02.05.2008 - Artículo
Tanzanian success story: improved survival of children under 5

Article in The Lancet by scientists of SDC-funded health research centre

Tanzania is on track for meeting an important Millennium Development Goal: reducing the number of deaths of children under 5. By doubling its expenditure on health, introducing district grants and implementing key child-survival interventions, Tanzania lowered child mortality by 24 percent between 2000 and 2004. A recent article in the global medical journal The Lancet, co-authored by scientists at a research centre supported by the Swiss Agency for Development and Cooperation (SDC), outlines the reasons for this success story.

The article in The Lancet, published on 12 April 2008 under the title “Child survival gains in Tanzania: analysis of data from demographic and health surveys”, was co-authored by scientists at the Ifakara Health Research and Development Centre (IHRDC), a non-profit health research and resource centre headquartered in the Morogoro region of southern Tanzania.

Tanzania is a priority country of the Swiss Agency for Development and Cooperation (SDC) and focuses, among other areas, on the Tanzanian public health sector. SDC is a trustee of the IHRDC and a long-term contributor to the core costs of the institution. Major donors include the Government of Norway and the Bill and Melinda Gates Foundation. The Centre not only benefits the health of the villages surrounding it, but research conducted by the IHRDC’s team of scientists also “contributes to the development of health policies on a district and national level”, according to the Centre’s director and co-author of the Lancet article, Hassan Mshinda.

Shifts in national health policy by the Tanzanian government contributed largely to the reduction in child mortality from 141 deaths per 1000 live births in 1990 to 83 per 1000 live births in 2004. According to forecasts by the scientists, the number of deaths of children under 5 should further drop to 47 per 1000 live births by 2015, the deadline for reaching the Millennium Development Goals (MDGs). The authors find that these gains in improved child survival can be sustained to reach MDG 4, reducing child mortality.

The article in The Lancet outlines and analyses the steps taken by the Tanzanian government that led to this drop in child mortality. Among the most important are:

• More than doubling public health expenditure from 4.70 US Dollars per person to 11.70 US Dollars per person.
• Decentralisation of the health system by introducing grants that increased individual districts’ financial resources substantially
• Increasing key child-survival interventions, including integrated management of childhood illnesses, distribution of insecticide-treated nets (malaria prevention), Vitamin A supplementation and immunisation

The Lancet article concludes that these factors “can work synergistically to effect important progress towards MDG 4 in low-income countries such as Tanzania”. The authors believe that “increased health resources combined with strengthening of decentralised health systems to ensure that life-saving interventions reach those in need is a key child-survival strategy”.