HEALTH SECTOR

Although Tanzania’s health system is relatively well-developed, the economic crisis in the 1980s led to the system being worn down and undermined, and the sector was fragmented into donor-operated programmes.


Health reform launched in ´96
With a view to increasing general access to basic health services of good quality, the Government launched a health reform in 1996. The reform, which aims at relieving the structural problems of the sector including its severe underfunding, is based on giving higher priority to public health services, increasing the efficiency of the health system, mobilizing new financial resources and an institutional reform which comprises focus on the core activities of the Ministry of Health and Social Welfare and decentralising responsibility for public health services to local government authorities.

Massive support to the health sector
Denmark has supported Tanzania’s health sector for several decades, since 1996 as Sector Programme Support.

The current fourth phase of the health sector programme support covers the period of 2009 to 2014 with a total budget of 910 million Danish kroner.

The programme continues the trend of increasing focus on the district health services, in accordance with the government’s decentralisation reform, health sector strategy and channelling an increasing proportion of funds as sector budget support through basket mechanisms.

Focus on HIV and AIDS
The current phase supports the government’s Health Sector Strategic Plan III (2009-2015) and the 2nd National Multi-Sectoral Strategic Framework on HIV and AIDS (2008-2012), which is in line with the MKUKUTA (Tanzania’s Poverty Reduction Strategy). The sector budget support is supplemented by earmarked funding in areas where Denmark has comparative advantage, e.g. prior experience or is considered preferred donor by government. The well-developed division of labour between the development partners forms part of the rationale for choice of earmarked support areas.

The fight against HIV and AIDS, which is one of the biggest tasks for the health system and development in general, receives substantial support directly from a number of development partners. The Danish-funded health sector programme supports HIV and AIDS by strengthening Tanzania Commission for AIDS and it's capacaty building programmes and activities for regional and local government authorities.

The support is, in accordance with the government’s strategies, increasingly incorporating the private sector.

There is a well-developed sector wide approach with government led development partner coordination. A number of important development partners, including Denmark, channel their funding through common basket arrangements.

Differences between mainland and Zanzibar
The support is, with the exception of some private sector institutions, utilising government systems. On the mainland of Tanzania, approximately 95% of funds are integrated in or reflected in government budgets. On Zanzibar, this is not the case due to financial management systems, which are not yet sufficiently reliable. Support to the health sector on Zanzibar focus on rehabilitation and maintenance of clinics and hospitals, supply of drugs and medical equipment, and promotion of health sector reform and management.