Poverty and Human Development Report 2009 - UNDP in Tanzania

POVERTY AND HUMAN DEVELOPMENT REPORT 2009
Examination of age-disaggregated data on child mortality (Figure 4) reveals that the greatest
change has occurred in post-neonatal and infant mortality. Neonatal mortality has improved to
a much smaller extent, and now accounts for a growing share of under-five deaths. Neonatal
deaths are inextricably linked to maternal healthcare, where little progress has been made in
recent years.
The THMIS 2007/08 found surprisingly little disparity in under-five mortality rates 34 between urban
(110) and rural (112) areas. However, significant differences persist in mortality risk across wealth
quintiles; the mortality rate for children in the least poor 20% of households (101) is 22% lower
than the poorest (129). A more pronounced gap is observed between mortality rates for children
of mothers with secondary education or higher (78) and children whose mothers have no formal
education (129). Nonetheless, the latest data suggest that socio-economic inequalities in underfive
mortality have narrowed. These improvements are less likely to be due to increases in health
service provision or access, which have not changed much over the past five years, but may be
linked to reduction in malaria burden. Gains in malaria control over this period have provided
relatively greater benefit in rural areas where prevalence was higher, as was child mortality
(Smithson, 2009).
Malaria Control
THMIS 2007/08 was the first nationally representative household survey to investigate the
prevalence of malaria, and so provides valuable information to assess the impact of control
measures in tackling the disease. Malaria has accounted for the largest burden of morbidity and
mortality in Tanzania, especially among young children.
The burden of malaria is highly unevenly distributed across the country. In 2007/8, malaria prevalence
in children 6-59 months of age was less than 5% in five Mainland regions, while prevalence in five
other regions was 30% or more. The regions most affected are Kagera, Mara and Mwanza, which
border Lake Victoria, and Lindi and Mtwara on the south-eastern coastline (Figure 17).
34 Child mortality rates are expressed as under-five or infant deaths per 1,000 live births.
54