[et_pb_section fb_built=”1″ admin_label=”!! PLEASE DO NOT EDIT !!!” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}”][et_pb_row use_custom_gutter=”on” gutter_width=”1″ admin_label=”!!! PLEASE DO NOT EDIT !!!” _builder_version=”4.20.4″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}”][et_pb_text admin_label=”SUMMARY ” _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”10px||20px||false|false” global_colors_info=”{}”]<\/p>\n
Tanzania prioritizes primary health care for Universal Health Coverage, achieving progress in reducing under-five and maternal mortality. However, neonatal mortality stagnates. Despite financing challenges, Tanzania progresses towards sustainable health financing, requiring political commitment and collaboration for reform implementation.<\/strong><\/p>\n [\/et_pb_text][et_pb_text admin_label=”TEXT – BLOCK 1 ” _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||1em||false|false” global_colors_info=”{}”]<\/p>\n Tanzania has long prioritized primary health care (PHC) as the pathway to achieving Universal Health Coverage (UHC) and pioneered several service delivery innovations with significant reductions in under five and maternal mortality and are on track to achieve SDG. Despite these improvements, neonatal mortality has stagnated over the past 15 years. Therefore, greater, and better investments are needed to improve quality of care and health outcomes.<\/p>\n [\/et_pb_text][et_pb_text admin_label=”TEXT – BLOCK 2 ” _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||1em||false|false” global_colors_info=”{}”]<\/p>\n To this end, the PORALG, the Ministry of Health, and UNICEF convened a symposium during the International Primary Health Care Conference in Dodoma, Tanzania in March 2024. This blog features the \u2018what\u2019<\/em> and the \u2018how\u2019<\/em> of sustainable financing for PHC can be achieved, as presented and discussed during the forum.<\/p>\n [\/et_pb_text][et_pb_text admin_label=”TEXT – BLOCK 2 ” _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||0px||false|false” global_colors_info=”{}”]<\/p>\n [\/et_pb_text][ba_gradient_heading title=”What: Sustainable resources for PHC” html_tag=”h3″ primary_color=”#455A64″ secondary_color=”#455A64″ admin_label=”HEADING (50-60 characters)” _builder_version=”4.21.0″ _module_preset=”default” title_font=”||||||||” title_font_size=”24px” title_line_height=”1em” custom_padding=”15px||10px||false|false” global_colors_info=”{}”][\/ba_gradient_heading][et_pb_text admin_label=”TEXT – BLOCK 3″ _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||1em||false|false” global_colors_info=”{}”]<\/p>\n International evidence shows that higher government spending<\/a> is associated with better health service coverage. Over the past ten years, domestic expenditure for health in Tanzania has increased. However, its domestic healthcare spending remains lower than that of neighbouring countries and international benchmarks. Specifically, recent evidence<\/a> revealed that despite significant increases in the past years in salaries and vital pediatric and maternal commodities, government spending on PHC is less than half of the required resources needed to deliver quality services according to national standards, with greater shortages for commodities procurement and at the dispensary level. Dr. Wilson Charles Mahera, Deputy Permanent Secretary Health, PORALG emphasised the study findings on the regional differences in service delivery productivity, where some regions have better health outcomes for the same spend.<\/p>\n [\/et_pb_text][et_pb_text admin_label=”TEXT – BLOCK 4 ” _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||0px||false|false” global_colors_info=”{}”]<\/p>\n As highlighted in the panel discussion, information is key to understanding the costs of PHC and identifying and addressing the funding gap. Inadequate resources slow down the achievement of national and international policy objectives. In addition, health care investments must focus on priority interventions that will make health care cheaper, e.g.\u00a0 vaccinating children against measles against responding to a measles outbreak, preventing HIV infection against ARV\u2019s.<\/p>\n [\/et_pb_text][ba_gradient_heading title=”How: Revenue raising for PHC” html_tag=”h3″ primary_color=”#455A64″ secondary_color=”#455A64″ admin_label=”HEADING (50-60 characters)” _builder_version=”4.21.0″ _module_preset=”default” title_font=”||||||||” title_font_size=”24px” title_line_height=”1em” custom_padding=”15px||10px||false|false” global_colors_info=”{}”][\/ba_gradient_heading][et_pb_text admin_label=”TEXT – BLOCK 5″ _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||1em||false|false” global_colors_info=”{}”]<\/p>\n The domestic revenue mobilisation study<\/a> estimated the revenue-generating impact of various health tax policy reforms and modelled the public health impact of the proposed tax policy reforms. Specifically, the analysis focused on the revenue sources of the Equity Account under the Universal Health Insurance Act, examining alcohol, tobacco, and sugary drinks.<\/p>\n [\/et_pb_text][et_pb_text admin_label=”TEXT – BLOCK 6″ _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||1em||false|false” global_colors_info=”{}”]<\/p>\n The study found that to expand the revenue base of the sector and, more broadly, the government, there are two scenarios to increase the tax rate by the projected inflation and GDP growth rate, and an additional 5%. While the additional revenues would not be sufficient to cover the PHC funding gap, if the Ministry of Finance decided to pursue this proposal and ringfence the additional revenues to fund the health sector, there would be enough resources to cover half of the existing health centers and all the health sector administration costs respectively. Learning from the region, notably, Zimbabwe, suggests that raising and ring-fencing domestic resources is feasible, through a recently-introduced Health Fund Levy<\/a> through which five percent of the duty charged on airtime is ring-fenced to improve access to quality health care for all Zimbabweans.<\/p>\n [\/et_pb_text][ba_gradient_heading title=”How: Realising efficiencies for PHC” html_tag=”h3″ primary_color=”#455A64″ secondary_color=”#455A64″ admin_label=”HEADING (50-60 characters)” _builder_version=”4.21.0″ _module_preset=”default” title_font=”||||||||” title_font_size=”24px” title_line_height=”1em” custom_padding=”15px||0px||false|false” global_colors_info=”{}”][\/ba_gradient_heading][et_pb_text admin_label=”TEXT – BLOCK 7″ _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||1em||false|false” global_colors_info=”{}”]<\/p>\n Sustainability cannot be achieved by implementing vertical programs. Therefore, the Ministry of Health, the President\u2019s Office Regional Administration, and Local Government have implemented a comprehensive framework for service delivery integration. Where conversations are starting on integrated mentorship and supportive supervision, scale-up of integrated data management systems including electronic medical records is imminent. These operational reforms promoted by the MOH have been accompanied by efforts to harmonise planning and budgeting efforts to promote efficient resource utilisation. Additionally, there are opportunities to learn from the more efficient regions about approaches to utilise resources more effectively<\/p>\n [\/et_pb_text][et_pb_text quote_border_color=”#EA3A32″ admin_label=”pullquote” _builder_version=”4.21.0″ _module_preset=”default” quote_font=”Oswald|||on|||||” quote_text_color=”#5EAABC” quote_font_size=”26px” quote_line_height=”1.3em” custom_padding=”||2em||false|false” global_colors_info=”{}”]<\/p>\n We\u2019re not starting from zero and never have been \u2013 Tanzania contributes a significant proportion of health financing but there is a high dependence, particularly in priority programs. We need more and need more efficient investment.<\/em><\/p><\/blockquote>\n Ms. Elise Lang, Health Financing Advisor, USAID<\/p>\n [\/et_pb_text][et_pb_text admin_label=”TEXT – BLOCK 8″ _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||1em||false|false” global_colors_info=”{}”]<\/p>\n\n