Urgent need to raise quality of health, education services
DAR ES SALAAM, Tanzania, May 27, 2016—Tanzania has made significant progress in delivering education and health services, particularly in the areas of rural health infrastructure and teacher attendance, according to the latest Service Delivery Indicators (SDI) published today. However, the new data also highlight weaknesses that are contributing to low levels of learning in primary schools and tragic mortality levels among mothers and newborns. Tanzania’s maternal mortality rate is very high at 432 deaths per 100,000 live births.
“While Tanzania has reduced child mortality, mothers and newborns are still at high risk of untimely death; and while the country has achieved near-universal primary school enrollment, one in four children cannot read a paragraph in Kiswahili in Standard Four,” said Keith Hansen, World Bank Group Vice President for Human Development. “Service Delivery Indicators are public data that citizens can use to hold the government accountable for education and health services, and that the government can use to inform reform efforts in these sectors. As Tanzania aspires to achieve middle-income status by 2025, SDI is an example of the kind of data transparency and accountability that could be transformational.”
Health infrastructure is improving rapidly, especially in rural Tanzania, going from 5 percent of health facilities with clean water, power, and improved sanitation in 2010 to 36 percent in 2014. Serious challenges remain, including getting more health workers out to rural areas—which have only 9 percent of the country’s doctors and 28 percent of its health workforce—and boosting their diagnostic capacity. The data show that three out of five health workers cannot identify severe dehydration, a fatal condition for children.
In education, teacher absenteeism from schools has fallen sharply by 40 percent, leading to 24 more teaching days a year. However, 37 percent of the teachers who were in school were still not in the classroom and teaching. Therefore, classroom absence remains a challenge and points to school leadership and management issues. Teacher-pupil ratios have become more manageable, dropping by 20 percent across the country, but remain very high in urban schools. Importantly, teacher knowledge continues to be a serious issue, with only one in five mastering the curriculum they teach.
The World Bank, REPOA and the African Economic Research Consortium (AERC) have partnered to produce this round of data for Tanzania. SDI surveys have so far been done in eight African countries—Kenya, Mozambique, Niger, Nigeria, Senegal, Tanzania, Togo, and Uganda, capturing the service delivery experience of 370 million people. Tanzania and Senegal pioneered these surveys in 2010.
Comparing recent SDI data across East Africa, Tanzania’s performance falls between that of Kenya and Uganda. But Tanzania does better than these countries on some indicators. For example, the health worker absence rate of 14 percent in Tanzania is much higher in Uganda (49 percent) and Kenya (28 percent). Pupils in Tanzania are four times more likely to use a textbook in class than those in Uganda.
“The Service Delivery Indicators take a look into the black box of service delivery that lies between expenditure on the one hand and the lagging human development outcomes on the other, and this evidence helps guide results-oriented solutions of tomorrow,” said Bella Bird, World Bank Country Director for Tanzania, Malawi, Somalia and Burundi. “The World Bank is pleased to support the government of Tanzania in results-based financing in health and education, which are beginning to show positive results in service delivery improvements."
The World Bank’s current investment in human development in Tanzania is US$822 million, covering education, health, and social safety nets. This is through IDA, its fund for the world’s poorest countries. In addition, the WBG manages grant co-financing of US$236 million, taking its total human development investment in Tanzania to over US$1 billion.