Poverty and Human Development Report 2009 - UNDP in Tanzania

Health
CLUSTER II- CONCLUSIONS AND POLICY IMPLICATIONS
The continued decline in under-five mortality means that Tanzania is on track to meet the
MKUKUTA goal in 2010 and even the MDG for under-five mortality in 2015 (MDG 4). This
extraordinary improvement in child survival since 1999 is most likely explained by gains in malaria
control, particularly coverage of mosquito nets (especially ITNs) and more effective treatment.
Recent gains in under-five nutrition, anaemia and fever incidence are probably also attributable
to the decline in malaria. The rate of measles vaccination also remains high, but coverage of
DPT-HB3 vaccination declined significantly between 2004 and 2007 and recovered slightly in
2008. However, there have been negligible improvements in rates of skilled birth attendance
or facility-based deliveries – indicators of lower risks in maternal mortality - and little change in
neonatal mortality.
Encouragingly, HIV prevalence rates have declined for both men and women, and across all age
groups, including among youth (15-24 years) which is a key indicator of new infections. However,
the decline in the prevalence rate among young women is not significant, and has not declined
as rapidly as young men. Care and treatment services for HIV and tuberculosis have also shown
performance improvements, following major increases in external support. Indicators of general
health service delivery from the HBS 2007, however, do not exhibit any marked improvement.
Distance to the nearest health facility has marginally decreased, but people are no more likely
to consult a health provider when ill than they were in 2000/01. But, there has been a shift in
utilisation to government providers from mission/private health facilities. Investments in preservice
training have yet to result in an increase in the availability of skilled health workers.
In sum, major progress has been made on some key health indicators – largely as a result of
successful implementation of new technologies – but provision of maternal healthcare services
(particularly skilled attendance and availability of emergency obstetric care) lags far behind.
Investment in quality antenatal, delivery and post-natal services is urgently required to bring
down the high rates of maternal and newborn deaths in Tanzania.
Water and Sanitation
The latest survey data show a downward trend in access to clean and safe water in both urban
and rural areas. These data were collected before any increases in access due to the Water
Sector Development Programme, but the trend is nevertheless very worrying. At the current rate
of progress MKUKUTA and MDG targets for water supply are out of reach.
Data also indicate almost no improvement in household sanitation. The HBS 2007 show that
access to basic sanitation facilities is close to the MKUKUTA target but as discussed the vast
majority of traditional pit latrines are ‘unimproved’ and of poor hygiene. Positively, routine data
from MoEVT show some progress towards targets for school sanitation between 2003 and 2006,
but levels have plateaued since then. At the current rate of progress, the MKUKUTA target for
school sanitation will not be met.
93