Presentation Tanzania PBF Course Nairobi

1. PBF EXPERIENCE IN
TANZANIA
1
Mbeya
Rukwa
Tabora
Ruvuma
Iringa
Singi
da
Dodoma
Kigoma
Shinyanga
Kagera
Arusha
Mwanza 139
Mara
Morogoro
Mtwara
Lindi
Kilimanjaro
Tanga 162
Pwani
Dar es salaam
Kusini 109Mjini Magharibi
Kusini Pemba
Kaskazini Pemba
Mainland
Zanzibar

2. Background
• Area: 926,000 sq km
• Population = 40 mil(2002).
• Capital: Dodoma
• > 120 tribes.
• Language: Swahili(English)
• Regions: 25
• 133 councils.
• Health facilities: 5,618 (2009) 2

3. Health indicators
• Maternal Mortality- 578/100.000 live births
• UMR- 81/1000 live births (TDHS 2009/10)
• IMR-51/1000 live births ( TDHS 2009/10)
• NMR -26/1000 live births (TDHS 2009/10)
• CPR 36% all methods, 27.4% modern methods. (TFR 5.4)
• HIV/AIDS prevalence 6%
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4. Health Services System in
Tanzania
Community Health ServicesCommunity Health ServicesCommunity Health ServicesCommunity Health Services
DispensariesDispensariesDispensariesDispensaries
Health CentersHealth CentersHealth CentersHealth Centers
District HospitalsDistrict HospitalsDistrict HospitalsDistrict Hospitals
RegionalRegional HospHosp..RegionalRegional HospHosp..
Specialize/Specialize/
Consultant Hosp.Consultant Hosp.
National HospitalsNational Hospitals
Specialize/Specialize/
Consultant Hosp.Consultant Hosp.
National HospitalsNational Hospitals
ReferralReferral
systemsystem
Community/ HouseholdCommunity/ Household
District CouncilDistrict Council
Regional SecretaryRegional Secretary
Ministry of HealthMinistry of Health
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5. The Current Situation
• The Ministry embarked in Health Sector Reform in 90’s and re
organize its structure by decentralizing Primary health services-
District level.
• Allocation formula based on Population 70%, land size 10%,
Under five mortality 10 % and Poverty 10%.
• District Health Management Teams (DHMT) were established
with semi-autonomous authority
– Develop Comprehensive District Health Plans where by Pay for
Performance is one of the mandatory activity in the Operation Plan
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6. Current situation cont
Financial support comes from:
1. Central Government
2. Donors ( Health Basket funds).
3.Council own sources and
4. Other supplementary sources i.e. Cost
sharing, Community Health
funds(CHF),NHIF.
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7. Current situation cont…
• The Ministry implement its roles through National StrategyStrategy
For Growth and Reduction of PovertyFor Growth and Reduction of Poverty
• National Health Policy and five year Health Sector Reform
Strategic Plan(2009-2015).
• Primary Health Service Development Programme (MMAM)
(2007-2017).
• Monitoring of Health Sector Performance.
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8. Opportunities to introduce
PBF
• Existing systems at all levels.
• PBF piloting site - Rungwe District.
Training:
• 12 Faith based organizations (FBOs).
• 3 Public owned H/F
• CHMT and HMT members (5).
• Council Management team (2).
Key stakeholders:
• Christian Social Services Commission (CSSC),
• KCMC,CORDAID.
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9. Challenges….
• Not in line with the existing National policies.
– Employment policy,
– Procurement Act.
– Local government financial Act /regulations.
– Inadequate financial management capacity skills
at the low level (Health centers and
Dispensaries).
• Inadequate data collection system (HMIS)
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10. Way forward
• PBF Advocacy should start at the National
Level to downward.
• Capacity building of health workers on
financial management (Public & Private).
• Policy review to match with PBF principles.
• Improve on HMIS
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ASANTENI – ZIKOMO -
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