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UNITED REPUBLIC OF TANZANIA 
 
 
 
 
PROGRESS REPORT ON IMPLEMENTATION STATUS ON 
SOME OF KEY MILESTONES TO FACILITATE IMPROVED 
PERFORMANCE IN THE HEALTH SECTOR 
 
( Tanzania Joint Health Review 11-13 March 2002 Main 
Report ) 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
23/04/2003 
 
   2 
 
 
 
 
 
 
 
 
REVIEW AREA  MILESTONES  PROGRESS JULY 2002  RESPONSBL
E 
1.  HIV/AIDS  •  The MoH will conclude 
development of Health 
sector strategic plan for 
the next 3 years including 
the scaling up of VCT, 
STI management and 
HBC interventions as well 
as continuation of 
condom supply 
promotion. The plan will 
outline institutional 
arrangements for 
HIV/AIDS management 
and coordination. It will 
be developed in 
collaboration with 
development partners 
and shared in the next 
SWAps meeting to be 
held on 26
th July 2002 
•  The MoH to draft and 
distribute a circular to 
provide additional specific 
guidance to improve the 
HIV/AIDS component of 
district plans by June 
2002 
•  The  MoH in collaboration 
with partners and 
stakeholders  completed 
development of the Health 
Sector HIV/AIDS strategic 
plan at end of Feb 2003. 
The strategic plan has 
addressed all the areas 
contained under main 
review recommendations. 
Further the HIV/AIDS 
strategy priority issues have 
been integrated in the 
Health Sector Strategic Plan 
2003-2006 
 
 
•  Circular was sent to all  
districts in the country in 
May 2002 ( Guideline 
developed by NACP and 
TANESA has been 
distributed to all CHMTs in 
the country  through a 
circular)  
NACP in 
consultation 
with CMO 
2.  Decentralisation  Extend the HSR process and 
basket funding to all 
remaining districts on 
conditions that the PORALG, 
MoH and partners have 
agreed on minimum 
readiness criteria and 
adequate supervision capacity 
by Regional Secretariat for 
councils is guaranteed at an 
early date (July 2002). The 
MoH and PORALG will 
complete preparation for 
rolling out of third phase 
councils by December 2002 
 
•  Readiness criteria plan was 
prepared and circulated to 
Basket partners in May 
2002.     Some progress 
has been made to 
implement plan as follows: 
￿  Core RS staff  (RMO, 
Accountant, Local 
government officer and 
regional accountant were 
reoriented to strengthen 
their capacity to support 
councils. Steps have been 
initiated to ensure adequate 
supervisory capacity by 
regional secretariat. 
PORALG organised a 
consultative meeting with 
sector ministries including 
health to reach consensus 
on composition/ structure 
of regional secretariat to 
PORALG in 
collaboration 
with MoH   3 
adequately play its 
envisaged roles. Consensus 
was reached on how to 
address the issue. Based on 
the discussion PORALG has 
prepared a cabinet paper 
on the number of sector 
technical staff required in 
the regional secretariat to 
enhance their capacity 
 
  •  Information on resource 
allocation to councils and 
facilities for every 
financial year will be 
compiled by PORALG by 
February  of that year 
•  Information on allocation of 
resources for the GOT and 
Basket has been included in 
the MTEF covering the 
period July 03/June04.  
•  PORALG through the Local 
government Reform 
programme hired a 
consultant to compile and 
analyse information on 
resource allocation. 
Consensus was reached 
with sector ministries on 
allocation criteria options to 
apply. Sector block grant 
implementation team has 
been established  and 
outline of an 
implementation plan has 
been prepared.  
 
•  The terms of reference of 
studies on rehabilitation of 
health facilities includes 
identifying recurrent 
resources requirements for 
maintenance of  equipment, 
transport means and 
buildings 
PORALG 
  •  Revision of the 
Subvention agreement 
with voluntary agency 
hospitals will be 
concluded by October 
2002 
•  The meeting to review the 
subventions was held in  
September 2002 but 
negotiations with 
stakeholders on actual 
subventions to pay are 
continuing  
DHS 
  •  Accelerate Orientation 
and training of regional 
health management 
teams and regional 
secretariat and finalise 
institutional 
arrangements and define 
tasks to take over the 
planning support, 
supervision and 
monitoring functions in 
relation to district health 
•  PORALG has continuously 
been involving the regional 
health secretariat in the 
training and orientation 
with a view to equip them 
with adequate skills to 
enable them effectively 
support the councils. 
PORALG and MoH have also 
developed a criteria to be 
applied by RS during 
assessment of council  
DPP/PORALG/
DPS   4 
services.MoH and 
PORALG will continue to 
facilitate this process 
health plans and  quarterly 
financial and technical 
reports. The RS will be 
oriented on the new criteria 
by June 2003 
3.  Human 
Resources 
•  PORALG will take 
proactive action to fill 
critical vacancies to 
ensure that appropriate 
health workers can 
provide essential health 
services, particularly in 
under served areas. 
PORALG  will provide 
progress on this in the 
next review 
•  PORALG did request the 
councils to submit a list of 
vacant posts in different 
sectors in order to obtain 
permission for recruitment 
from Civil Service 
commission.  Permission 
was got and some of the 
vacant posts were filled but 
others are still vacant 
because the councils could 
not get people willing to 
work in certain localities 
PORALG 
  •  The MoH will complete 
the following studies for 
the preparation of the 
new long term human 
resources plan. HRH data 
base development, 
absorption of graduates 
into public/private health 
institutions, HR attrition 
due to HIV/AIDS, mobility 
of HR in the health sector 
in SADC countries 
•  HRH data is currently being 
entered into computer 
followed by data analysis 
and projections 
•  HIV/AIDS study  has been 
planned , budgeted for 
under NACP MTEF 
2003/2004 
•  The study on absorption of 
graduates into public and 
private health institutions 
and one on mobility of HR 
in the health sector in SADC 
countries were not done 
due to lack of funds 
DHR 
4.  HMIS  •  The MoH will table a 
proposal by March 2002 
on how it envisages 
strengthening HMIS to 
fulfil its role and present 
this to the SWAp 
committee meeting in 
June 2002 
 
 
•  The MoH will ensure that 
the statistical abstract will 
be published before the 
end of April. If  sufficient 
in house capacity is not 
available to meet this 
deadline then this activity 
should be contracted out 
•  Proposals for strengthening 
of the HMIS were finalised 
and shared with partners at 
the September 2002 SWAp 
meeting. The MoH has 
started implementing some 
of the key proposals 
including transfer of 
personnel to HMIS. 
•  The MoH has received and 
distributed 1000 copies of 
the 2002 Health Statistics 
Abstract 
•  A progress report on the 
current status is hereby 
attached to update on the 
steps covered and the  way 
forward 
DPP  
5.  Rehabilitation 
and Maintenance 
of Health 
facilities 
•  MoH will make the terms 
of reference for the 
strategic planning for 
rehabilitation of existing 
hospital infrastructure 
available to interested 
stakeholders             
(including          
•  Terms of reference 
were prepared as 
planned. The TOR were 
circulated through the 
HSR sec to all partners 
in June 2002 
•  TOR for rehabilitation 
needs assessment 
MOH/PORALG 
    5 
development partners) by 
June 2002 
 
•  The rehabilitation needs 
assessment study for PHC 
should be completed by 
October 2002 as a basis 
for strategic planning so 
that urgent renovations 
of facilities can 
commence without 
further delays 
•  The terms of reference of 
studies on rehabilitation 
of health facilities should 
include identifying 
recurrent resources 
requirements for 
maintenance of  
equipment, transport 
means and buildings 
study for PHC were 
finalised and approved 
by the central board & 
TOR were forwarded to 
IDA for no objection 
after that it will be 
issued to short listed 
firms  
•  Technical proposals 
have been evaluated 
and financial proposals 
will follow after getting 
no objection from IDA. 
Next step will be award 
of 
 
•  The terms of reference  
of the studies have 
included identifying 
recurrent resources 
requirements for 
maintenance of  
equipment, transport 
means and buildings 
 
•  Given the experience 
gained under TEHIP,GTZ /KFW, 
HAN’S project DFID,  it is clear 
that LGAs can rehabilitate  the 
dispensaries and  Health 
Centers, annually through the 
CCHPS. What is required is a 
budget line for rehabilitation 
with pool under DHIRC. 
National Construction council 
will act as a consulting and 
advisory focus to 
Council.  
 
For the District and Regional 
Hospitals the needs assessment 
study need to be completed 
and contracted out under ICB 
procedures. DHS/PORALG 
(DHIRC) are working on this. 
6.  MALARIA 
STRATEGY  
The MoH to activate a 
National Advisory Committee  
for Malaria Control by  June 
2002 
 
National Advisory Committee 
for Malaria control was 
revitalized as planned.  The 
committee meets once a year it  
last met in May 2002 and will 
meet again in May 2003 
DPS 
7.  INTEGRATION  The Office of CMO to identify 
deliverables in the next year 
and present a plan of action 
at the next SWAps meeting 
on 26th June 
The deliverables were identified 
and based on that 
implementation plan was 
prepared. Some of the activities 
planned for implementation 
during 2002/2003 are being 
carried out lack of funds have 
hindered implementation of all 
CMO   6 
activities that were planned to 
be conducted during financial 
year 2002/2003  
 
UPDATES: 
•  Integration of vertical 
programmes is a process 
approach;  
-  A position paper of 
integration of 
programmes has been 
developed by the support 
of Consultants. 
 
-  Strategic activities of 
integration of vertical  
programmes have been 
completed and 
operationalization of the 
integration process 
including study area 
have been put on the 
HSSP 2003-2006. 
 
•  Integration of service 
delivery at different 
levels has been 
addressed through; 
 
-   Comprehensive 
Councils   health plans 
where all the 
stakeholders who are 
providing services at 
the Districts, activities 
are reflected in the 
CCHPs. 
 
-  The establishment of 
Health serv ices boards 
of which the 
composition includes 
the presence of the 
private sector and civil 
society. 
 
 
 
 
 
 

Progress Report on Implementation Status on Some of Key Milestones to Facilitate Improved Performance in the Health sector(Tanzania Joint Health Review 11-13 March 2002 Main Report)

http://ihi.eprints.org/469/1/ihi_(81).pdf

Progress Report on Implementation Status on Some of Key Milestones to Facilitate Improved Performance in the Health sector(Tanzania Joint Health Review 11-13 March 2002 Main Report)

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