1. Conclusions and Recommendations
TRM Highlights
Conclusions and Recommendations

2. Representation
All key stakeholders – MOHSW, PMORALG, Private sector, NGOs, CSOs
Regional and District health managers
MOHSW Departments, Agencies, Programs
Participation was good; discussions and perspectives frank and quality. Some sessions enjoyed intense exchange of views

3. Highlights Satisfactory immunization coverage
Child mortality reduction surpassing target
Sloth in reduction of Maternal mortality and neonatal mortality
Persistently high stunting
Facility deliveries 60% (compared to 80%)
FP target (80%) will not be met (now 43%)
High HRH gap calls for more effort in HSS and CBHC revitalization

4. National Average 7.4 DDSM 0.66 Key
Human Resource (AMO, MO, Nurses/Nurse Midwife Laboratory staff) Per 10,000 Population by Region 2013
Kagera
5.2
Mara 6
Mwanza 7
Arusha 8.6
Geita 3.1%
Simiyu 2.5%
Kigoma 3.3%
Kilimanjaro
National Average 7.4
Shinyanga 4,9%
Manyara 7.3%
Tabora 2.9%
Singida 5.5
Dodoma 6.9
Tanga 6.7
Katavi 2.5% =
Morogoro 7.9
Pwani 9.6
DDSM 0.66
DSM 13
Rukwa 4.7%
Mbeya 10.1
Iringa 11.3
Lindi 8.3%
Key
0 – 4.9%
Njombe 10.9%
5.0 – 6.9%
Ruvuma 7.2% %
>10
Mtwara 6.5

5. Major Causes of Death are preventable
Under five years
Above five years
2/3rd of deaths due to
Malaria
Pneumonia
Anaemia
Underlying causes
Malnutrition
45% of deaths due to
HIV/ AIDS
Malaria
Tuberculosis
Other causes
NCDs

6. Key aspects for policy level attention
Significant inequity in HRH distribution – adverse in West
Data issues affecting robustness of information and evidence for decisions
Limited availability of funds within the sector
Universal coverage compels establishing One compulsory NHI with safeguards for the poor
Clients charter – one of ways to mitigate against corruption

7. Aspects for policy level attention ctd
Harmonization, integration, quality, efficiency are key guides (to avoid duplication, optimize resources, increase revenue, enhanced utilization)
BRN aspects
4 work streams will form an integral part of HSSP IV
Its principles (Prioritization, Equity, efficiency, accountability and quality) and themes should apply even beyond the targeted regions

8. TRM proposed SWAp Policy priorities 2015/16
BRN work streams
- Equity (HR distribution)
- Efficiency (Performance management)
- MNCH BEmONC, CEmOC
- Commodities and medicines security
Community Health
Health Care Financing
Accountability
Social Determinants of Health

9. Conclusion from panel discussions and closing session
Partners would like to ensure GOT is supported in BRN
A strong well-functioning health system is crucial considering looming threats (Ebola, Marburg)
Revenue increase is possible
PPP is an important entity to optimize

10. Conclusion ctd
Evidence base needs attention: PMORALG working to have a system and Technical Team to support and monitor health plans
MOHSW has major tasks at hand - new health basket MoU, HCF strategy, RBF model and HSSP IV
DPs support commitment reaffirmed

11. Recommendations Extend efforts against leading causes of death
Strengthen health systems for better RCHS
Coordinated health promotion and well supported community based health
Foster peer learning and sharing best practices (e.g Mbeya, Singida)

12. Recommendations ctd
Reverse the observed decline in health sector budget
Strengthen TWGs and governance
Strengthen data quality, completeness, timeliness and analytical capacity

13. Thank you for your attention