By Anna Sawaki, White Ribbon Alliance Tanzania, Communication and Media Officer
Tanzania has made big strides in reducing the deaths of children under five years old, to the extent of attaining the Millennium Development Goal of reducing deaths of under-fives from 99 to 43 out of 1,000 - even before the set time of 2020.
However, the Tanzania Demographic Health Survey (TDHS) report of 2015 paints a grisly picture about maternal and newborn health in the country. This grand health survey that takes place every five years indicated that the number of maternal deaths have increased from 8,000 per year in 2010, to 11,000 per year in 2015. Additionally, the report shows that for every single maternal death, six newborns die (i.e., 66,000 newborn deaths per year), bringing the total number of deaths due to maternal-related complications to 77,000. This brings the total number of deaths per day to 211. And according to Rose Mlay, the National Coordinator of White Ribbon Alliance Tanzania (WRATZ), this number is equivalent to three Tanzanian national carrier vessel bombardiers, with carrying capacity of 70 passengers, crashing on a daily basis, and killing all passengers on board.
“This cannot be tolerated,” she said. Mlay explained that the absence of emergency medical care when expectant mothers need it most is the foremost cause of this disturbing increase in maternal deaths. Mlay was speaking at a seminar that was attended by 315 Members of Parliament at the Parliament premises in Dodoma on February 7th, 2017. She sadly noted that even in the current 2016/2017 budget, 48 councils did not budget for Comprehensive Emergency Obstetric and Newborn Care (CEmONC) services in their Comprehensive Council Health plans (CCHPs). Mlay further said that even those councils which budgeted for this service did not have a clear budget line for it, or, the budget was used for other purposes different from what had been budgeted for.
The one-day seminar that brought to light these challenges in the maternal, newborn and child health docket in Tanzania was organized by WRATZ in conjunction with Parliamentary Group for Safe Motherhood (PGSM) with the support of UNICEF. The event was specifically organized to get honorable Members of Parliament (MPs) to discuss ways of reducing these increasing maternal and newborn deaths in the country because MPs are members of councils where the budget process starts - and they are also responsible for approving the national budget. The seminar aimed at pointing out issues related to the improvement of Reproductive Maternal Newborn Child and Adolescent Health (RMNCAH) budget allocation and expenditure.
“Our 2017/2018 budget should include a CEmONC budget line. We request that you only approve the budget that indicates a CEmONC line. If it does not have it, kindly do not approve it,” Mlay told the MPs.
Speaking at the same event, the Minister of Health, Social Development, Gender, Elderly and Children, Hon. Ummy Mwalimu challenged the MPs who were present about what they would do first if they had 70 million Tanzania shillings ($30USD). "Between building a market and an operating theater, what would you do first?" she asked. "Why build a market and leave a theater yet people can even trade under trees?"
Hon. Ummy explained that MPs need to start feeling the pain of these women; only then will the maternal death rate be curbed, even without the intervention of the Minister of Health. As an example, she pointed to the simple equipment required to do a urine test that costs only 9,000 Tanzania shillings ($4USD) for 50 persons. “But you will find a health center going without one for ages,” Hon Ummy painfully remarked. “If we really mean to reduce maternal and newborn deaths, I request us Members of Parliament not to approve Comprehensive Council Health Budgets (CCHPs) that do not prioritize safe motherhood."
Representing the UNICEF country representative, Dr. Asia Hussein requested MPs to make sure that the Government sets aside enough money specifically for the health sector. She also asked the MPs to ensure that all the money set aside for the health sector strengthening is released and used for the intended purposes. Dr. Asia encouraged the MPs to continue pushing the Ministry of Health, Social Development, Gender, Elderly and Children to provide reports about the maternal, newborn, children and youth health situation in Tanzania (RMNCAH Score Card) on a quarterly basis.
Hon. Hawa Chafu Chakoma called upon the Government to hasten the process of amending the Marriage Act, 1971, as a process of ending teenage pregnancies. The Marriage Act puts the acceptable age for marriage at 14 years old, an age by which teenagers are not physically mature enough to have babies. Teenage pregnancy are a contributing factor to maternal deaths in Tanzania.
Hon. Peter Selukamba, who is also the Chairperson of Parliament’s social committee, wound down the seminar by urging MPs to crosscheck with their district medical officers to make certain that CEmONC budget is included in their district budgets for 2017/2018. He further urged them to make sure to closely monitor their budgets, even after including CEmONC line items, to make sure the funds are used according to plan.
All MPs pledged to follow up with their Regional and Medical Officers to make certain that CEmONC budgets are included in their 2017/2018 CCHPs plans and to influence all CCHP plans to allocate CEmONC budget if it is non-existent.
To learn more about WRA Tanzania’s life-saving work, please click HERE.