1. CHALLENGIES FACING TANZANIA IN ATTAINING UNIVERSAL ACCESS TO HEALTH By J.J. Rubona MOHSW, Tanzania Amref Health Africa International Conference 24 – 26 November 2014, Nairobi Kenya.

2. Outline  Selected Statistics on Health in Tanzania  Challenges to Reach Universal Access to Health  Polices and Strategies to Address Challenges  Way Forward

3. Selected Statistics on Health in Tanzania  Total pop.= 45 mil. (2012 Census)  Population growth rate = 2.7%  Life expectancy at birth 61 years  IMR 45/1000 live birth (2012 Cen.)  TFR 5.2 children per woman  MMR 432/100,000 births far to reach a target of 265/100,000 births in 2015  National Average for density clinicians and nurses is at 7.7 per 10,000 against WHO recommended MNCH indicator of 22.8 per 10,000  NHI + CHF = 18% of population

4. Challenges to Reach Universal Access to Health  Funding level (9 -12%) Abuja Decl. 15%. Per Capita Expenditure below USD 54 WHO recommended level.  Long distance to a health facility problem of transport  Availability of skilled staff (554 dispensaries without skilled workers.  Availability of medical supplies still a problem in most of HFs  Quality of health services not good  Good Governance (attitude, corruption) still a problem

5. Polices and Strategies to Address Challenges  National Polices  Soon after independence Universal Access for Health was on agenda ( Free medical services)  Vision 2025 (Turning Tanzania into middle income country)  National Strategy for Economic Growth & Reduction of Poverty  Sectorial polices  Health Policy in 2007  Development Plan for Primary Health Care (MMAM 2007 - 2017)  Health Sector Strategic Plan III (2009-2015 - HSS)  Health Financing Strategy (Universal Health Insurance)  Local Government Policy  Policy of decentralization by Devolution. This was supported by the Health Sector Reform since 1990s. (Health Boards and Committees)

6. Way Forward Guiding Principles for HSSP IV (2015 – 2020)  Follow Government Policies  Equity, quality and accessibility of health services  Build on partnership  Government institutions  Civil society, private sector (PPP) and Development Partners  Build on resource envelope  Health Financing Strategy (Universal Health Insurance Coverage)  Human resources (to reduce current gap)

7. 23 October 2013 JAHSR 7 Guiding Principles for HSSP IV  Follow Government Policies  Equity and accessibility of health services  Build on partnership  Government institutions  Civil society, private sector, Development Partners  Build on realistic resource envelope  Financial resources  Human resources

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