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Health Sector Strategic Plan III:"partnerships for delivering the MDGs" July 2009-June 2015

Ministry of Health and Social Welfare, (M.&S.) (2008) Health Sector Strategic Plan III:"partnerships for delivering the MDGs" July 2009-June 2015. UNSPECIFIED. (Unpublished)

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This third Health Sector Strategic Plan reflects the strategic intentions of the health sector for the period 2009 – 2015. It does not go into detail of operational activities, which are provided in specific strategic plans and work plans of institutions and programmes. This document is a guide for strategic planning at sub-national levels and for annual planning. Tanzania is classified by the UN as one of the least developed countries. About 25 % of Tanzanians were living below the poverty line in 2007. Over the past ten years Under Five Mortality Rate and Infant Mortality have reduced. However Maternal Mortality and Neonatal Mortality remain persistently high. The health system is gradually expanding, but not enough to cover the unmet needs of the population. There is an acute shortage of staff: only 35% of the required personnel is in place to provide health services. The health sector is guided by national policies, such as Government Reforms. The National Strategy for Development and Poverty Reduction (MKUKUTA) provides the global direction for achievement of the Millennium Development Goals (MDGs). The Health Policy was updated in 2007, providing Government’s vision on long-term developments in the health sector. The Health Sector Reforms programme continues with further strengthening of Local Government Authorities and hospitals to improve their performance. The Primary Health Care Strengthening Programme aims at improving accessibility and quality of the health services. The Human Resources for Health plan targets at solving the human resources crisis in the sector. HSSP III consists of four dimensions: the eleven strategies concentrate on specific topics in the health service delivery related to diseases and management. The crosscutting issues elaborate on the approach towards quality, equity, gender and governance. The document explains which types of services or provided in the health sector, and also explains what are the role and responsibilities of each level in the health system. Levels in the sector; The accessibility to District Health Services will be improved, amongst other through implementation of the Primary Health Care Strengthening Programme (MMAM in Kiswahili). All facilities will provide a complete package of essential health interventions in accordance with the guidelines for their level. Community involvement will be strengthened, to improve health. The referral system in the district (horizontal and vertical) will be strengthened to ensure appropriate treatment for patients. The Tanzania Quality Improvement Framework (TQIF) provides guidance for introduction of quality systems, including accreditation. Supervision by Regional Health Management Teams (RHMTs) and Regional Hospital staff will contribute to quality improvement. With regard to management of District Health Services, further decentralisation to health facilities will improve needs-based planning and implementation. Further integration of MOHSW and LGA management systems will streamline operations. Performance-based systems like Pay-for-Performance (P4P) will enhance motivation and
productivity of health workers, Referral Hospital Services will be more accessible to patients who need advanced care through an adequate referral system, and measures to prevent bypass. The quality of care will improve by implementation of the TQIF ; hospitals will have a Quality Assurance unit to promote quality. The hospital reforms programme will improve financial management and human resources anagement. Hospitals will develop strategic plans and capital investment plans. Hospital boards will ensure community participation in management. The central level support by headquarters departments and agencies will be streamlined. More functions will be delegated to operational level. Further integration of programmes
will lead to more coherence in the health services. Head quarters will introduce a rigorous system of annual action planning Strengthening of RHMTs is very important for technical supervision on behalf of the MOHSW. Zonal Resources Centres provide training and technical support to training institutions. Increase of numbers and improvement of the quality of human resources for health (HRH) are most important for improve accessibility and quality of health services. The HRH planning and information system will be strengthened. Recruitment and retention of staff will be institutionalised in close collaboration with LGAs. The introduction of performance-based systems will improve motivation and productivity of health staff. Continuing Professional Development (CPD) is necessary to keep health workers updated. Training institutions will increase their production by higher numbers of graduates and will improve their quality through update of the curricula. Health Care Financing is fundamental for realising the ambitions of the MOHSW. The Ministry aims at increasing the health budget to 15% of the Government budget. Increasing the funding through the Health Basket Fund is another way of resource mobilisation. The Ministry will develop strategies to increase complementary financing through the Community Health Fund and National Health Insurance Fund. The
management of these funds will improve and a regulatory body for health insurances will be created. Increased collaboration with the private sector will open up opportunities for investments in health. Public Private Partnerships will be important for achieving the goals of the health sector. PPP forums will be installed at national, regional and district level. The Service Agreements will be used in all LGAs to contract private providers for service delivery. The private training institutions will be more involved in production of HRH, based on their specific competencies Maternal Newborn and Child Health will improve as result of general measures like increasing the number of primary health facilities, increasing the number of competent staff and improving equipment and supplies in health facilities. A better referral system will increase access to emergency obstetric care. The communities will be more involved in MNCH to improve behaviour and practices with regard to reproductive health. Diseases control programmes will equally benefit from general improvements in health facilities. The diagnostic capacity (in labs) will improve and equipment and supplies increased.The TQIF will stimulate further introduction of treatment guidelines and clinical standards. The HIV/AIDS programme will continue with increased access to ARV treatment to PMTCT and Post Exposure Prophylaxis. Prevention and Voluntary Counselling and Testing will be stimulated, as well as treatment of sexually transmitted diseases. All hospitals will guarantee safe blood transfusions. In the malaria programme vector control through Insecticide Treated Nets and Indoor Residual Spraying will be stepped up. The adequate diagnosis and treatment will be further expanded. In the tuberculosis programme the DOTs strategy will continue, while vigilance for Multi Drug Resistant TB will be high. The leprosy control and disability prevention programme will be implemented in all districts. There will be more attention for neglected diseases, even if they have only regional importance, by training of staff and provision of medicines, to reduce unnecessary suffering and death. Non-Communicable Diseases become more and more important with the shifting demographic situation. More attention for healthier lifestyles and better treatment will be stimulated. With regard to environmental health, the focus is on implementing the new Public Health Bill, and on introducing adequate measures for adherence to the legislation. Emergency Preparedness is a new theme in the strategic plan, but important now due to globalisation health threats may come up unexpectedly. Capacity building of all levels is planned to deal with emergencies or prevent them. Quick mobilisation of resources will be realised, when needed. Social welfare is also a new and challenging theme in the HSSP. The capacity has to be built in all districts to provide social welfare and protection services. The regulatory framework has to be developed and community-based programmes have to be initiated or strengthened, shifting from a charity approach to a rights-based approach. Monitoring & Evaluation help to improve evidence-based decision making and to enhance public accountability. The Ministry will develop a comprehensive M&E and Research policy and strategy, to ensure that more integration and harmonisation will be achieved. Integration of the MOHSW monitoring systems with the PMO-RALG and MKUKUTA systems will be achieved. The Health Management Information System will be revisited.
At national level there will data warehouses, where information from several sources is merged, and used for further analysis. Other issues, Capital investments need to be made to expand the health service network. Standards for infrastructure, maintenance, equipments, and means of transport need to be developed or revised, to increase efficiency and quality. The MOHSW and zonal workshops will provide support to districts and hospitals Medicines and medical supplies may never be missing in health facilities. The zonal warehousing and distribution improved of medicines will be improved. Management of medicines and supplies at district and health facility level will be improved, together with more rational prescription of medicines. Quality improvement is a major aim of the Ministry: in service delivery, in human resources and in management. Equity needs to be emphasised: geographic equity for underserved populations and equity for vulnerable groups, who cannot fend for themselves. Gender in health needs attention, because of specific health needs of women and men. The health services should be more alert to respond to those needs, especially of women who are more vulnerable to health problems. The involvement of men in family programmes will be stimulated. Communities own their health: healthier lifestyles will reduce suffering. Ownership of health should also extent to participation in management of health facilities, in order to make those facilities more responsive to specific health needs. Coherence between health reforms and health programmes, MKUKUTA and MDGs activities, government reforms and LGA reforms will enhance efficiency and effectiveness. The health sector should benefit from complementarity: more delegation and more partnerships, cutting back duplication and unhealthy competition. All stakeholders have to play their role. The MOHSW head quarters will concentrate more on its stewardship role, and delegate more operational tasks to LGAs, PMO-RALG and departments and agencies. Coordination with other ministries, partnerships with the private sector and with Development Partners will improve the implementation of the strategic plan. Mechanisms are in place for joint planning, monitoring and evaluation through the SWAp. There has been a gradual increase in Government funding over the last years. It may be expected that this increase will continue. Also the funding through the Health Basket Fund will increase. However, due to planned large investments, there will still be a funding gap of 24% during the implementation period of the strategic plan. Innovative ways of raising funds, from Government, from Development Partners and from the Private Sector will be used to fill this gap. A coherent system of quarterly, annual and periodic monitoring is planned, using selected
indicators. Coherence between MOHSW and LGA monitoring and discipline in reporting will ensure timely and reliable provision of information on progress and constraints in implementation of the strategic plan

Item Type: Other
Keywords: Mortality Rate, Infant Mortality, Poverty,Health Care, Community Health, Health Sector Management
Subjects: Policies, Strategies, Plans, Guidelines
Divisions: Ministry of Health and Social Welfare > National AIDS Control Programme (NACP)
Depositing User: Mr Joseph Madata
Date Deposited: 21 Feb 2013 06:29
Last Modified: 13 Aug 2013 05:51

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