Right Honorable, Stephen Harper, the Prime Minister of
Canada and our kind Host;
Your Majesty Queen Rania of Jordan;
Your
Highness, the Aga Khan;
Melinda
Gates, Co-chair of the Bill & Melinda Gates Foundation;
Dr.
Margaret Chan, Director-General of the World Health Organization;
Mr.
Anthony Lake, Executive Director of the UNICEF;
Distinguished Guests;
Ladies and Gentlemen,
Appreciation
Once
again allow me to commend Rt. Hon. Stephen Harper, Prime Minister of Canada for
conceiving the idea to convene this Summit on maternal, newborn and child
health. I congratulate him also for the
wonderful organization. Prime Minister
Harper has demonstrated exemplary leadership on this all important matter from
the Muskoka 2010 G8 Summit to the UN Commission on Information and
Accountability for Women’s and Children’s Health and through several other initiatives
to this Summit. I am sure I speak on
behalf of many people on this planet when I say, we sincerely appreciate his
invaluable contribution and ask him to continue to do the good work.
I am
delighted to join you this morning and speak at this important session on
"Doing More Together Globally".
I subscribe to the idea that doing more together globally is the best thing
to do. Our past and recent experience in addressing issues of women's and
children's health have not suggested otherwise. It is imperative that we build
upon this experience of working together as we do the countdown to the 2015
MDGs deadline, and prepare for the post 2015 phase.
Tanzania: Where We Came From and
Where are We
Excellencies, Ladies and gentlemen,
Tanzania’s
experience in implementation of MDG 4 and 5 has taught us many lessons as we travel
towards the 2015 deadline and chart the path towards post 2015 development
agenda. I say so, because, the results tell the story about the successes made and
the targets not yet met that deserve attention going forward.
As we
examine this experience, it is important to note that, Tanzania was worse off before
the proclamation of the MDGs than where we are today. At the dawn of the new millennium maternal mortality
was at 870 per 100,000 live births, infant mortality rate was 115 per 1,000 live
births and under five mortality rate was at 191 per 1,000 live
births. The coverage of contraceptives was 7
percent, and only 43.9 percentage
of women gave birth at the health facilities under the care of skilled health
professional.
When the
MDG 4 and 5 targets were announced it appeared to be too ambitious goals for us
to attain. We were tasked to lower the
maternal mortality rates to 193
deaths per 100,000 (from 870) live births, neonatal mortality to
19 deaths per 1,000 live births (from 119)
and under five mortality to 54
deaths per 1,000 live births (from 191) by 2015.
Today,
less than 600 days towards the
deadline, Tanzania maternal mortality rates in 2010 were 454 deaths per 100,000
live births, neonatal rate was 21 (2012)
deaths per 1,000 live births and
under five mortality is at 54 deaths
per 1,000 live births. The use of
contraceptive has increased to 27
percent from 7 percent and women
who give birth at health facilities and attended by skilled midwives are 51 percent.
Indeed, in
the span of 14 years, comparatively, a lot of ground has been covered and much
has been achieved. Tanzania has met the
MDG target for under-five mortality rate, we are close to meeting neonatal
mortality rate target. But, we are far
from meeting the target with regard to maternal mortality rate which has been
cut by 45 percent but for short of the expected 75 percent cut as stipulated in the MDG 5.
It is
very clear from these statistics that there has been progress, but not good
enough particularly with regard to mothers.
Work is still in progress to accelerate the pace of implementation. As alluded to earlier, I am hopeful that we
may be able to meet the newborn target by 2015 but not as hopeful with maternal
mortality and skilled health worked.
What has Worked Well
Excellencies,
Ladies and Gentlemen;
These hard
won results have been achieved through a number of interventions undertaken
through concerted efforts by our government, families and communities. But, support from our development partners
including bilateral and multilateral donors as well as the private sector;
private foundations and the wider civil society community has made a huge
difference.
When I got into office in 2005, I made a promise
to make health care one of the top priority agenda of my administration. We immediately undertook a comprehensive review
of the situation in the health delivery system.
Subsequently, we come up with the New National Health Policy of 2007 and
designed the Primary Health
Services Development Program (2007-2017) to implement the Policy. We also put in place a number of policy
instruments including Health Sector Strategic Plan III, Roadmap to Accelerate
Reduction of Maternal, Newborn and Child Deaths, Immunization Costed Plan,
Family Planning Costed Plan, Human Resources for Health Strategic Plan and now the
Sharpened Plan to Accelerate Reduction of Maternal, Newborn and Child Deaths.
These Policy
and Program were aimed at addressing access to health care and service delivery
and capacity related bottlenecks. We gave ourselves the overarching ambition to
improve access to health care within a radius of 5 kilometers from where people
live. It meant building health delivery
facilities where they don’t exist particularly in the rural areas. Also, we undertook to provide all health facilities
with the requisite equipment, medicines and skilled health personnel.
To
implement these ambitious plans and programmes, the government raised the health
budget fivefold from 271 billion
shillings (US dollars 170 million) in 2007 to 1.4 trillion shillings (US
dollars 860 million) in 2013. This
investment has paid off in many respects. Some 1,640 new dispensaries, 122 new
health centers and 19 new hospitals
have been built. Considerable improvement has been done with district, regional
and zonal hospitals as well as the national hospital at Muhimbili.
Since
2007, we have upgraded facilities in many of the old dispensaries to enable
them to undertake birth related services.
With health centres, we are building capacity to perform cesarean
section. We have expanded training and
employment of health professionals. We
have improved on the availability of medical equipment and medicines including
vaccines.
Besides,
addressing the accessibility challenge we also undertook specific measures
which helped in reducing maternal and child mortality. With regard to child mortality measures
included sustained high immunization coverage, improved malaria control, increased
coverage of Integrated Management of Childhood Illnesses, Vitamin A coverage to
over 90 percent and improved
nutrition including breast feeding. Besides the above measures, other measures
include dealing with asphyxia, pregnancy and birth related complications,
infections, premature birth.
With
regard to mothers, measures included improved perinatal care, coverage of intermittent
preventive treatment for malaria, anaemia etc.
improved access to sender skilled health personnel.
What is
required of all of us now is scaling up on these interventions. We commit ourselves to continue to increase
the health budget. We will continue to
work closely with partners and friend of Tanzania in this endeavour. For, I believe with continued support from
partners and friend like Canada and many nations in the developed world,
private foundations, the UN and its agencies (WHO, UNICEF, UNFPA) as well as Bill
and Melinda Gates Foundation, Aga Khan Foundation and several others, we should
be able to do more and achieve more.
Way Forward
Excellencies,
Ladies and Gentlemen;
I have shared with you our
experience, our challenges and our optimism for the days ahead of us. We have
come a long way as far as maternal, new born and child health is concerned. We
have demonstrated how far we have gone with little resources and capacity
constraints. What is clear is that, the
issue we are confronting is not about not knowing what needs to be done, nor
lack of interest or political will to do it.
It is, in essence, a function of capacity constrains which are
associated with the low level of development we are in our being a developing
country.
Our
experience, gives us no reason to lose hope or renege on our commitment. I am
personally committed to see acceleration in interventions, more accountability
and better results with regard to women’s and children’s health delivery by
2015 and beyond. The recent introduction
of the Maternal, Newborn and Child Health Score card speaks volumes about our
resolve to do better in this regard. In
conclusion, allow me to say that with improved health systems, more resources and
accountability, we can punch above weight. Fortunately, the world we live in has
enough resources, wealth, technology and people of goodwill. If we continue to work
together in this noble course as demonstrated at this High Level Summit, our
objective will be realized in no time. Saving
women and children lives is and must remain a shared responsibility. This fight
must be won, and win comprehensively. Losing is not an option.
I thank
you for your kind attention.
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