Sustaining a Life-Saving Maternal Health Program in Tanzania

Tanzania has the sixth highest number of maternal deaths in the world, with one woman dying every hour from complications of pregnancy or childbirth. These deaths usually result from a woman’s lack of access to health care, especially for women in regions such as Kigoma.

Kigoma has one of the highest total fertility rates in Tanzania, while also experiencing extremely high maternal and neonatal deaths. This situation makes the need for health services urgent.

In 2006, Bloomberg Philanthropies and other partners began supporting Tanzania’s maternal and reproductive health program in Kigoma to implement the government’s health priority of saving lives by increasing access to emergency obstetric care, reproductive health services and family planning. The government’s policy of task shifting and prioritization of maternal health were catalytic for the program, which focused on decentralizing health care to the village level by upgrading and equipping health facilities and training non-physician health providers. Since then, 1,100 maternal deaths have been prevented, 86 health facilities have been upgraded, more than 70,000 babies have been delivered in those upgraded health centers and more than 400 health workers have been trained to provide care and community education. In the summer of 2019, the international partners supporting this program will formally exit and the Tanzania government will begin to fund and operate the program.

Recognizing the impact and importance of sustaining this program, the partners brought on the Global Health Advocacy Incubator in 2016 to advocate for the continuation of these essential services after the program is turned over to the government. The Global Health Advocacy Incubator gave recommendations to the partners, helped them formulate a strategic plan and provided continual technical assistance as they implemented it. The Global Health Advocacy Incubator led implementing partners through an extensive political mapping and strategic planning process which highlighted the need to ensure comprehensive maternal health services were budgeted for through direct advocacy at all levels of government. The Global Health Advocacy Incubator and our partners mapped decision-makers in the budget process to identify advocacy targets, supported tactics and strategies such as informational events, fact sheets and high-level meetings to build a base of support in Parliament, and engaged local governments to build their capacity to incorporate comprehensive maternal health services into their requested health budgets.

As the end of the program approaches, we are already seeing the results of our coordinated advocacy efforts. In July 2018, Tanzania’s minister of health announced the allocation of 365 health care providers to the Kigoma region, the highest allocation in the country since a 2015 hiring freeze. As of today, 90 percent of those providers have reported to their facilities.The Global Health Advocacy Incubator and our partners are confident that targeted advocacy has helped to safeguard vital health services for communities in Tanzania and ensure that life-saving services will continue to be available to those who need them most.