Tanzania's health spending is still far less than what is recommended by the World Health Organisation (WHO), stakeholders were told today at a policy debate in Dar es Salaam.
Speaking at the breakfast event organised by the Policy Forum, Dr. Flora Kessy of the Mzumbe University said that the WHO has recommended a per capita health spending of US$54 and the government’s own target is as outlined in the third Health Sector Strategic Plan (HSSP III) was a per capita health spending of US$ 15.75 by 2009/10 but this has not been met.
She noted that although health spending was stable in nominal terms during the period of financial years 2006/07 to 2011/12, it declined slightly in real terms and that in fact the expenditure in health as percentage of the total Government expenditure was declining which was a big concern.
“Government funding still remains the dominant source of public health financing,” she said, adding however, that for the financial year 2011/12, foreign funds for health amounted to 41% of the budget whilst 59% came from government funds.
She also revealed that in spite of the country’s development budget in health continuing to grow, it was still faced with poor performance in the sector. For instance, in the financial year 2011/12, the recurrent budget in the health sector was spent by 54% and the development budget was spent by 45.7%, observing that the recurrent budget was performing better than the development budget. Dr. Kessy urged the government to increase the health share of the government budget to 15% as per Abuja Declaration commitment stating that the 15% share towards health was a realistic target and complemented other sectors like education and agriculture.
She added that because the National Health Insurance Fund (NHIF) continued to hold significant amount of unspent funds, efforts should be made to bring the rural communities on board as only 8% of the Tanzanian population is currently covered by the scheme. “The NHIF unspent balance as percentage of its total income stood at 59% for financial year 2010/11 and the percentage of funds paid out to health services against total income of NHIF was 27%.”
Mr. Simon Moshy of SIKIKA, a civil society organisation advocating for accountability in the health sector also made a presentation and called on the government to apply the ‘Health Block Grant Allocation Formula’ which was developed in 2002 considering allocation factors such as a particular area’s population (70%), the under-five mortality in the area (10%), its poverty count (10%) and the district‘s vehicle route (10%). According to SIKIKA’s own analysis, this health block grant formula is not applied.
Mr. Also urged the government to improve in the distribution of medicines and medical supplies and end the persistent lack of funding for these supplies. “Sikika’s survey from May to August 2011 showed that from 100 inquiries for a specific essential medicine or medical supply, on average, 29 were reported to be out of stock. Meanwhile, the need for essential medicines and supplies set for the financial year 2012/13 according as expressed by the Medical Stores Department is 198 billion shillings and the Medium Term Expenditure Framework has budgeted 75.5 billion shillings.”