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Tanzania

HP+ More recent Tanzania publications are available.

  • Based on the UTETEZI Project curriculum, Advocacy for Improved Access to Services for MSM: A Workshop Curriculum for a Multi-Stakeholder Policy Advocacy Project, this advocacy for policy change guide is designed for use by MSM (men who have sex with men) groups, community-based organizations (CBOs), civil society organizations (CSOs), and individuals working in HIV and MSM health to help them advocate regionally, nationally, and locally for improved HIV and health-related MSM policies. In particular, this guide can serve as an important tool for CSOs working on MSM issues in hostile legal environments.

  • In this brief, the USAID- and PEPFAR-funded Health Policy Project (HPP) offers analysis on the GOT’s tax revenue collection prospects and explores tax reforms that the GOT may implement in the future. Growth in tax revenue has been linked with countries’ progress on universal health coverage (UHC), especially in countries with low tax bases (Reeves et al., 2015). In Tanzania, the HSSP IV and HFS both identify tax reform as an important mechanism to raise the total allocation to health, and reduce the resource gap in the health sector. As has been experienced in other countries, earmarked tax revenues, from a growing overall tax base, can help secure financing for health. This brief also investigates the process by which Tanzania’s Ministry of Labor (MOL) and the Ministry of Infrastructure and Communication (MOIC) were able establish tax “set-asides” for programs in their sectors, and whether it is feasible for something similar to be done for the MOHCDGEC that would pool tax revenue specifically for health and HIV and AIDS. For example, such a set-aside was accomplished in Zimbabwe with the AIDS Levy, introduced in 1999, which is charged on individuals, companies, and trusts at a rate of 3% of taxable income or profits. This revenue, estimated at US$157 million collected over 2009-2014 (Kutyauripo, 2015), is allocated to the National AIDS Trust Fund in Zimbabwe to be managed and disbursed for HIV programming, including 50% for antiretrovirals (ART).  

  • The USAID- and PEPFAR-funded Health Policy Project (HPP) conducted a budget analysis to examine the GOT’s final FY 2015/16 health sector budget. HPP’s analysis examined the trends in budget allocations for health, patterns of distribution, and funding sources. Findings from this analysis may be used to advocate for efficient and effective budget allocations for HIV and essential medicines, and can be shared with key stakeholders, including decisionmakers from the Ministry of Health and Social Welfare (MOHSW), the National AIDS Control Program (NACP), TACAIDS, national- and district-level elected leaders, the media, and the public.

  • There is considerable uncertainty surrounding key population size and HIV prevalence estimates in Tanzania. To address this data gap, the USAID- and PEPFAR-funded Health Policy Project (HPP), the Ministry of Health and Social Welfare, and the Tanzania Commission for AIDS held a one-day workshop in Dar es Salaam in April 2014 to discuss and reach consensus among key stakeholders on key population estimates for mainland Tanzania. A Delphi method was used to seek consensus on the estimated size of and HIV prevalence among the three key populations in Tanzania: female sex workers, men who have sex with men, and people who use/inject drugs. The workshop processes and outcomes are summarized in this report. 

  • The National AIDS Control Program (NACP) in the Ministry of Health and Social Welfare (MoHSW), with support from the USAID-funded Health Policy Project (HPP), engaged in a stakeholder-driven process to estimate the costs of the Third Health Sector HIV and AIDS Strategic Plan (HSHSP III) for the fiscal years 2013/2014-2017/2018. This report describes the HSHSP III costing process and shows the cost results by NACP program unit and HSHSP III impact area and strategic objective.

  • The Government of Tanzania (GoT) has recognized the need to stop gender-based violence and strengthen services for survivors of GBV. In 2011, the Ministry of Health and Social Welfare (MoHSW) developed management guidelines for GBV services delivered within the health care setting and began training service providers in accordance with these guidelines. In 2012, with support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through its Gender-based Violence Initiative (GBVI), the MoHSW began a phased rollout of these guidelines through training and facility support. The GBVI was aimed at strengthening coordination of GBV prevention and response efforts and their integration within existing HIV interventions. As the MoHSW moves forward with scale-up of the national guidelines, policymakers and program managers have identified the need to better understand the costs associated with GBV service delivery – for the purposes of estimating resource requirements for scale-up and also for exploring factors that drive the costs of GBV service delivery. The purpose of this study was to estimate the cost of delivering GBV services per client encounter at public health facilities in Tanzania and to understand the cost drivers of GBV service delivery in order to inform scale-up policies and planning. 

  • The Health Policy Project (HPP) helped countries achieve their health goals by building capacity for policy, advocacy, governance, and finance at multiple levels. The project developed global tools and best practices for policy work, promoted South-South sharing and collaboration, and carried out regional and country-specific policy initiatives. The files included in this zip document provide brief program overviews for each country highlighting key accomplishments. Individual briefs are available from the country pages.

  • The purpose of this guidance manual is to outline steps for estimating the cost of post-GBV services at the health-facility level. It provides the user with practical steps for conducting a costing study, including preparing for data collection, collecting and managing data, and analyzing and using the results. It provides detailed instructions on how to use the GBV Program Cost Calculator, an MS Excel-based tool developed under the Health Policy Project (HPP) that enables the use to generate unit cost estimates of providing health facility-based post-GBV interventions to a single client during one health facility visit. The cost data generated from these steps are meant to represent the cost of providing services and not on the cost to the client for seeking services. The results on the cost of post-GBV services generated from implementing these steps are to support program managers, policy makers, funding partners and government ministries to plan and scale-up GBV intervention services.

  • The Sub-Saharan Africa MSM Engagement (SAME) Tool was developed based on literature reviews and expert/technical inputs from the USAID- and PEPFAR-funded Health Policy Project (HPP), the Johns Hopkins School of Public Health, amfAR, African Men for Sexual Health and Rights (AMSHeR), and USAID. In collaboration with eight leading MSM organizations—one each from Rwanda, Malawi, Togo, Mozambique, Zambia, Tanzania, Ghana, and Cameroon—HPP and AMSHeR piloted the tool from April to June 2013, in both English and French. This poster summarizes the pilot study, and was presented at the 20th International AIDS Conference in July 2014.

  • As countries increasingly make national commitments to family planning (FP), there is also a need to foster accountability for fulfilling them. In Tanzania, as in many countries, those commitments can be manifested in many different ways. Top-down, high-level policy documents, including poverty-reduction strategy papers and national development strategies, often include commitments to FP. Within the Ministry of Health, which bears the responsibility for implementing FP commitments, strategy documents, such as Tanzania’s One Plan for Maternal and Child Health, incorporate FP as a priority. In addition, Tanzania’s costed implementation plan (CIP) for FP-developed in 2010 and later rolled into the One Plan-identifies challenges to achieving commitments, presents appropriate strategies and the costs for implementing them, and estimates the benefits if the country is successful.

  • As part of the USAID-led PEPFAR Sustainable Financing Initiative to increase domestic resources for HIV, the USAID- and PEPFAR-funded Health Policy Project created 31 macro-fiscal and health financing profiles for 18 countries that are transitioning to a higher income status, have high HIV burdens, and/or rely heavily on donor funding. These country profiles assess past trends and future projections in key indicators related to a country's ability to grow economically and dedicate more financial resources to health, including HIV.

    The macro-fiscal profiles provide overviews of each country's economic growth, political economy, and government revenue and expenditure. The health financing profiles analyze government, external, and out-of-pocket spending on health; health financing functions, including revenue contribution and collection, pooling, and purchasing; and HIV financing trends.

    You may download individual briefs on this page.

  • Tanzania’s sustained development and transition to middle-income status depend on the health of its people. In recognition of this fact, the Government of Tanzania (GOT) has prioritized reproductive, maternal, newborn, child, and adolescent health (RMNCAH), adopting a broad foundation of policies to inform RMNCAH programming. Yet, in recent years, progress toward achieving Millennium Development Goal (MDG) targets for child, maternal, and neonatal health has been uneven, in large part due to funding and implementation challenges. To overcome these challenges and accelerate progress, the GOT developed a National Road Map Strategic Plan to Improve Reproductive, Maternal, Newborn, Child and Adolescent Health in Tanzania (2016-2020): One Plan II. In 2015, the USAID-funded Health Policy Project (HPP) conducted an analysis to project the costs and health impacts of achieving the government’s new commitments outlined in the One Plan II, and to identify the remaining challenges for implementing the plan.

  • In order to evaluate the distribution of health workers across Tanzania, relative to health needs, the USAIDfunded Health Policy Project (HPP) examined existing sources and conducted new analyses of human resources for health (HRH). Drawing on the results of these analyses, HPP proposes within this brief specific policy actions to improve 1) supply and retention of skilled health workers; 2) distribution of health workers; and 3) processes for hiring skilled health workers.

  • The USAID- and PEPFAR-funded Health Policy Project (HPP) conducted this analysis to explore the current status of benefit packages and the feasibility of incorporating HIV services, including ART, into insurance schemes in Tanzania. We used structured interviews of insurance providers to collect qualitative data and also gathered secondary data from insurers and other sources to provide a basis for profiling different schemes and insurers. Our main objectives were to understand what services and benefits are currently being covered and what barriers prevent insurers from including HIV services within benefit packages, and to offer conclusions on the plausibility of financing HIV services through health insurance in Tanzania. Unlike previous studies, which looked only at the private insurance sector, this analysis also includes schemes managed by the National Health Insurance Fund (NHIF) as well as a micro-insurance provider.

  • International health programs and donors throughout the world increasingly recognize the importance of promoting gender equality to improve health and development outcomes. International initiatives such as the Sustainable Development Goals include specific gender equality goals and targets. Yet, translating gender equality goals into action is challenging. Practical tools for integrating gender into health policies and programs are needed. The USAID-funded Health Policy Project (HPP) prepared this brief to provide policymakers, donors, and program managers with real examples of methods for promoting gender equality in family planning, maternal and child health, and gender-based violence policies and programs.

  • In sub-Saharan Africa (SSA), expected national fertility levels and country-level observations demonstrate repeated mismatches in magnitude and/or direction.Thus there is an unfulfilled demand for better explaining, understanding, and communicating how fertility changes. Accurately predicting fertility is critical for understanding how populations may be expected to change, and for managing expectations about the possible impacts of TFR-affecting policy levers. The USAID-funded Health Policy Project produced this poster for the 2015 Population Association of America conference to determine to what extent can the accuracy of predicting fertility in SSA using the proximate determinants framework be improved by implementing revisions, with emphasis on the contraception index.

  • Tanzania’s government recognizes that the country’s sustainable development and transition to middle-income status depends on the health of the Tanzanian people. To that end, the country has worked hard to achieve Millennium Development Goal (MDG) 4 to reduce child mortality and MDG 5 to improve maternal health. This USAID and PEPFAR-funded Health Policy Project brief explores the current policy framework for reproductive maternal, neonatal, child, and adolescent health (RMNCAH), and provides plans for intervention and strengthening of RMNCAH in the short, medium, and long term. 

  • A high proportion of Tanzania’s total health spending comes from foreign donors and households (out-of-pocket), rather than from sustainable sources such as government tax-based revenue or health insurance. While the country has made enormous strides in improving its population’s health, the Government of Tanzania and its development partners recognize that the current health financing structure is not sustainable. The government is now considering several crucial changes to how healthcare in Tanzania is financed; as part of this effort, the country is finalizing a health financing strategy and scaling up new programs to accelerate service delivery coverage and improve quality.

    In support of building a sustainable structure, the USAID- and PEPFAR-funded Health Policy Project reviewed the country’s healthcare financing situation to provide a baseline against which innovation and policy change can be gauged. This report provides a broad overview of the health financing landscape in Tanzania as of 2014 and aims to highlight those aspects suggesting a greater reliance on domestic and sustainable resources to accomplish Tanzania’s health goals. 

  • While Tanzania has made significant progress on priority health indicators, the limited effectiveness of health financing constrains its ability to achieve more.Despite challenges Tanzania is making progress toward sustainable financing. This USAID and PEPFAR-funded Health Policy Project brief explores the country's prospects for sustainable financing and explores the linkages between financing and universal health coverage. 

  • Over the past decade, the performance of Tanzania’shealth system has been mixed. The country will achieve many of its 2015 targets for malaria, HIV and AIDS, tuberculosis, and child health, but progress in reproductive health is lagging. Currently, nearly half of the country’s health budget is covered by donor funding—the largest share in the world. This USAID and PEPFAR-funded Health Policy Project brief provides an overview of Tanzania's existing health system, including: human resources for health, health financing, commodities and supplies, and monitoring and evaluation and health management information systems.

  • The USAID- and PEPFAR-funded Health Policy Project (HPP) supports health systems strengthening (HSS) by bringing together different actors and disciplines within the health system to improve policy and ultimately achieve more equitable and sustainable access to health services. The importance of HSS for HIV and AIDS, tuberculosis, and malaria programs is recognized in Tanzania’s national strategic plans.

    In May 2014, USAID/Tanzania approached HPP to assist the Ministry of Health and Social Welfare’s Directorate of Policy and Planning in conducting a rapid HSS assessment with two main objectives: to build initial consensus around priority HSS actions that will inform a new national HSS strategy, and to provide information for the ministry to advocate for additional HSS funding. The latter includes presenting HSS priorities, activities, and actions to the Global Fund’s Tanzania National Coordinating Mechanism to be considered for inclusion in the upcoming grant application process.

  • Tanzania's Ministry of Health and Social Welfare chose the OneHealth Tool, a model for medium- to long-term strategic planning in the health sector, to inform development and prioritization of the Fourth Health Sector Strategic Plan 2015/16–2019/20 (HSSP IV). Specifically, the OneHealth Tool was used to estimate the resource requirements and resources available for the health sector over the next five years, the impact on maternal and child health and HIV if HSSP IV service delivery targets are met, and the human resources constraints in scaling up health services. The results of Tanzania's OneHealth application are summarized in this report and provide an evidence base for strategic planning and resource allocation.