Global Health
Over the last 15 years, Tanzania has made a number of important achievements in public health, including a decline in childhood deaths. Between 2001 and 2010, HIV prevalence fell from 7.1 to 5.7 percent. In addition, there has been a six-fold increase in the number of Tanzanian adults who know their HIV status, and more adults are protecting themselves from HIV infection through condom use. More children are fully immunized and sleep under insecticide-treated nets. Increased numbers of pregnant women are taking preventive treatment to reduce the consequences of malaria in both the woman and her unborn child.
Many challenges, however, remain. Disparities are seen in maternal, newborn and child health, and Tanzania still faces an HIV/AIDS epidemic and other widespread communicable diseases such as tuberculosis, malaria, respiratory infections and diarrheal diseases. These issues are exacerbated by underlying food insecurity and nutritional deficiencies. In addition, Tanzania has some of the lowest coverage rates of health personnel in the world.
USAID is working with the Government of Tanzania to control malaria, prevent mother-to-child HIV/AIDS transmission, provide children with life-saving nutritional supplements, train health workers, improve maternal health facilities and scale up voluntary family planning services. In addition, USAID is working with indigenous Tanzanian organizations to address women’s and girls’ empowerment.
HIV/AIDS
USAID works to mitigate the impact and spread of Tanzania’s HIV/AIDS epidemic in partnership with the Government of Tanzania, other U.S. agencies, and a wide range of implementing partners through the President’s Emergency Plan for AIDS Relief (PEPFAR). In 2010, the United States and Tanzania signed a five-year partnership framework to scale up HIV/AIDS prevention efforts while maintaining support for care and treatment. Through PEPFAR, USAID is also extending the reach and quality of the programs addressing gender-based violence into specific regions of Tanzania.
USAID’s key prevention activities include behavior change interventions, HIV counseling and testing, and services to prevent mother-to-child transmission of HIV. USAID is also leading an interagency voluntary male circumcision initiative that is helping to prevent and diminish the spread of the disease. USAID assistance also provides treatment, care and support to HIV-positive individuals and their families. Almost 70,000 individuals are receiving antiretroviral treatment through USAID-supported facilities and nearly 4,600 individuals with TB received integrated TB/HIV care and treatment. In addition, more than 121,000 individuals are receiving compassionate palliative care services through USAID.
USAID supported the creation and implementation of the National Plan of Action for Orphans and Vulnerable Children, and sponsored an orphans and vulnerable children data management system that improves service coordination. More than 326,000 children have been reached with this service.
Malaria
Malaria is the leading cause of death for Tanzanian children and is a major cause of maternal mortality. Under the President’s Malaria Initiative, USAID strives to reduce malaria by employing an integrated approach. USAID supports the national malaria prevention and case management strategies through education, bed net distribution, indoor spraying, and strengthening of the health care system, especially for children and pregnant mothers.
With USAID support, Zanzibar has essentially halted malaria transmission, with prevalence at less than 1 percent, and shifted its focus to sustainability. On the mainland, 2010 DHS data indicate that the number of households with at least one insecticide-treated net increased from 38 percent in 2007 to 63 percent in 2010. USAID continues a mass media campaign to create awareness and encourage healthy behavior, and has protected over 6.3 million people in high-risk Lake Zone districts through indoor spraying.
In addition to training health workers to include malaria prevention during prenatal care, USAID has also focused on improving their diagnostic and treatment skills. USAID has helped to procure and distribute nearly 14 million courses of artemisinin combination therapies, a highly effective treatment that allows for shorter treatment courses and better protection against drug resistance. Malaria treatments are distributed throughout through public and private centers as well as refugee camps in Western Tanzania.
Maternal and Child Health
Infant and child mortality are improving significantly to 51 and 81 deaths per 1,000 live births, but progress has been slower on maternal and neonatal mortality, which stands at 454 deaths per 100,000 live births and 26 deaths per 1,000 live births, respectively.
USAID’s maternal and child health programs support antenatal care, safe delivery and management of child illness. The safe delivery program builds local capacity to address high maternal mortality and neonatal care. The antenatal care program has transitioned from training of health providers to setting up external supervision and internal quality improvement systems that address the quality of service provision. The program is also integrating prevention of mother-to-child transmission of HIV with maternal health programming, in collaboration with PEPFAR. USAID is also supporting national childhood immunization efforts that include the introduction of vaccines to prevent pneumonia and diarrhea.
Family Planning
USAID voluntary family planning programs are being integrated with other health services to contribute to the goal of reducing maternal mortality. Although the total fertility rate has fallen from 5.7 to 5.4 births per woman in recent years, there have been no significant changes in Tanzania’s unmet need for family planning.
The use of modern contraception in Tanzania has increased from 20 percent to 27 percent between 2005 and 2010, with use of any family planning method increasing from 26 percent to 34 percent. After sustained efforts to improve contraceptive security and logistics, national contraceptive distribution has improved, but resource allocation and stockouts remain problematic.
USAID works to increase information about voluntary family planning options as well as improve the forecasting, ordering and logistics systems for commodities.
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