United Republic of Tanzania

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Background information

In the United Republic of Tanzania, the health of children and women is threatened by poor nutrition, gender inequalities and female illiteracy levels. Some specific public health concerns are outlined below.

HIV prevalence

HIV prevalence previously recorded as 9.9% (Poverty and Human Development Report 2000) is currently reported at 7% (2003 -2004 Indicator Survey, National AIDS Control Programme). The cross-cutting effects of the pandemic have produced a rapidly growing orphan population. Responses to mitigate the attendant economic and social effects are piecemeal and insufficient .

The high prevalence of malnutrition (21.8% underweight, 37.7% stunting of children) and high level of food poverty (22% below food poverty line and 39% below basic needs poverty line) is a grave concern for individuals already weakened by HIV. Agriculture has persistently been affected by factors resulting in low productivity and incomes.

Access to health services

Inequity in access to social services is mainly due to skewed income distribution, high levels of income poverty and non-functional social protection for the poor. The low income of the majority of the populations hinders their accessibility to health services as medicines and other services are unaffordable. At the national level, low financial capacity limits adequate resource allocations to the sector leading to inadequate service provisions.

Main national health policy orientations and priorities

Public/private partnership and equity of access to quality primary health services are key policy foci under sector reforms in which decentralized management and people’s participation in financing and governance of health services are key features. An essential health interventions package is the main frame for prioritization, HIV/AIDS, TB, Malaria and MCH being at the apex.

National resources - human, financial and materials including essential medical equipment and medicines - are still quite insufficient to ensure availability of and access to essential health services of good quality. While health workforce management and retention are at the centre of current debate searching for effective resolve sustainable financing and making exemption mechanisms work to benefit the poor is a priority health system issue.

The ability to produce and use information (strengthening systems and skills for evidence based planning and management) is another priority system needed.

Macro-economic, political and social context

Macro-economic stability achieved in Tanzania is evidenced by GDP growth that increased steadily since mid-1990s surpassing the 6% target defined in PRS by 2002 (PHDR 2003).

According to Tanzania Annual Economic Surveys of 2004 and 2005 the GDP growth is still increasing. However, these achievements have not translated into improved equitable household income; the economy predominantly depends on small-scale agriculture, a slow reforming sector (non-traditional exports).

Since introduction of multiparty democracy, the political climate is one of good governance, assurance of peace and social stability. This sets the stage for an improvement in health status of the population.