Policies, plans, no action, oh my! Six ways Tanzania can make moves in child health
To the average passerby, Dar es Salaam is a busy, bustling city. With a lovely coastline, welcoming people, and so much culture, it seems Tanzania is humming. And undoubtedly, it is. However, for all of Tanzania's development and progress—like many Sub-Saharan African countries—there remains a hidden burden that impedes the country's ability to fully recognize it's potential.
Child mortality rates, particularly those from pneumonia and diarrhea, are not decreasing rapidly enough for Tanzania to meet its Millennium Development Goal 4 target of a two-thirds reduction. Children continue to succumb to these preventable killers; a vicious tether to slow progress and development concerns.
However, as outlined in PATH's recent Tanzania policy report, a few key updates to the country's policies and strategies could save more children's lives. In honor of the Global Week of Action, here are six ways Tanzania can turn policies and plans into lifesaving action:
1. Register a co-packaged Oral Rehydration Product (ORS) and zinc product: Research has shown that packaging ORS and zinc together into a “diarrhea treatment kit” improves the chances that a caregiver will understand that zinc is an essential component of diarrhea treatment. Registration is crucial to make this co-packaged product available in Tanzania.
2. Officially revise Integrated Management of Childhood Illness (IMCI) guidelines to identify diarrhea treatment as ORS plus zinc: It's commonly understood—and recommended by the Integrated Global Action Plan for Prevention and Control of Pneumonia and Diarrhea (GAPPD)—that comprehensive diarrhea treatment means to use ORS and zinc together. However, it's important that Tanzania's national guidelines officially define diarrhea treatment according to global best practices.
3. Revise IMCI guidelines to denote amoxicillin as first line treatment: By using amoxicillin dispersible tablets as first line pneumonia treatment, Tanzania has been a leader in following recommendations outlined by WHO and the GAPPD. Now it's time to officially align national guidelines with global best practice and list amoxicillin dispersible tablets.
4. Allow community case management by Village Health Workers (VHWs): Children in rural Tanzania should be able to access the same high quality care as those in urban areas. Policy updates are needed to lift the ban on stocking VHWs with treatment commodities and to bring trained, supervised VHWs into the more remote areas of Tanzania to help close the equity treatment gap between rural and urban communities.
5. Allow Accredited Drug Dispensing Outlets (ADDOs) to provide treatment: While ADDOs are already trained and supervised by the Tanzanian government, they only serve as a referral mechanism to other providers-even if they are the only provider in the community. If policies were updated to allow ADDOs to stock diarrhea and pneumonia treatment commodities themselves, more communities could have access to these life-saving drugs.
6. Allocate funds to treatment of diarrhea and pneumonia: Government prioritization and resources go a long way in Tanzania. Now is the time for the government to take action by specifically highlighting diarrhea and pneumonia as a child health priority and allocating specific funds for comprehensive treatment.
These policy changes won't happen overnight. In today's world of quick-fixes and immediate satisfaction, we can't lose sight of long-term investments to make lasting change. Now is the time for the government of Tanzania to take global action and chart a new path to reduced child mortality. The lives of Tanzania's children depend on it.
Photo credit: Gareth Bentley/PATH.