Safe Motherhood: A Review - Family Care International

Tanzania
Strategy for Reproductive Health
and Child Survival (1997–2001)
Following the International Conference
on Population and Development in
Cairo in 1994, the government developed
a comprehensive strategy for reproductive
and child health. This broader strategy,
titled “The Strategy for Reproductive Health
and Child Survival 1997–2001,” aimed to
improve the health of women, children, and
adolescents. With regard to maternal health
care, the Strategy aimed to reduce maternal
mortality by 50% by the year 2001 through
the following strategies:
• improving the nutritional and socioeconomic
status of women;
• strengthening postabortion and
antenatal care;
• reviving postnatal care;
• increase human resource capacity for
managing maternal care;
• strengthening management of obstetrical
problems in health facilities; and
• enhancing efficiency of the referral system.
The Strategy was developed in the context
of health sector reform (see next section),
and provided a framework for district level
planning. While no formal evaluation of the
Strategy has been undertaken, anecdotal
evidence indicates that little progress has
been made toward stated indicators.
Reproductive and Child Health
Strategy (2005–2010)
A follow-up strategy document,
Reproductive and Child Health Strategy
2005–2010, was developed based on the
experiences and lessons learned from the
implementation of the previous versions. The
vision of the Strategy is to foster “a healthy
and well-informed Tanzanian population
with access to quality reproductive and child
health services that are accessible, affordable,
sustainable, and which are provided through
an efficient and effective support system.”
Maternal health is identified as a key priority,
and includes the following areas of action:
focused antenatal care, skilled care during
childbirth, care for obstetric emergencies,
postpartum care, postabortion care, family
planning, and prevention of harmful practices
(e.g., female genital mutilation). 84
The Strategy also puts forward a framework
for research and monitoring and evaluation
in an effort to better assess service
utilization patterns and monitor progress on
implementation of interventions.
Health Sector Reform
and Decentralization
In 1996, the government instituted a
process of health sector reform which
included the decentralization of health care,
cost-sharing, and other modifications in the
delivery of health services. The planning,
monitoring, and management of health
services is devolved to district health
management teams, as part of a strategy
to provide greater autonomy in identifying
and prioritizing the health needs of the
districts. The government continues to guide
policy formulation and regulation, while
the private sector plays a more prominent
role in the provision of health services. As
part of this effort, cost-sharing of health
services are decentralized to health centers
and dispensaries, and communities assume
84 United Republic of Tanzania, Ministry of Health. Reproductive and Child Health Strategy 2005–2010 (Draft), 2005.