Over the past decade, Tanzania has made substantial progress in the health sphere. Child and infant mortality have declined rapidly, life expectancy has improved, and contraceptive prevalence rates have started to rise. However, the country still faces a host of health-related challenges. Many Tanzanians lack access to high-quality health services. Nearly one in four women would like to prevent pregnancy, but lack access to family planning. Total fertility, maternal and neonatal mortality, and teenage pregnancy rates remain high and improvements in contraceptive prevalence—while improving—are uneven between regions. Further, the HIV epidemic continues to undermine citizens’ health and well-being, with the burden falling disproportionately on women and key populations.
Tanzania also faces significant resource gaps in financing its health sector. The government relies heavily on external resources, especially to support its HIV program. Declines in donor support highlight the urgent need for Tanzania to mobilize domestic resources for health to ensure its population continued access to HIV-related and other essential health services. In today's restricted funding environment, this requires maximizing existing resources while exploring innovative ways to improve health financing and mobilize additional resources.
HP+ works with partners in Tanzania to strengthen the country's health system by:
Combating HIV, gender-based violence, and socioeconomic inequities and enhancing access to health services for key and underserved populations
Supporting the implementation of national family planning goals and global FP2020 commitments
Fostering an enabling environment for family planning and reproductive health services
Generating evidence to inform policies for improving domestic resource mobilization
Supporting health financing reform for universal health coverage, including providing technical assistance for the development of a health financing strategy and scale-up of health insurance mechanisms
We assist the government of Tanzania, development partners, and civil society organizations to:
Quantify resource requirements and strengthen institutional and individual capacities to generate and analyze costing data
Improve the execution process of national plans for family planning
Improve technical efficiency of HIV services to generate savings, making HIV programs more affordable and accelerating the shift from development assistance to domestic financing
Cost and conduct prioritization analyses of health sector plans and strategies and effectively steward the execution of the plans, including Tanzania’s National Family Planning Costed Implementation Plan 2019-2023
Tanzania Helps Local Leaders’ Implement and Fund Family Planning Programs
August 2021 —
HP+ recently helped planners in Tanzania ensure that local family planning services systems reflect national-level guidance. HP+ provided technical support to update the National Package of Essential Family Planning Interventions for Comprehensive Council Plans and ensure that both it and the National Family Planning Costed Implementation Plan (NFPCIP) 2019-2023, are incorporated into revised guidelines for the local level decisionmakers and used as the key reference documents for subnational budgeting and planning for family planning. Integrating these family planning guidelines within council level plans—which previously contained no FP planning guidance—is expected to increase domestic resource mobilization for family planning and further support efforts to encourage sustainable family planning budget allocation and disbursement among local government areas. It is also anticipated to increase the effectiveness and speed of NFPCIP 2019-2023 implementation at all levels and increase uptake of modern contraceptives.
Tanzania launches its fifth Five-Year Health Sector Strategic Plan
July 2021 —
Tanzania recently launched its fifth five-year health plan, a TSh 47 trillion roadmap for saving more than 200,000 lives and reducing HIV incidence by 50 percent. The Five-Year Health Sector Strategic Plan (HSSP V) also lays out strategies for averting more than 400,000 disability-adjusted life years and reducing infant, neonatal, and maternal mortality. To estimate the cost of the strategy, equivalent to US$20.3 billion, HP+ used the OneHealth tool. HP+ also estimated the resources available for the health sector from all sources. The mission of the plan, which covers 2021 to 2026, is to provide sustainable health services with standards that are acceptable to all citizens without financial constraints, based on geographical and gender equity. In her address during the June 24 launch, Honorable Minister for Health, Community Development, Gender, Elderly and Children, Dr. Dorothy Gwajima said the plan will expand reach of primary health services and address the prevention and treatment of both communicable and non-communicable diseases.
Tanzania Stakeholders Plan for Sustainable Financing for Family Planning
May 2021 —
Tanzania has taken some steps to broaden financing for family planning. During a two-day workshop convened last month by HP+, Tanzanian stakeholders discussed options for sustainable financing for family planning services, focusing on segmentation of the family planning consumer market and integration of family planning into the county’s national health insurance scheme. HP+ will model several policy scenarios for financing the scale-up of family planning services to reach the modern contraceptive prevalence rate outlined in the Tanzania National Costed Implementation Plan. The modeling will quantify costs to the government and to women under scenarios in which family planning is offered for free to all users, is incorporated into the health insurance benefits package, and is expanded through commercial products. The findings will be used to advocate for a sustainable option to finance family planning scale-up, with the intent of increasing domestic resource mobilization for family planning, increasing private sector engagement in the delivery of family planning services, and improving access to family planning for the underserved and vulnerable in Tanzania.
HP+ Efforts to Reduce Stigma in Health Facilities Featured in AIDS Special Issue
September 2020 —
A journal article authored by HP+ project staff in collaboration with local partners was published this month in a special issue of AIDS. The article, which describes the development and implementation of a three-stage approach to reducing HIV stigma in health facilities, features the approach that HP+ implemented in Ghana and Tanzania. It is an evidence-based, adaptable, scalable approach that has proven successful in generalized and concentrated epidemic settings and can be used to address stigma toward any population. Results of endline evaluations in both countries demonstrate the intervention’s effectiveness, showing significant reduction in drivers and manifestations of stigma and discrimination among facility staff.
Virtual HIV Costing and Management Training Delivered in Three Countries
August 2020 —
In August, HP+ facilitated a virtual training for research institutions and government representatives in Kenya, Tanzania, and Uganda on applying the Activity-Based Costing and Management methodological approach to HIV services. HP+ strengthened the capacity of these institutions and participants to implement data collection; conduct analysis; develop research protocols and data collection instruments; secure ethical clearance; facilitate stakeholder consultations; and develop reports using the approach. Findings from the analysis can help policymakers and partners to more effectively allocate resources, improve monitoring efforts, optimize investments, and drive efficiencies through improved delivery of services.
Tanzania Stakeholders Reflect on Traction Gained Executing the Family Planning Costed Implementation Plan
August 2020 —
This month, HP+ and Tanzania’s Reproductive and Child Health Section of the Ministry of Health, Community Development, Gender, Elderly, and Children worked together to convene the first semi-annual family planning implementers meeting. The meeting, which was held virtually, focused on review and discussion of current progress in implementing the country’s family planning costed implementation plan (CIP) related to subnational roll-out, program and funding coverage, and achievement of results. According to performance data collected for the first year of CIP, Tanzania is on track or gaining traction to meet performance targets for six of ten results; progress has been delayed for the remaining four results.
Tanzania Scales Up Execution of its National Family Planning Costed Implementation Plan
February 2020 —
In Tanzania, 90% of district councils (167) have been oriented to the country’s national family planning costed implementation plan (CIP) and supported to develop action plans for inclusion in councils’ 2020/21 budget requests. In 2019, HP+ supported the Ministry of Health, Community Development, Gender, Elderly, and Children in national dissemination of the CIP. These efforts involved supporting the facilitation of dissemination workshops to enable local government authorities to understand and buy into the plan—important steps toward increasing budget allocation for family planning at the local level.
Increasing Uptake and Yield of HIV Testing Services in Tanzania
February 2020 —
Nudges such as mobile airtime or membership in a health insurance scheme might be helpful in motivating someone to get tested for HIV, suggest the results of a USAID-funded analysis carried out in Tanzania by Health Policy Plus (HP+). HP+ staff met February 5 with officials from the Tanzania health ministry, PEPFAR, implementing partners, and other stakeholders in Dar es Salaam to discuss the study results. Patients and health providers in the study found the incentives attractive and easy to administer. Only 61 percent of the country’s estimated 1.5 million HIV-positive individuals know their status, and Tanzania is looking for cost-effective ways to increase testing uptake.
Investing in Family Planning to Accelerate Progress toward the SDGs in Tanzania
February 2020 —
HP+ applied the Family Planning-Sustainable Development Goals (FP-SDGs) Model with stakeholders in Tanzania to project how family planning investments can accelerate progress toward the SDGs. HP+ worked alongside local stakeholders to strengthen their capacity to generate projections from the model and interpret results. Advocates have used results to make the case to Parliamentarians and others to prioritize and expand family planning in support of broader development goals. Model results estimate that increasing family planning investments in Tanzania could, by 2030, reduce maternal mortality by 47% and increase the proportion of the population using safe drinking water by 20%, among others.
PEPFAR Minimum Requirements Webinar
February 2020 —
HP+ led a webinar on January 30th to discuss how countries -- with examples from Botswana, Nigeria, Tanzania, Kenya and Indonesia -- have met PEPFAR’s minimum program requirements for policies and practices essential for success. With special guest Sylvain Bowra of the State Department in Botswana, HP+ contributors shared a new resource illustrating the status of each of the minimum requirements across all PEFPAR countries.
Stigma and Discrimination Total Facility Approach Featured by PEPFAR
January 2020 —
The HP+ “total facility approach” to reducing stigma and discrimination in health facility settings is being featured on the PEPFAR solutions website. This showcases the work carried out by HP+ in Tanzania and Ghana as an important solution for the HIV response. PEPFAR Solutions are impactful, data-proven approaches intended to guide others in program design and implementation. U.S. government staff and partners around the world use the solutions website as a resource for HIV program design. Having the stigma-reduction approach featured also makes it accessible to mission staff around the world as they embark on their COP20 planning processes.
Scaling up Locally-owned Accountability Tools to Strengthen Collaboration and Make Progress Toward FP2020 Goals
July 2019 —
HP+ worked with Uganda-based Samasha Medical Foundation to scale-up its Motion Tracker—a locally-produced, civil society led tool that strengthens accountability and helps countries make progress toward their FP2020 commitments. HP+ supported its scale up from Uganda to Tanzania and Zambia, which resulted in broader community and stakeholder involvement and stronger FP2020 commitments in both countries that can be tracked and monitored. HP+’s work with Samasha helped cement the Motion Tracker as a sustainable, locally-grown approach to strengthening self-reliance and joint accountability, with Samasha receiving additional funding from the World Health Organization and the New Venture Fund to continue their work in Uganda, Zambia, and Tanzania, and further expand to Nigeria.
Assessing the Financial Viability of Single National Health Insurance
December 2017 —
HP+ published a notable brief summarizing critical considerations and key steps for implementing a single national health insurance (SNHI) scheme in Tanzania. Based on an actuarial study to project the SNHI scheme's financial viability, the brief’s primary worth is in how it can inform efforts by other countries in the region to implement similar insurance reforms.
USAID Support Builds Sustainability of Tanzania’s HIV Response
January 2017 —
The Government of Tanzania has committed 5.5 billion Tanzanian shillings (US $2.42 million) to the country's AIDS Trust Fund (ATF) for fiscal year 2016/17. This injection of funds, alongside the appointment of an independent board of governors to manage the ATF, represent important milestones in the trust fund's development. Once fully operational, the ATF could significantly reduce the country's dependence on external funders and promote the sustainability of Tanzania's HIV response. The ATF’s recent progress is due in part to support from USAID through the Health Policy Project, which provided technical assistance to the Tanzania Commission for AIDS starting in May 2015.
