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Members of IDRC Board of Governors to Visit Tanzania
Members of the International Development Research Centre (IDRC)
Board of Governors will visit Tanzania from November 5 to 8, 2003. The purpose
of their visit is to familiarize themselves with the Tanzania Essential Health
Interventions Project (TEHIP), supported by IDRC.
TEHIP, in collaboration with the Ministry of Health and Council Health
Management Teams (CHMTs) of Morogoro and Rufiji Districts, tested how and to
what extent evidence can guide decentralized planning in health. By integrating
research and development efforts, the project developed new tools, approaches,
and information systems that equip CHMTs at the district level to prepare plans
based on local information. This enables funds for health interventions to be
targeted to the most critical health problems.
While in Tanzania the Governors will meet with some of TEHIP's key stakeholders.
They will pay a courtesy call to the Permanent Secretary in the Ministry of
Health, Ms Mariam J. Mwaffisi, as well as visit some of the project's roll-out
points in Morogoro Region.
Board of Governors members participating in the visit are: Mary Coyle, Director,
Coady International Institute, St. Francis Xavier University, Nova Scotia;
Maurice Foster, Retired Parliamentarian, Ontario; Nora Olembo, Professor in the
Department of Biochemistry, University of Nairobi; Jean-Guy Paquet, President
and Chief Executive Officer, National Optics Institute in Quebec; Rodger Schwass,
Professor Emeritus and Senior Scholar, Faculty of Environmental Studies at York
University, Ontario; and Linda Sheppard Whalen, Chief Executive Officer for
Long-term Environmental Action Centre in Newfoundland.
The Governors will be accompanied by the Canadian High Commissioner to Tanzania,
Her Excellency Hon. Janet Graham. In addition IDRC participants will include
Connie Freeman, Regional Director for IDRC's Eastern and Southern Africa
Regional Office (ESARO) and Lee Kirkham, Regional Controller, ESARO, as well as
Denys Vermette, Vice President, Resources Branch, and Johanne Bernier, Human
Resources Director, both from IDRC, Ottawa.
IDRC is a Canadian public corporation created to help developing countries use
science and technology to find practical, long-term solutions to their social,
economic, and environmental problems.
BACKGROUNDER
The Tanzania Essential Health Interventions Project
Between 1977 and June 2003, TEHIP, in collaboration with the Ministry of Health
and Council Health Management Teams (CHMTs) of Morogoro and Rufiji Districts,
tested how and to what extent evidence can guide decentralized planning in
health. By integrating research and development efforts, the project developed
new tools, approaches and information systems that equip CHMTs at the district
level to prepare plans based on local information rather than merely
implementing plans or programs imposed from above. This enables funds for health
interventions to be targeted to the most critical health problems.
Various products from the project whose impact in health delivery have been
proven decisive are now being disseminated. Tanzania and other developing
countries are keenly interested in the results of TEHIP's initiative to develop
and refine several tools to help CHMTs collect and analyse information
TEHIP's initiative is a well-conceived response to the 1993 World Development
Report -Investing in Health, which proposed ways for low-income countries to
cope with a situation where resources for essential health care do not match the
catalogue of health problems. With financial assistance from Canada's
International Development Research Centre (IDRC), Tanzania became the first
country to examine the feasibility of a process of planning and setting
priorities at district level in low-income countries.
New Planning Tools
An example of one of the tools that has proven to be of great use to district
health planners, is the Burden of Disease profile. The tool simplifies and
communicates complex information on local mortality by transforming it into
easy-to-read graphs, tables, and charts. The tool has enabled CHMTs to change
their planning outlook from mere budgeting to actual priority setting and to
allocate their scarce resources to cost-effective interventions that address all
the major causes of premature death. There is evidence that the interventions
carried out in the project area have significantly reduced mortality rates
despite the devastation of HIV/AIDS.
The Burden of Disease Profile interfaces smoothly with another tool that
provides a one-page summary and graphical Apictures@ of aspects of annual plans,
thus helping health planners analyse their budgets and expenditures. Called the
District Health Accounts tool, it is pre-loaded with information such as
district populations, essential drug prices, exchange rates, capitation
allowances, and Ministry of Health guidelines. The tool is distributed to
districts annually.
One of TEHIP's fundamental development intervention was the community-led
rehabilitation of health facilities. The communities provided funds and labour
to complement those of district authorities to improve dilapidated dispensaries.
This proved to be a good entry point to stimulate popular participation to
improve health service access and utilization.
In response to research findings that identified weaknesses or gaps in the new
district planning/priority/budgeting setting using an evidence-based approach,
TEHIP addressed issues such as strengthening District Health Management by
building the capacity of CHMTs in planning, management, and administration. It
also strengthened communications for improved health service delivery. As more
efforts and resources are now being channelled into a roll-out of the tools in a
logical sequence, the focus is now on Ministry Of Health (MOH) Zonal Training
Centres that could be well placed not only to disseminate the products on a
wider scale, but also to address the key priority of human resource training and
development for the country at large.
Future Outlook
As TEHIP enters its final phase, some of its activities are being handed over to
Tanzanian institutions. The Rufiji Demographic Surveillance System, which was
concerned with accurately assessing the impact of TEHIP's interventions within
the two pilot districts, is in the process of being placed under the auspices of
the Ifakara Health Research and Development Centre (IHRDC). The Centre is also
running a similar Demographic Surveillance System in Kilombero and Ulanga and
the value of these systems to the health sector and others is increasingly being
recognised. To ensure that what has been achieved during the implementation of
the project is actively integrated into Tanzania's decentralized health sector
reform process, IDRC and the United Nations Fund (UNF) have committed funds for
a three-year roll-out period (2003-2005).
TEHIP's products and results can be viewed on its Web site at
http://www.idrc.ca/tehip
The International Development Research Centre has supported projects in Tanzania
since 1973. To date, IDRC has supported 116 projects in the country,
representing an allocation of $18.3 million. Major partners have included the
Centre for Housing Studies, Muhimbili University College of Health Sciences, the
Ministry of Health, the Sokoine University of Agriculture, the Economic and
Social Research Foundation, the Tanzania Commission for Science and Technology,
the Tanzania Industrial Research and Development Organization, and the
University of Dar es Salaam. Currently, IDRC is funding 8 projects in Tanzania.
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