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Improving Tanzania’s Health System, Governance, and Nutrition


Abt Global has had a huge impact in improving the quality of life for Tanzania’s citizens.
 
Abt-led projects have strengthened health financing, service delivery methods, and other parts of the health system while also advancing improvements in food security and agriculture. These USAID-funded projects have reached 23 of the nation’s 31 regions.

“Abt’s technical expertise in building health system capacity is well established,” said Diana R. Silimperi, M.D., division vice president for International Health. “As we focus on key components of the country’s government systems, we will promote inclusive and evidenced-based planning, management, and implementation.”

Kiabakari Secondary School students in Mara region paint numbers on new chairs. The new classroom furniture was one result of a training provided by the Public Sector Systems Strengthening (PS3) Activity. This training focused on citizen engagement in decision-making and development activities and included councilors – elected politicians representing citizens from wards, which are comprised by various villages. Photo credit: Gladys Mkuchu, PS3
Kiabakari Secondary School students in Mara region paint numbers on new chairs. The new classroom furniture was one result of a training provided by the Public Sector Systems Strengthening (PS3) Activity. This training focused on citizen engagement in decision-making and development activities and included councilors – elected politicians representing citizens from wards, which are comprised by various villages.
Photo credit: Gladys Mkuchu, PS3

Strengthening Governance across Tanzania

Abt-led programs are working with multiple partners to help Tanzania’s government perform more efficiently and effectively.
 
The Public Sector Systems Strengthening (PS3) project strengthens public systems to improve service delivery, particularly in underserved areas. PS3 directly links systems strengthening and service delivery by integrating across systems functions and working across all levels of government and in the public and private sectors.
 
PS3, which began in July 2015, has trained 2,086 Local Government Authority (LGA) Councilors on improving citizen engagement, strengthening committee functioning, and better understanding their roles as councilors.
 
Other interventions PS3 began or continued include the:

  • Launch of a new facility financial accounting and reporting system to help ensure that public funds are managed and used appropriately at facility level;
  • Introduction of Tanzania’s first-ever standardized regional and LGA websites which allows LGAs to share information and documents with citizens and the private sector;
  • Redesign of PlanRep, the government’s planning software, to ensure efficiency, accountability, consistency, and uniformity and quality of LGA plans, budgets, and reports; and
  • Support for implementation and expansion of the national results-based financing (RBF) program.

The Health Finance and Governance (HFG) project, is working with government stakeholders to address health financing constraints and support the Ministry of Health’s (MOH) health systems strengthening initiatives.
 
HFG has supported the development of the country’s first health financing strategy by conducting critical background research to provide evidence needed for the inclusion of various financing options.

Learn more about the HFG project in Tanzania

Partnering with the Private Health Sector

The Tanzanian government has a large role in health care delivery, but Abt also works with private physicians, clinics, and associations to improve the availability and quality of health care services.
 
The Abt-led Sustaining Health Outcomes through the Private Sector Plus (SHOPS Plus) project is working to increase the use of priority health services through the strategic expansion of private sector approaches in the health system. SHOPS Plus is building private provider’s capacity to improve and sustain the delivery of health services and strengthening the sustainability of Tanzania’s accredited drug dispensing outlets, for example.

SHOPS, the predecessor project to SHOPS Plus, worked with the Tanzanian government, NGOs, and private sector umbrella organizations to increase the provision of quality HIV and AIDS services through the private sector by:

  • Improving the policy environment for the private sector to provide HIV and AIDS services;
  • Building the capacity of the private sector to deliver and scale up services; and
  • Increasing the availability of information on the private sector’s role in the provision of HIV and AIDS related services.

SHOPS also conducted a private health sector assessment in 2012 to find ways to strengthen public and private partnerships within the health system.

Learn more about SHOPS Plus in Tanzania.

Preventing Disease

On mainland Tanzania, more than 40 percent of all outpatient cases are attributable to malaria, resulting in an estimated 10 to 12 million clinical malaria cases annually. An estimated 60,000 to 80,000 people die from malaria each year in the mainland.
 
The President’s Malaria Initiative Africa Indoor Residual Spraying (PMI AIRS) project works to prevent malaria on both the mainland and Zanzibar areas of Tanzania. The 2017 spray campaign sprayed 664,622 structures, protecting more than 2.5 million residents. This includes more than 490,000 children under five years old and more than 94,000 pregnant women.
 
Learn more about PMI AIRS in Tanzania.

Community health workers in North-West Tanzania conduct malaria testing of children to determine the impact of indoor residual spraying. In 2016, the PMI AIRS Project sprayed 536,368 houses with insecticide in Tanzania, protecting 400,000 children under five years old from malaria. Photo credit: Richard Oxborough, PMI AIRS
Community health workers in North-West Tanzania conduct malaria testing of children to determine the impact of indoor residual spraying. In 2016, the PMI AIRS Project sprayed 536,368 houses with insecticide in Tanzania, protecting 400,000 children under five years old from malaria.
Photo credit: Richard Oxborough, PMI AIRS

Strengthening Food Security
Nearly 40 percent of Tanzanian children suffer from stunted growth or anemia — or both — because of malnutrition. Each year in Tanzania, vitamin and mineral deficiencies contribute to the deaths of more than 27,000 children and 1,600 women. Malnutrition in Tanzania has multiple causes, including some poor Tanzanians’ lack of understanding or awareness of the importance of good nutrition.
 
The Tuboreshe Chakula project worked to dramatically increase the supply — and demand — for nutritious and fortified foods. Swahili for “Let’s Improve Food,” Tuboreshe Chakula introduced dosifier machines that add micronutrient powder to flour and working with processors to add Vitamin A to sunflower oil. It introduced a commercially distributed, low-cost micronutrient powder that can be sprinkled on food given to children aged six months to five years — when malnutrition is most likely to affect children’s development.
 
By the project’s end, half of the people in surveyed populations were consuming fortified flour, up from none at the start. Also, more than half of the shops in target regions stocked the fortified flour.