1.1 HIGHLIGHTS of MDG AND MKUZA in

Report
HIGHLIGHTS OF MDGs & MKUZA II IN ZANZIBAR
HEALTH SYSTEM OPPORTUNITIES &
CHALLENGES
Presented by : Dr. Mkasha Hija Mkasha (On behalf of Acting DG)
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Introduction
• Eight 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
earlier
• Goal 4, 5 and 6 are directly related to health
and the remaining are indirectly related
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Intro. Cont……
• To reach the desired targets Zanzibar
developed its national strategy (MKUZAZSGRP),
• While at Ministerial level - Health Policy
which is translated into sector Strategies and
annual plan of action
• Robust Health systems are required to meet
the MDGs in each of the six building blocks.
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Goal 1: Eradicate extreme poverty and hunger (Indirect)
Indicator
Reduce % of
underweight for
children Under 5
years
Reduce % of stunting
for children
Under 5years
Target 2015
Status
19.9%
13.9% (2014
National Nutrition
Survey – Preliminary
results)
23.8%
24.4% (2014
National Nutrition
Survey – Preliminary
results)
Zanzibar has shown an improvement in reducing
malnutrition
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Goal 4: Reduce child mortality
Progress has been made in reducing infant and child mortality
Indicator
Target 2015
Status
Reduce Under-five mortality rate
(U5MR)
67/1,000 live
births
66/1,000 live births (2012 census
preliminary results)
Reduce infant mortality rate
(IMR)
40/1,000 live
births
46/1,000 live births (2012 census
preliminary results)
Increase Proportion of children
vaccinated against measles
Reduce Neonatal mortality rate
(NMR)****MKUZA
100%
15/1,000 live
births
>100% (HMIS Bulletin ,2013)
29/1,000 live-births (2009/10 TDHS)
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Goal 5: Improve maternal health
1. Reduce Maternal
Mortality
Trend of MMR
MMR 2015 target =
170 /100,000
live births.
Remains a challenge
Joints efforts are
needed to
reduce
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Improve maternal health cont...
Indicator
Target
2015
Status
90%
60% (HMIS Bulletin,
2013)
60%
56.6% (HMIS Bulletin,
2013
20%
12.4% (TDHS 2009/10)
2. Proportion of births attended by skilled
health personnel
3. Increase percentage of births
delivered in health facilities*** MKUZA
4. Contraceptive prevalence rate*** MKUZA
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Goal 6: Combat HIV/AIDS, malaria and other diseases
HIV: Indicator
Target 2015
Status
HIV prevalence among general
population*** MKUZA
< 1%
1.1% (2012 THMIS)
HIV prevalence among pregnant
women aged 15 -24 years
0.3%
0.6% (2014 ANC
HIV Prevalence among CSW
reduced *** MKUZA
HIV Prevalence among MSM***
5.4%
8.6% (IBBSS, 2012)
6.1%
2.6% (IBBSS, 2012)
7.5%
11.3% (IBBSS, 2012)
surveillance)
MKUZA
HIV Prevalence among IDUs
reduced *** MKUZA
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HEALTH SYSTEM OPPORTUNITIES &
CHALLENGES
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Opportunities
• Political stability and commitment
• Availability of national plans to support MDGs
implementations (Vision 2020, MKUZA and sector
policy and strategies
• Government commitment in health issues
• Partners financial and technical support to the health
sector
• Extensive health system in Zanzibar
• Health management information system (HMIS) uses
(DHIS2)
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Challenges
Governance
• Implementation of the health policy
• Inadequate monitoring and follow up
Human Resource
• Inadequate skills in caring neonates
• Treatment according to guidelines is a
challenge at all levels
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Challenges ….
Human Resource cont...
• Shortage of medical specialist (high number
of support staff)
–Gynecologist: none available
vs.
minimum staff requirement = 12
–Anesthetic nurses and doctors are not
available all maternity emergencies in all
hospitals
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Challenges ….
Logistic, Drugs and Medical Supplies
• Inadequate medical equipment, drugs and
supplies
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Challenges ….
Finance
• Underfunding of the health sector (per capita
expenditure is ($23) which is lower than that
recommended by WHO of $ 60
• Donor - driven support
• Sustainability of Malaria financing
• Imbalance funding from vertical programmes (lots of
fund are allocated to vertical programs than other
areas)
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Challenges …
Service delivery
• Negative attitudes in provision of health
services (YFS and condom)
• No referral guidelines at all levels
• Low health education in the community
• In adequate interventions on neonatal
death
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Challenges ….
Health Information
• Incomplete data for neonatal deaths at
community
• High stigma for PLHIV
• Insufficient of vital data on civil registration
• Causes of morbidity and mortality are not
classified using ICD 10
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Thank you
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