS • Tanzania has used the GAVI ISS as an opportunity in the following areas; • Implement RED/REC strategy to 70 and thereafter 52 councils to reduced the number of unvaccinated children • Increasing the quality of immunisation services through implementation of DQA/DQSA • Conduct training to health care workers and capacitate staff to provide vaccination services

  12. Opportunity-4 • Monitoring Evaluation Strengthening Initiative (MESI) a consortium of partners are supporting and rolling over from the initial two regions and now are in 8 • District Health Information System (DHIS) supported also by WHO is rolling over in 44 Districts this year to cover all the 132+ districts in the coming few years. • This is important area for evidence gathering • IVD programme continue to benefit from this initiatives and has a component in GAVI-HSS forthcoming to strengthen and integrate the information system in the DHIS

  13. WORLD BANK SUPPORT • The World Bank has supported the health sector reforms since 1988, by conducting Policy studies, and a moving report “Investing in Health 1993” these studies and report had a big bearing in the health sector to date. • Provided Credits “Population Health & Nutrition Project 1992-1995”, HSDP 1 and HSDP II and currently there is an ongoing Credit to Support District Health Services • The WB contribute to the health Basket Fund

  14. Immunization Performance in Tanzania

  15. Immunization performance 2000 -2012 * Data up to Sept, 2012

  16. Tanzania Routine Immunization performance 2000 -2012 * Data up to Sept, 2012

  17. Tanzania Routine Immunization Penta 3 performance 2007 -2010 Districts DTP 3 performance 2009 2010 Below 80% 80% to 89% 90% + 2012-Jan-Sept 2011

  18. Confirmed Measles Cases and Deaths, 2007-2012

  19. A balance between sustainable outreach services and reaching the maximum number of children Cold chain capacity for New Vaccine Sector-wide barriers Shortage of means of transportation Human resource limitations Inadequate Finance resource to sustain the high reached coverage Challenges Scattered populations Difficult terrains 19

  20. Next steps or way forwards • Continue to solicit support from partners towards IVD and meeting the MDGs 4&5 in this programme • Global Funds to support HSS and align funds to the sector priorities in the MTEFs and the National Programmes including the GAVI funds • Using a harmonized system of health information and reporting • Use of Health system Funding Platform opportunity for Health system strengthening support to improve immunization services – awaiting approval by the GAVI-Board

  21. FULL IMMUNISATION WITH POTENT QUALITY VACCINES Is The Best Gift To The Child , In The First Birth Day Thank you for listening

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