BUDGET FOR MATERNAL AND NEWBORN HEALTH IS UNKNOWN
INVEST
INVEST
INVEST In Maternal And Newborn Health For Reduced Poverty And Enhanced Economic Growth
Tanzania is among the top ten sub-Saharan African countries contributing to 61% of global maternal deaths and 66% of all newborn deaths (One Plan, 2008). Maternal health complications cause Tanzania to lose about 8,000 women every year from its productive labor force amounting to over 160,000 women in the last 20 years (TDHS, 2004). This constitutes a significant loss since over half of the agriculture labor force is made up of women. The World Health Organization confirms that high maternal mortality rates have a statistically significant negative effect on GDP (2006).
Poor maternal health results in a crippled labor force and reduced economic growth.
Invest in
MATERNAL and NEWBORN HEALTH
through targeted budget lines
Adequately detail reproductive and child health budget line to include essential maternal and newborn health services for hospitals, dispensaries and health posts. These include: • • • • •
Antenatal care, Neonatal care, Postpartum care, Post abortion care, Family planning
Ensure Timely Release Of Funds For Quality Service Delivery
The targeted budget lines for quality service delivery are: • • • • •
Deployment of skilled health workers Provision of essential equipment and supplies Infrastructure improvement for delivery, post natal and laboratory services Establish neonatal units Develop and conduct tailor made training for appropriate staff
Invest in Emergency Obstetric Care by • • • • •
Employing skilled birth attendants Ensuring availability of emergency transport Making provisions for adequate drugs and supplies of good quality Functional referral systems Functional services available 24 hours a day everyday Five direct causes of maternal death are due to the following complications: Hemorrhage Eclampsia Unsafe abortions Infections Obstructed Labor
Approximately 15% of all births will be complicated and we cannot predict which ones. Emergency Obstetric Care is essential for managing these complications. Eye s nes Wit
“My afterbirth wouldn’t come out so I had to be taken by stretcher to Tunduru Hospital where I was given assistance and also had a blood transfusion. So I don’t think it is good to give birth at home.”
(Rehema, 25)
Invest in Family Planning by ensuring adequate budget allocation for: • Availability of at least 3 methods at all health facilities • Skilled attendants at all health facilities • Supporting people to make an informed choice
M
aternal health is compromised by frequent childbearing, childbearing at a young age and having many children. Furthermore, evidence suggests abortion complications cause between 13 and 30% of maternal deaths in Tanzania (AMMP). One in five Tanzanians cannot access family planning services adequately to avert these situations.
E
very dollar invested in reducing unmet need for family planning services we will reduce by $2-4 dollars incurred in expenditures on maternal and newborn health. (Adding it Up, 2008) Thailand saw savings of 16 USD in medical and infant care expenses as well as other social services (education, food etc.) while Egypt saved as much as 31 USD for every dollar.
I
nvestments in family planning results in a large active labor force that has fewer children – consequently a ‘demographic window’ opens when the number of producers in the population grows more rapidly than the number of dependents. With proper investments during this time poverty can be reduced by about 14% between 2000 and 2015. About one-third of East Asia’s economic growth has been attributed to this demographic window. (UNFPA, 2005)
Only 46% of births are attended by a skilled birth attendant. (DHS, 2004/2005) “Only 38% of health posts are filled. (One Plan, 2008). Skilled attendance at all births is considered to be the single most critical intervention for ensuring safe motherhood, because it hastens the timely delivery of emergency obstetric and newborn care when life-threatening complications arise
(http://www.unfpa.org/mothers/skilled_att.htm)
INVEST
In Skilled Birth Attendants
Training | Employment | Deployment | Retention SKILLED ATTENDANCE AT BIRTH SAVES MOTHERS AND BABIES 100 % of birth without skilled attendant Maternal mortality ratio per 100,000 live births Infant mortality ratio per 1000 live births
75
50
25
0
Europe
Americas
Western Pacific
Western South-East Eastern Pacific Mediterranean Asia without without China India
SOURCE : World Health Organization, April 05
South-East Asia
Africa
Invest
in Maternal and Newborn Health services to ensure there are no drugs and supply barriers • Adequate and free medicines, supplies, equipment.
Ministry Of Health And Social Welfare Audit allocated funds and systems for the provision of maternal and newborn health drugs and supplies and take action to prevent delays Ministry of Health and Social Welfare, Ministry of Finance – Allocate specific and adequate budget for quality Maternal and Newborn Health services required for childbirth or delivery
Prime Minister’s Offi ce Regional Administration and Local Government, Ministry of Health and Social Welfare – Change budget guidelines to: • Detach Maternal and Newborn Health drugs and supplies from the cost-sharing pool of funding • Ensure specific budget codes for delivery kits and Maternal and Newborn Health drugs and supplies • Audit allocated funds for maternal and newborn health services
Ministry of Health and Social Welfare and PMORALG plan for adequate drugs and supplies. Medical Stores Department – procure and distribute in a timely manner good quality drugs and supplies
White Ribbon Alliance in Tanzania The White Ribbon Alliance (WRATZ) was launched in March 2004 with 13 members. It currently has 2500 individual members and 107 member organizations and is still growing. WRA-TZ Vision All women and newborns in Tanzania enjoy essential, quality and life-saving safe motherhood services in a supportive environment
WRA-TZ Mission WRATZ aims to become a grassroots movement for safe motherhood that inspires action to save womens and newborns lives in Tanzania.
WRA-TZ Contacts For more information on WRATZ and to obtain a membership form, please contact WRATZ Coordinator. Mobile : +255 754 316 369 Email : rmlay@futuresgroup.com Postal Address: C/O JHPIEGO, Ring Street 481, Garden Road, Mikocheni A P.O. Box 7190, Dar Es Salaam Phone: 255 22 2771346/48 Fax: 255 22 2771341
Advocacy Package Sponsors Design By Sameer Kermalli
Photos By Sala Lewis