Speeches

White Ribbon Day

Venue: kuranga District, Coast Region

April 22, 2009

Remarks by USAID Mission Director Robert Cunnane (as prepared)

First of all I wish to thank the White Ribbon Alliance for Safe Motherhood in Tanzania (WRATZ), the Ministry of Health and Social Welfare (MoHSW), Coast Region and partners, including the ACCESS and MAISHA projects which we support, for hosting this event. Annually, over half a million women worldwide die from pregnancy- and childbirth-related conditions, as do almost four and a half million newborns; and in Tanzania it is estimated that every minute one woman dies of child birth related causes. This is a terrible tragedy, because many of these deaths could be prevented through simple interventions.

Global progress overall towards achieving the Millennium Development Goals has been slow, particularly Goals 4 and 5 which relate to child, newborn and maternal health. Tanzania has had some admirable success in reducing the under-five mortality rate, but as we know it continues to struggle with some of the highest rates of maternal and newborn deaths in the region. The good news is that - the political commitment to improve maternal and newborn health in Tanzania is strong. At a special event on the margins of September's UN MDG progress meeting, President Kikwete called attention to maternal and child health and the need for added global resources to improve the quality of care for mothers and children. The desire is there at the very highest levels to make significant changes quickly, and for the better.

Last year the Tanzanian MoHSW developed and launched a 7-year strategy, called the One Plan, to guide coordinated implementation of maternal, newborn and child health interventions and the delivery of quality maternal and child health services. The One Plan notes the many challenges that Tanzania faces in its efforts to reduce maternal, newborn and child morbidity and mortality. But the ambitions of the One Plan will not be achieved unless we address the challenges outlined in the One Plan which include weak health infrastructure, a crisis of human resources, deficiencies in equipment and supplies, poor quality of services, and inadequate community involvement in the creation of solutions.

USAID is very aware of the challenges facing Tanzanian health systems. USAID, among other partners, has been supporting the MoHSW for a number of years to strengthen access to and quality of maternal and newborn services. In addition to improving access to family planning and birth spacing which have a well known impact on reducing maternal mortality, USAID has funded the ACCESS program, which focused on improving antenatal care and Malaria in Pregnancy. The ACCESS program supports the training of providers, provision of equipment and supplies and improving the quality of Antenatal care services. As of December 2008, approximately one-third of health facilities providing antenatal care have a provider trained in the WHO’s focused antenatal care approach. USAID will continue to support this effort over the next few years until all antenatal care providers are trained.

In 2008, the United States government, on behalf of the American people, provided nearly $6 million for maternal and child health programs in Tanzania - not including the significant support provided to expecting mothers through our HIV/AIDS PMTCT and Reproductive health programs. We are proud to note that Tanzania has now been designated a USAID Maternal and Child Health Priority country, which means that we should be seeing an increase in funding for maternal and child health in the coming years.

With increased resources, and in line with the Government of Tanzania’s One Plan, USAID is supporting a new 5-year program called MAISHA: this stands for “Mother and Infants, Safe, Healthy, Alive”. The objectives of the MAISHA program are to reduce the major causes of maternal mortality such as postpartum hemorrhage as well as newborn mortality due to infection, asphyxia, malaria and congenital syphilis. The program will start up this year in Lindi and Mtwara Regions and expand to the remaining regions over the following two years. MAISHA will strive to improve availability and quality of basic emergency obstetric and newborn care services in all districts of Tanzania, to save the lives of mothers and their newborns.

Under MAISHA, the American people – through USAID – will continue to support the White Ribbon Alliance of Tanzania in its advocacy and community mobilization efforts to improve safe motherhood and reduce maternal, newborn and child mortality in Tanzania. The White Ribbon Alliance, its membership, and the leaders, health workers, community activists and wananchi who are concerned about women’s health and have championed it, have brought about increased political commitment for safe motherhood, improved maternal health policies, and new by-laws at village level to reduce maternal and newborn deaths. But as we all know, there is much more to be done to build up the systems that need to be functioning in order that maternal and newborn lives can be safe.

Today marks the launch of the next step – a national campaign to have a “Clear Cut Budget for Maternal and Newborn Health from National to Family Levels”. Promises without resources are empty promises, and it is critically important that the real costs of improving maternal health are clear, the resources for action are mobilized and made available, and we see real results on the ground in terms of improved maternal health.

USAID remains committed to working in a complementary manner with the MoHSW and key partners such as WRATZ to ensure that motherhood is safe and Tanzania’s health system, communities and families play their part. Together, we can reduce maternal and newborn mortality in Tanzania.