Presentation at the Global Maternal Newborn Health Conference, October 19, 2015
Background: The Government of Tanzania has failed to deliver its commitment to ensure that 50% of health centers provide CEmONC by 2015. Health facility assessments conducted in 2013 in Rukwa region, serving a population of more than one million citizens, found that none of the health centers were providing CEmONC, health centers lacked critical infrastructure, equipment, and supplies, and most health centers did not have the health workers necessary to provide emergency services.
Methodology: Equipped with information from the assessments, E4A/WRA Tanzania set out to address the lack of citizen’s engagement and accountability and advocate for district and regional plans. While supporting citizens in advocating to district and regional policy makers, WRA Tanzania also worked to support district and regional policy makers and planners to respond and act on the citizens’ demands. At the national level WRA Tanzania persuaded the Prime Minister to require districts to include a specific line item for CEmONC in their annual budgets, so that allocation and spending on CEmONC would be transparent and could be monitored.
Results: As a result of WRA’s work, all 169 districts of Tanzania included a specific budget for CEmONC in their 2015 Comprehensive Council Health Plans. As of April 2015, Rukwa region has succeeded in ensuring that 50% of health centers provide CEmONC. Women in each district of Rukwa now have access to life saving care. Moreover, citizens remain engaged and are working with health facility mangers and officials to monitor progress and improvements in CEmONC.
Conclusion: WRA Tanzania’s campaign has addressed the barriers to the implementation of CEmONC in Rukwa and demonstrated that progress can be accelerated in a short period of time with concentrated effort, community engagement and political will.