|Explaining progress towards Millennium Development Goal 4 for child survival in Tanzania|
||Debora Niyeha, Deogratius Malamsha, Rose Mpembeni, Debora Charwe, Saul Epimark, Khadija Malima, Akum Aveika, Tricia Aung, Elizabeth Hazel, Yvonne Tam, and Rebecca Heidkamp
||Journal of Global Health, 8(2): 021201; DOI: 10.7189/jogh.08.021201
||Background During the Millennium Development Goal (MDG) era
(1990-2015) the government in Mainland Tanzania and partners
launched numerous initiatives to advance child survival including the
comprehensive One Plan for Maternal Newborn and Child Health in
2008-2015 and a “sharpened” One Plan strategy in early 2014. Moving
into the Sustainable Development Goal era, the government needs
to learn from successes and challenges of striving towards MDG 4.
Methods We expand previous work by presenting data for the full
MDG period and sub-national results. We used data from six nationally-
representative household surveys conducted between 1999 and
2015 to examine trends in coverage of 22 lifesaving maternal, newborn,
child health and nutrition (MNCH&N) interventions, nutritional
status (stunting; wasting) and breastfeeding practice across Mainland
Tanzania and sub-nationally in seven standardized geographic zones.
We used the Lives Saved Tool (LiST) to model the relative contribution
of included interventions which saved under 5 lives during the period
from 2000-2015 compared to 1999 on a national level and within
the seven zones.
Findings Child survival and nutritional status improved across Mainland
Tanzania and in each of the seven zones across the 15-year period.
MNCH&N intervention coverage varied widely and across zones
with several key interventions declining across Mainland Tanzania or
in specific geographical zones during all or part the period. According
to our national LiST model, scale-up of 22 MNCH&N interventions
– together with improvements in breastfeeding practice, stunting and
wasting – saved 838 460 child lives nationally between 2000 and 2015.
Conclusions Mainland Tanzania has made significant progress in child
survival and nutritional outcomes but progress cannot be completely
explained by changes in intervention coverage alone. Further examination
of the implementation and contextual factors shaping these trends
is important to accelerate progress in the SDG era.