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Regional Differences in Intervention Coverage and Health System Strength in Tanzania

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  • Claud J Kumalija
  • Sriyanjit Perera
  • Honorati Masanja
  • Josibert Rubona
  • Yahya Ipuge
  • Leonard Mboera
  • Ahmad R Hosseinpoor
  • Ties Boerma

Abstract

Background: Assessments of subnational progress and performance coverage within countries should be an integral part of health sector reviews, using recent data from multiple sources on health system strength and coverage. Method: As part of the midterm review of the national health sector strategic plan of Tanzania mainland, summary measures of health system strength and coverage of interventions were developed for all 21 regions, focusing on the priority indicators of the national plan. Household surveys, health facility data and administrative databases were used to compute the regional scores. Findings: Regional Millennium Development Goal (MDG) intervention coverage, based on 19 indicators, ranged from 47% in Shinyanga in the northwest to 71% in Dar es Salaam region. Regions in the eastern half of the country have higher coverage than in the western half of mainland. The MDG coverage score is strongly positively correlated with health systems strength (r = 0.84). Controlling for socioeconomic status in a multivariate analysis has no impact on the association between the MDG coverage score and health system strength. During 1991–2010 intervention coverage improved considerably in all regions, but the absolute gap between the regions did not change during the past two decades, with a gap of 22% between the top and bottom three regions. Interpretation: The assessment of regional progress and performance in 21 regions of mainland Tanzania showed considerable inequalities in coverage and health system strength and allowed the identification of high and low-performing regions. Using summary measures derived from administrative, health facility and survey data, a subnational picture of progress and performance can be obtained for use in regular health sector reviews.

Suggested Citation

  • Claud J Kumalija & Sriyanjit Perera & Honorati Masanja & Josibert Rubona & Yahya Ipuge & Leonard Mboera & Ahmad R Hosseinpoor & Ties Boerma, 2015. "Regional Differences in Intervention Coverage and Health System Strength in Tanzania," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-14, November.
    • Handle: RePEc:plo:pone00:0142066
    DOI: 10.1371/journal.pone.0142066
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    References listed on IDEAS

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    1. Ties Boerma & Patrick Eozenou & David Evans & Tim Evans & Marie-Paule Kieny & Adam Wagstaff, 2014. "Monitoring Progress towards Universal Health Coverage at Country and Global Levels," PLOS Medicine, Public Library of Science, vol. 11(9), pages 1-8, September.
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    1. Kisumbe Lazaro Alman & Mashala Lameck Yusuph, 2020. "Performance Appraisal Experiences and Its Implications on Human Resource Decisions in Decentralized Health Services in Shinyanga Region, Tanzania," Journal of Public Administration and Governance, Macrothink Institute, vol. 10(2), pages 181193-1811, December.
    2. Susan F Rumisha & Janeth George & Veneranda M Bwana & Leonard E G Mboera, 2020. "Years of potential life lost and productivity costs due to premature mortality from six priority diseases in Tanzania, 2006-2015," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-18, June.

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