TRM Highlights Conclusions and Recommendations Representation All key

TRM Highlights Conclusions and Recommendations

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

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

Human Resource (AMO, Nurses/Nurse Midwife Laboratory staff) Per 10, 000 Population by Region 2013 Mara 6 Kagera 5. 2 Mwanza Geita 3. 1% 7 Simiyu 2. 5% Arusha 8. 6 National Average 7. 4 Kilimanja ro 14. 8 Shinyanga 4, 9% Manyara 7. 3% Kigoma 3. 3% Tabora 2. 9% Tanga 6. 7 Singida 5. 5 Katavi 2. 5% Dodoma 6. 9 Iringa 11. 3 Rukwa 4. 7% Key Mbeya 10. 1 = Morogoro 7. 9 D D S M DSM 13 Pwani 9. 6 0. 6 6 0 – 4. 9% 5. 0 – 6. 9% 7. 0 - 9. 9% Lindi 8. 3% Njombe 10. 9% >10 Ruvuma 7. 2% Mtwara 6. 5

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

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

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

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

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

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 Mo. U, HCF strategy, RBF model and HSSP IV • DPs support commitment reaffirmed

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)

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

• Thank you for your attention