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Tanzanian-German Programme

to Support Health (TGPSH)

Tanzanian-German Programme

to Support Health (TGPSH)

Phase 1: Jan 2003 – Dec.2006Inception.

Phase 2: Jan.2007 –Dec. 2009 Consolidation

(Dr. O. M.E. Kisanga-National TGPSH Co-ordinator )

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Programme GoalProgramme Goal

Contributes to improve the health and well-being of all Tanzanians with a focus on those at most risk and to encourage the health system to be more responsive to the needs of the people

<shared national goal>

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Programme backgroundProgramme background Fusion of Historic German Development Co-operation

Projects in health and related field*Family Health Project*HIV control*Reproductive health and

DED CIM,INwent KFW

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The Programme aims at:The Programme aims at:

Enhanced structural effects (Decentralisation, PPP, Transp financial Management)

Facilitating introduction of cross-sectoral / overarching issues into Progr components

(Gender, Youth, Civil Society, governance structures-CHSB, FGCs)

Increased economic efficiency through flexible use of resources (instruments, personnel, others)

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Programme DimensionProgramme Dimension

National level : MOHSW,MOE,TACAIDS Regions level: Lindi, Mtwara, Mbeya, Tanga, (Dodo) Operational level: 28 Districts of the 4 regions

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Features of the ProgrammeFeatures of the Programme

1.Contribution to Sectoral programmes(HSR,SWAP,HSSP,LGR,NSF-AIDS)

2. The cross-sectoral dimensions(MAC,RCH,DEC,HRH)

3.Multi-level approach (link micro, meso and macro)

4.Co-operation with different stakeholders5 A Combination of Complementing Instruments of

GDC (Financial-(kfW), Technical (GTZ,DED, Inwent,CIM)

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The Programme Components

The Programme Components

1. HIV / AIDS2. Reproductive Health3. Social Security & Health Financing 4. Human Resources for Health5. District Support and Quality management6. Public Private Partnership

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Fighting HIV/ AIDSFighting HIV/ AIDS Key issues: Multisectoral and comprehensive approach Expected results : An increasing percentage of the population

takes advantage of available preventive health care and uses the services of multisectoral AIDS control, provided by public services and civil society organizations

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Reproductive HealthReproductive Health Key issues: Safe Motherhood Community-based services Focus on youth Advocacy Peer education and extracurricular activities Expected Results :

The population, in particular adolescents, has access to information about sexual and reproductive health as well as to high quality reproductive health services

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Health FinancingHealth FinancingKey issues:

Increase government share and household spending on health Relate to macro-economic and poverty reduction strategies Improve management of scarce financial resources (value for

money) Expected resultsProcedures of Social Security and Health financing are used more

successfully.

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Human Resources for HealthHuman Resources for HealthKey issues:

Capacity Building through Human Resources Development

Zonal Training Centre are an opportunity for scaling up „best practice“

Electronic networking (MOHSW, MUCHS, ZTC) for distance learning and coaching

Expected results Quality and quantity, of human resources of the relevant

health facilities improved

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District Health & Quality Management

District Health & Quality Management

Key issues: Quality – a responsibility for health workers Comprehensive Council Planning for resource

management Orientation towards performance and outcome Growing concern on client-satisfaction

Expected results:

The decentralized health services in the regions deliver efficient, comprehensive services according to needs

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Public Private PartnershipPublic Private PartnershipKey issues:

Support establishment and functionality of PPP Forums at all levels

Contractual approach as a strategic tool: service agreements

Support of faith based health care providers through CSSC

Expected ResultsThe cooperation of public and private health services, in

particular the faith-based , are institutionalized and supported by the national agenda of the government

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Implementation results-processImplementation results-process HIV/AIDS Control Competence centre-Mbeya-

address Community/multisectoral concerns Adolescent and mothers health improved through

advocacy and contraception MPH improve DMOs and RMOs perfomance Planning tools improve financial accessibilty CHF contributes to improved service provision Improved Public and private co-operation

improves moth &Child access to quality services

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Implementation ResultsImplementation Results

Contribution to national Indicators:

Infant mortality from 99 (2002) - 68/1000 (04/05) Decreased child mortality (147(02) to 112 (04/05) Increased number of deliveries under skilled

supervision (36 % to 59% (2008)

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Implementation ResultsImplementation Results

Assessed in Supported Regions Increased deliveries under skilled supervision

Tanga: 35% to 64%Mbeya: 37% to 44%Mtwara: 28% to 37%Lindi: 49% to 54%

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Implementation ResultsImplementation Results

Contribution to adressing MDGs —27/31 outputs

Contribution to addressing MKUKUTA-poverty reduction and Human right - 28/31 outputs

Gender equity (Male involvement in PMTCT, Peer ed, CHF enhancement) -26/31 outputs

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Challenges:Challenges: HRH –the number ,the capacity the motivation The need for an effective policy back-up The Resistant Maternal Mortality Health is rather a human right not confined to providers Reform is a process; perfection means turning over a

critical number of stones to make a way.