Maternal & child health

The situation

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The situation

© UNICEF Tanzania

 
Today, Tanzanian children stand a better chance of surviving past their fifth birthday than ever before.

The government’s implementation of high-impact health programmes such as routine immunization, Vitamin A supplementation, prevention of mother-to-child transmission of HIV, and improved management of common childhood illnesses, has saved the lives of thousands of children across the country.

However, challenges persist, and preventable and treatable diseases such as malaria, pneumonia, diarrhoea and neonatal conditions continue to claim the lives of Tanzanian children every day. Early marriage and childbearing remain high in some regions and economic groups, worsening existing vulnerabilities.
 

Progress

  • Facility deliveries have increased from 47 per cent in 2005 to 63 per cent in 2015.
     
  • Skilled assistance during delivery has increased from 46 per cent in 2005 to 64 per cent in 2015.
     
  • The immunization rate has been maintained at a high level – DTP3 coverage was 98 per cent in 2015 and the number of unvaccinated children has gone down from 47,013 in 2014 to 35,047 in 2015.
     
  • The mother-to-child HIV transmission rate is 3.6 per cent at 6 weeks after birth and 6 per cent at the end of breastfeeding. This is significant progress as the country moves towards the elimination goal of less than 5 per cent at the end of breastfeeding.
     
  • Tanzania made good progress on the target for Millennium Development Goal 4. Under-five deaths per 1,000 live births declined steadily from 166 in 1990 to 112 in 2005 and 67 in 2015. Infant mortality decreased from 68 to 43 per 1,000 live births between 2005 and 2015.
     

Challenges

  • Health sector spending increased slightly from 6.3 per cent in 2012/13 to 6.6 per cent 2014/15, though it remains significantly below the Abuja target.
     
  • Health systems and service delivery require strengthening. The availability of drugs and supplies remains a challenge. The systems for referral and transport are inadequate. Limited access to insurance schemes and informal payments at health facilities pose financial barriers to access. The coverage of basic emergency obstetric and newborn care is low with only 20 per cent of dispensaries and 39 per cent of health centres offering delivery services that provide all signal functions.
     
  • Largely preventable and treatable diseases such as malaria, pneumonia and diarrhoea cause the death of 270 children under 5 years of age every day. There are wide socio-economic and geographical disparities in child mortality, largely due to inequities in access to, and use of, health services. Regional and economic inequities cause imbalances in child survival. Under-five mortality swings from 56 per 1,000 live births in the Northern regions and Zanzibar to 88 per 1,000 live births in the Lake regions, and from 87 per 1,000 live births in the urban mainland to 76 per 1,000 live births in the rural mainland.
     
  • While there was a 47 per cent reduction of the maternal mortality ratio (MMR) between 1990 and 2012 (870 and 232 deaths per 100,000 live births respectively), Tanzania did not make sufficient progress to attain its Millenium Development Goal of reducing MMR to 193 per 100,000 live births. Previous gains are being eroded as the MMR increased to 556 per 100,000 live births in 2015.
     
  • There are broad gaps in births assisted by skilled health professionals in rural and urban areas (55 per cent and 87 per cent respectively) and region (96 per cent in Kilimanjaro and 95 per cent in Dar es Salaam to 42 per cent in Simiyu).
     
  • The percentage of women (20–24 years) who have given birth or are pregnant with their fi rst child by the age of 18 has increased from 23 per cent in 2010 to 27 per cent in 2015. Vast variations are observed based on the place of residence – 19 per cent in urban versus 32 per cent in rural areas, and 27 per cent in mainland Tanzania versus 8 per cent in Zanzibar.
     
  • Adolescent sexual and reproductive healthcare is inadequate – teens and young people report that confidentiality is often not respected, and services are expensive and not youth-friendly. Medication is also in short supply.

 

 
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