Presentation on theme: "HIGHLIGHTS OF MDGs & MKUZA II IN ZANZIBAR"— Presentation transcript:
1 HIGHLIGHTS OF MDGs & MKUZA II IN ZANZIBAR HEALTH SYSTEM OPPORTUNITIES & CHALLENGESPresented by : Dr. Mkasha Hija Mkasha (On behalf of Acting DG)
2 IntroductionEight Goals were set during 1990 Millennium Development Declaration to guide the development process with defined targets for each goal which are to be achieved by 2015 or earlierGoal 4, 5 and 6 are directly related to health and the remaining are indirectly relatedDirect means all targets belongs to health sectorIndirect means there are some indicators which has to be provided by other sectorMKUZA: Zanzibar Strategy for Growth & Reduction of Poverty (ZSGRP)
3 Intro. Cont……To reach the desired targets Zanzibar developed its national strategy (MKUZA- ZSGRP),While at Ministerial level - Health Policy which is translated into sector Strategies and annual plan of actionRobust Health systems are required to meet the MDGs in each of the six building blocks.
4 Goal 1: Eradicate extreme poverty and hunger (Indirect) Zanzibar has shown an improvement in reducing malnutritionIndicatorTarget 2015StatusReduce % of underweight for children Under 5 years19.9%13.9% (2014 National Nutrition Survey – Preliminary results)Reduce % of stunting for children Under 5years23.8%24.4% (2014 National Nutrition Survey – Preliminary results)Mkuza II targets for underweight - reduce from 19% in 2010 to 15% by 2015Stunting reduce from 23% in 2010 to 20% by 2015The above achievements is due to
5 Goal 4: Reduce child mortality Progress has been made in reducing infant and child mortalityIndicatorTarget 2015StatusReduce Under-five mortality rate (U5MR)67/1,000 live births66/1,000 live births (2012 census preliminary results)Reduce infant mortality rate (IMR)40/1,000 live births46/1,000 live births (2012 census preliminary results)Increase Proportion of children vaccinated against measles100%>100% (HMIS Bulletin ,2013)Reduce Neonatal mortality rate (NMR)****MKUZA15/1,000 live births29/1,000 live-births (2009/10 TDHS)U5 MR Baseline (1988 census). U5MR Mkuza Targets - 50IMR baseline (1988 census). IMR Mkuza target - 48NMR baseline – 31/1000 in 2008
6 Goal 5: Improve maternal health 1. Reduce Maternal Mortality MMR 2015 target = 170 /100,000 live births. Remains a challenge Joints efforts are needed to reduceTrend of MMRDue to lack of national survey which can provide the rate of maternal deaths, the available information is from routine hospital data ie, Facility base/Institutional.
7 Improve maternal health cont... IndicatorTarget 2015Status2. Proportion of births attended by skilled health personnel90%60% (HMIS Bulletin, 2013)3. Increase percentage of birthsdelivered in health facilities*** MKUZA60%56.6% (HMIS Bulletin, 20134. Contraceptive prevalence rate*** MKUZA20%12.4% (TDHS 2009/10)*** Not included in MDGs target these belongs to MKUZA II targetsTarget set for anaemia pregnancy was not reliastic the rate was 1.7%
8 Goal 6: Combat HIV/AIDS, malaria and other diseases HIV: IndicatorTarget 2015StatusHIV prevalence among general population*** MKUZA< 1%1.1% (2012 THMIS)HIV prevalence among pregnant women aged years0.3%0.6% (2014 ANC surveillance)HIV Prevalence among CSW reduced *** MKUZA5.4%8.6% (IBBSS, 2012)HIV Prevalence among MSM*** MKUZA6.1%2.6% (IBBSS, 2012)HIV Prevalence among IDUs reduced *** MKUZA7.5%11.3% (IBBSS, 2012)Progress has been made in this goal. Zanzibar has reached at an eliminating stage of malaria.IBBSS - Integrated Biological & Behaviuoral SurveyHIV prevalence among pregnant women aged years is used as a proxy to the general population
10 Opportunities Political stability and commitment Availability of national plans to support MDGs implementations (Vision 2020, MKUZA and sector policy and strategiesGovernment commitment in health issuesPartners financial and technical support to the health sectorExtensive health system in ZanzibarHealth management information system (HMIS) uses (DHIS2)Health facility network, with at least one trained staff each)
11 Challenges Governance Implementation of the health policy Inadequate monitoring and follow upHuman ResourceInadequate skills in caring neonatesTreatment according to guidelines is a challenge at all levelsHealth policy - free health services
12 Challenges ….Human Resource cont...Shortage of medical specialist (high number of support staff)Gynecologist: none available vs. minimum staff requirement = 12Anesthetic nurses and doctors are not available all maternity emergencies in all hospitals
13 Challenges …. Logistic, Drugs and Medical Supplies Inadequate medical equipment, drugs and supplies
14 Challenges ….FinanceUnderfunding of the health sector (per capita expenditure is ($23) which is lower than that recommended by WHO of $ 60Donor - driven supportSustainability of Malaria financingImbalance funding from vertical programmes (lots of fund are allocated to vertical programs than other areas)
15 Challenges … Service delivery Negative attitudes in provision of health services (YFS and condom)No referral guidelines at all levelsLow health education in the communityIn adequate interventions on neonatal death
16 Challenges …. Health Information Incomplete data for neonatal deaths at community High stigma for PLHIVInsufficient of vital data on civil registrationCauses of morbidity and mortality are not classified using ICD 10