Spark of Hope: People’s Health Movement Tanzania
To honour the 100th anniversary of their founder, Nelson Mandela, The Elders chose to celebrate grassroots leaders working for the freedoms Madiba dedicated his life; peace, health, justice and equality. This organisation, or ‘Spark of Hope’, is one of 100 organisations each representing a unique idea for a freer, fairer world the Elders want to see.
Tanzania is suffering from a healthcare crisis. Only 49% of births are attended by skilled health workers, and this drops to 30% for the poorest of the population. Largely preventable and treatable diseases such as malaria, pneumonia and diarrhoea cause the death of 270 under 5s every day. Chronic stock-outs of essential medicines are commonplace and user fees for healthcare services are high. Adding to this crisis is the significant shortage of key frontline health workers (merely 5.2 clinical health workers per 10,000 people) despite widespread unemployment among doctors and nurses in the country.The primary cause of this problem is low levels of public health financing. Only 8% of the overall government budget is spent on health, with the majority being spent on urban hospitals which tend to benefit the better off. Meanwhile, a mere 15% of Tanzanians are covered by any formal health insurance, meaning a third of total health expenditure in the country is paid out-of-pocket by ordinary Tanzanians.
People’s Health Movement Tanzania (PHM) is campaigning to make the Right to Health real for all Tanzanians. They bring together health and human rights activists to engage in advocacy and policy dialogue with the common goal of transforming the Tanzanian health system. They are part of a wider network of People’s Health Movements in 70 countries around the world advocating for Universal Health Coverage. They support and learn from each other’s efforts, amplifying their voices and building a bridge between the local and the global.
Godfrey Philimon, the country coordinator for PHM describes the health worker crisis in his country. He says health professionals are being educated but not absorbed into the public health system. ‘Many are not employed due to governmental financial hardship’, he says. There has been too little focus on providing human resources for health by donors and the government. He says that ‘the most critical factor driving health system performance. The health worker, has been neglected and overlooked for too long’.
In fact, Universal Health Coverage (UHC) in Tanzania would be relatively easy for the government to achieve. They have already committed to it, both through agreeing the Sustainable Development Goals and signing the UN General Assembly resolution on UHC in 2012. To put this commitment into practice, the health budget would have to be increased to around 15% of the total (from 8.1%) and resources would need to be allocated more efficiently and equitably. In particular, additional funds should be allocated to recruiting more health workers (especially community health workers); increasing health worker salaries; procuring generic medicines and commodities; and ensuring that health facilities have additional recurrent funding to replace user fees income. PHM continues to collaborate with other organisations to lobby the government to make these necessary changes to achieve UHC. On the 12th December 2017 PHM, in collaboration with the Global UHC Coalition, have organised a march in Dar es Salaam to commemorate the fourth UHC Day to demand health for all.