The Policy Forum's July Breakfast Debate brought together key stakeholders to discuss the state of the health sector in Tanzania, focusing on the theme: "Post National Budget 2024/2025: Examining the Credibility Equation of Health in Tanzania." The event, organized in collaboration with TGNP and Stanbic Bank Biashara Incubator, centered on an in-depth analysis of the health sector budget and its priorities.
Happiness Maruchu, Senior Resource Person from TGNP, initiated the debate with a comprehensive review of the post-budget analysis for the health sector. Maruchu highlighted that the health sector budget as a percentage of the national budget has been consistently below 6% for four consecutive years, from 2021/22 to 2024/25. For the current fiscal year, the sector's share stands at 5.1%, down from 5.4% in 2023/24.
Despite budgetary constraints, Maruchu noted several positive developments in the health sector. Maternal mortality rates have significantly decreased from 556 per 100,000 live births in 2015/16 to 104 per 100,000 in 2021/22. Similarly, under-five mortality dropped from 67 per 1,000 live births in 2015/16 to 43 in 2021/22, and infant mortality declined from 43 to 33 per 1,000 live births. However, neonatal mortality showed no significant change. Teenage pregnancies have also slightly decreased from 27% in 2015/16 to 22% in 2021/22. Additionally, 55% of households have at least basic sanitation services, and approximately 71% of household members properly dispose of their excreta.
Dr. Kuduishe Kisowile emphasized the ongoing underfunding of the health sector, highlighting that it falls short of the Abuja Declaration's target of 15%. She pointed out critical challenges such as shortages of human resources, inadequate financing, poor service delivery, and a predominant focus on curative rather than preventive care. Dr. Kisowile stressed that 80% of revenue collection and expenditure goals are not met, exacerbating these issues.
The stakeholders underscored the need for increased investment in research, resources, and the manufacturing of health commodities. Participants expressed concerns about governance issues, noting that discrepancies often exist between the amounts raised and allocated in the budget, further complicated by increasing debt obligations. With a growing portion of the national budget required to service debt, other sectors, including health, face financial constraints.
A set of recommendations emerged to enhance the health sector. There was a call to increase the health sector budget to at least 10%, with the goal of eventually meeting the continental target of 15%. Emphasis was placed on improving transparency, increasing public participation, and strengthening budget oversight to foster a more citizen-centric budgeting process. Adopting these recommendations is expected to promote greater accountability and good governance, aligning with the objectives of the Health Sector Strategic Plan V (HSSP V).
The debate highlighted the critical role of the health sector in national development and the importance of government commitment to achieving universal health coverage. It was recommended that the government use data from the 2022 census to plan more effectively for the future. This includes providing a simplified breakdown of the health sector budget, improving the quality of services at the grassroots level, and exploring new financing ideas to attract more investment. One participant noted that by improving services to meet WHO standards, Tanzania could attract medical tourism and investment, further boosting the sector's growth.