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.
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 first 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.