June 2015 WorldBankNews; The World Bank Group’s Board of Executive Directors approved a US$200 million International Development Association (IDA)* credit to improve the quality of primary health care services in Tanzania, with a focus on maternal, neonatal, and child health services.
The Strengthening Primary Health Care for Results Program will also be supported by US$40 million from the Global Financing Facility (GFF), and $46 million from USAID, and $20 million from the Power of Nutrition (PoN) Trust Fund. Tanzania is the first country receiving money from the newly established PoN.
The Program will help the Government of Tanzania strengthen its primary health care, with a strong focus on the country’s Big Results Now in Health initiative.
This initiative aims to improve maternal, neonatal, and child health in poor regions with the highest burden by strengthening performance, governance and accountability in the country’s primary health care system. By 2035, Program activities are expected to contribute to preventing as many as 1 million infant deaths and 84,000 maternal deaths.
“By supporting the government to strengthen primary health care under the National Health Sector Strategic Plan, the Program will contribute towards sustainable improvements in health” says Philippe Dongier, World Bank Country Director for Tanzania.
“The Program’s strong focus on boosting services for mothers, infants and young children in poor communities will significantly improve health outcomes allowing families to benefit from the economic and welfare gains of better health.”
Over the last 10 years, Tanzania has successfully reduced death rates in younger age groups and surpassed the Millennium Development Goal related to child mortality. Despite such progress, maternal mortality ratio remains high at 432 deaths per 100,000 live births.
The neonatal mortality rate is also high at 26 per 1,000 live births, and stunting is persistent, affecting 42 percent of children under five-years-old. Rural areas, where the majority of Tanzania’s poor families live, are served by just 9.1 percent of the country’s total number of doctors.
To address such challenges, the Government plans to, among other things, expand emergency obstetric and neonatal care, develop a facility accreditation scheme, introduce results-based financing at the facility level, improve the distribution of skilled health care workers, especially in nine regions with critical shortages as well as increase the availability of essential medicine. It will also focus on strengthening community outreach and community led initiative to increase access to and use of vital health and nutrition services.
“By supporting the strengthening of primary health care as parts of the government’s strategic plan, the Program will contribute to improving health outcomes in Tanzania and help the country benefit from the economic and welfare gains of better health” says Rekha Menon, Task Team Leader for this Program.
“It will therefore contribute to the World Bank’s twin goals of poverty reduction and shared prosperity by improving health outcomes for the poor in Tanzania.”
Using the Program for Results (PforR) instrument, the Strengthening Primary Health Care for Results Program will disburse on the basis of a set of Disbursement-linked Indicators (DLIs). This approach supports the government’s own agenda using the systems of the Program, helps to motivate country implementers to find locally relevant and sustainable solutions, and helps to increase leverage of World Bank resources.
“The Program provides performance-based payments at all levels of the health systems – national, regional, district and facility. This approach is expected to facilitate the achievement of selected targets related to maternal, neonatal and child health by sending a signal to key stakeholders to focus on the most critical results” says Son-Nam Nguyen, Co-Task Team Leader for this Program.
The Global Financing Facility (GFF) that is supporting the Program is a new multi-donor trust fund for Reproductive, Maternal, Neonatal, Child and Adolescent Health (RMNCAH). The GFF helps finance national RMNCAH scale-up plans while at the same time focusing on results. It support countries in the transition toward sustainable domestic financing of RMNCAH; as well as contributes to a better-coordinated and streamlined RMNCAH financing architecture.
The Power of Nutrition is a new UK-based charity created in partnership with the Children’s Investment Fund Foundation (CIFF), UBS Optimus Foundation, DFID, UNICEF and the World Bank which aims to leverage up to a billion dollars by 2030 to tackle child under-nutrition in the poorest countries in the world.
USAID financing for this Program will be provided in the form of a single donor Trust Fund to be administered by the World Bank. It will focus on the results-based financing scheme at the provider level as parts of the Program.