Tanzania is among the top ten sub-Saharan African countries contributing to 61% of global maternal deaths and 66% of all newborn deaths (One Plan, 2008).

Maternal health complications cause Tanzania to lose about 8,000 women every year from its productive labor force amounting to over 160,000 women in the last 20 years (TDHS, 2004). � is constitutes a signi� cant loss since over half of the agriculture labor force is made up of women.

� e World Health Organization con� rms that high maternal mortality rates have a statistically signi� cant negative e� ect on GDP (2006).

INVESTINVESTINVESTINVESTINVESTINVESTINVESTINVESTINVESTINVESTINVEST

Poor maternal health results in a crippled

labor force and reduced economic

growth.

In Maternal And Newborn Health For Reduced Poverty And Enhanced Economic Growth

BUDGET FOR MATERNAL AND NEWBORN HEALTH IS UNKNOWN

Invest in MATERNAL andNEWBORN HEALTH

through targeted budget linesAdequately detail reproductive and child health budget line to include essential maternal and newborn health services for hospitals, dispensaries and health posts. These include:

Antenatal care, •Neonatal care, •Postpartum care, •Post abortion care, •Family planning•

The targeted budget lines for quality service delivery are:

Deployment of skilled health workers•Provision of essential equipment and •suppliesInfrastructure improvement for delivery, •post natal and laboratory servicesEstablish neonatal units•Develop and conduct tailor made training •for appropriate staff

Ensure Timely

Release Of Funds

For Quality Service Delivery

“My afterbirth wouldn’t come out so I had to be taken by stretcher to Tunduru Hospital where I was given assistance and also had a blood transfusion. So I don’t think it is good to give birth at home.”

Eye

Witness

(Rehema, 25)

Invest in Emergency Obstetric Care by

Employing skilled birth attendants•Ensuring availability of emergency transport•Making provisions for adequate drugs and supplies of good quality•Functional referral systems•Functional services available 24 hours a day everyday•

Five direct causes of maternal death are due to the following complications:

HemorrhageEclampsiaUnsafe abortionsInfectionsObstructed Labor

Approximately 15% of all births will be complicated and we cannot predict which ones. Emergency Obstetric Care is essential for managing these complications.

Maternal health is compromised by frequent childbearing, childbearing at a young age and having many children. Furthermore, evidence suggests abortion complications cause between 13 and 30% of maternal deaths in Tanzania (AMMP). One in five Tanzanians cannot access family planning services adequately to avert these situations.

Every dollar invested in reducing unmet need for family planning services we will reduce by $2-4 dollars incurred in expenditures on maternal and newborn health. (Adding it Up, 2008) Thailand saw savings of 16 USD in medical and infant care expenses as well as other social services (education, food etc.) while Egypt saved as much as 31 USD for every dollar.

Investments in family planning results in a large active labor force that has fewer children – consequently a ‘demographic window’ opens when the number of producers in the population grows more rapidly than the number of dependents. With proper investments during this time poverty can be reduced by about 14% between 2000 and 2015. About one-third of East Asia’s economic growth has been attributed to this demographic window. (UNFPA, 2005)

Invest in Family Planning by ensuring adequate budget allocation for:

Availability of at least •3 methods at all health facilitiesSkilled attendants at all• health facilitiesSupporting people •to make an informed choice

INVESTTraining | Employment | Deployment | Retention

Skilled attendance at all births is considered to be the single most critical intervention for ensuring safe motherhood, because it hastens the timely delivery of emergency obstetric and newborn care when life-threatening complications arise

(http://www.unfpa.org/mothers/skilled_att.htm)

In Skilled Birth Attendants

Only 46% of births are attended by a skilled birth attendant. (DHS,

2004/2005)

“Only 38% of health posts are fi lled.(One Plan, 2008).

Europe AfricaAmericas WesternPacifi c

EasternMediterranean

South-EastAsia

WesternPacifi c

without China

South-EastAsia without

India

0

25

50

75

100SKILLED ATTENDANCE AT BIRTH SAVES MOTHERS AND BABIES

SOURCE : World Health Organization, April 05

% of birth without skilled attendant

Maternal mortality ratio per 100,000 live births

Infant mortality ratio per 1000 live births

Invest in Maternal and Newborn Health services to ensure there

are no drugs and supply barriers• Adequate and free medicines, supplies, equipment.

Ministry of Health and Social Welfare, Ministry of Finance – Allocate specifi c and adequate budget for quality Maternal and Newborn Health services required for childbirth or delivery

Ministry of Health and Social Welfare and PMORALG plan for adequate drugs and supplies.

Medical Stores Department – procure and distribute in a timely manner good quality drugs and supplies

Ministry Of Health And Social WelfareAudit allocated funds and systems for the provision of maternal

and newborn health drugs and supplies and take action to prevent delays

PrimeMinister’sOfficeRegionalAdministrationandLocal Government, Ministry of Health and Social Welfare –Change budget guidelines to:

Detach Maternal and Newborn Health drugs and supplies • from the cost-sharing pool of fundingEnsure specifi c budget codes for delivery kits and • Maternal and Newborn Health drugs and suppliesAudit allocated funds for maternal and newborn health • services

The White Ribbon Alliance (WRATZ) was launched in March 2004 with 13 members. It currently has 2500 individual members and 107 member organizations and is still growing.

WRATZ Coordinator. Mobile : +255 754 316 369 Email : rmlay@futuresgroup.com

White Ribbon Alliance in Tanzania

WRA-TZ ContactsFor more information on WRATZ and to obtain a membership form, please contact

Postal Address: C/O JHPIEGO, Ring Street 481, Garden Road, Mikocheni A P.O. Box 7190, Dar Es Salaam Phone: 255 22 2771346/48 Fax: 255 22 2771341

WRA-TZ VisionAll women and newborns in Tanzania enjoy essential, quality and life-saving safe motherhood services in a supportive environment

WRA-TZ MissionWRATZ aims to become a grassroots movement for safe motherhood that inspires action to save womens and newborns lives in Tanzania.

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Design By Sameer Kermalli Photos By Sala Lewis