If the commitments to implement the Sharpened One Plan are honoured, then we could save the lives of 18,000 mothers and babies by the end of next year.
H.E. Dr. Jakaya Kikwete, President of Tanzania (right), at the launch of the Sharpened One Plan, together with Hon. Dr. Kebwe Kebwe, Deputy Minister of Health and Social WelfareYES, YOU READ THAT RIGHT - THAT AVERAGES OUT AT 30 MOTHERS AND BABIES LIVES SAVED EVERY DAY WHOM WE WILL OTHERWISE LOSE AND MOURN FROM TODAY THROUGH UNTIL END OF 2015...It’s been two weeks now since the landmark event when the Tanzanian President launched the Sharpened One Plan. Simply put, if the commitments to implement the Sharpened One Plan are honoured, then we could save the lives of 18,000 mothers and babies by the end of next year. These are needless, preventable deaths – of our most vulnerable, innocent and precious – at that miraculous moment of giving life. On the surface the political will and commitment is well voiced. We will see how deep this runs over the next 600 days.Evidence informing how best to save mothers and babies livesIt’s been a long journey to the point of launching this refocused roadmap for accelerating the survival of our mothers and babies over these next two years. Our project has been privileged to be at the heart of the process that has shaped the direction for saving our mothers and babies.The mid-term review of the Health Sector Strategic Plan III proved to be too light-touch on Reproductive, Maternal, Newborn and Child Health (RMNCH), despite the fact this is the area where the Health Sector is struggling the most. As such, the Ministry of Health’s Reproductive Child Health Section, together with leading development partners, decided that a more thorough review of progress and challenges in RMNCH delivery was required, and housed it within a mid-term review of the One Plan – the national strategy roadmap for accelerated reduction of maternal, newborn and child deaths 2008-15. And so the review started in earnest, structured around a quantitative analysis, a bottleneck analysis, and finally a qualitative analysis. This evidence base was then subjected to Lives Saved Analyses, to enable optimal targeting and costing of high-impact interventions, crucially responding to the coverage and equity disparities in women and children accessing life-saving maternity services. Moke guiding team of Ministry of Health staff in qualitative data analysis Our own Moke was at the forefront of this review. Ever-present throughout the process, in particular he championed the qualitative analysis, which was a quite remarkable achievement: Instead of taking the traditional (and recommended) route of contracting consultant expertise, instead Moke worked in an ‘umbilical partnership’ with the Reproductive Child Health Section to train up in qualitative data collection a team of 15 Ministry of Health team members.An intensive piece of fieldwork then took place with more than 120 interviews and focus group discussions conducted with a wide range of stakeholders in one week across six districts of Kilimanjaro, Singida, and Mara regions (based on comparative high to low RMNCH performance). Furthermore the same Ministry of Health team then conducted the transcriptions and data analysis of more than 2,500 pages of interviews, under Moke’s expert guidance; culminating in a qualitative analysis report being submitted to the Reproductive Child Health Section which had an unprecedented level of ownership; a quality which many took pride in; and a renewed determination to address the challenges and opportunities coming out of this thorough qualitative analysis of RMNCH delivery in Tanzania.Countdown to 2015Concurrent to the mid-term review, there has been another enormous effort invested in preparing a Tanzania Case Study as part of the Countdown to 2015. Global expertise, championed by the London School of Hygiene and Tropical Medicine, focused on understanding the progress and challenges in maternal and newborn health within a lens of two critical intervention areas: family planning, and quality of care at birth.Coordination at an early stage positioned the Countdown Case Study to be directly informing the mid-term review of the One Plan, instead of ending up an isolated parallel product. Importantly, the Countdown Case Study has heavily informed the Sharpened One Plan, with the two prioritised high impact interventions being family planning and quality of care at birth; as well as coverage and equity disparities informing where and who to be prioritised reflecting Countdown analyses.While the Tanzania Case Study is expected to be presented at the PMNCH Global Forum in Johannesburg towards the end of June, a Policy Brief was launched by the President parallel to the Sharpened One Plan which summarised the key lessons and recommendations from the Countdown analyses: Women and Children First: Countdown to ending preventable maternal, newborn and child deaths in Tanzania’.Hon. Joel Bendera, RC Morogoro, reading the newly-launched Tanzania RMNCH Scorecard Mutual accountability and transparencyI believe we can all take much heart from these policy milestones represented by the Sharpened One Plan and Countdown Case Study. Undoubtedly Tanzania’s direction and priorities in accelerating maternal and newborn survival is very much rooted in the latest evidence available. However, and critically, and as heavily recognised as a recurrent theme throughout the Sharpened One Plan, realising the opportunities and obligations for marked improvements in our mothers and babies survival will only be achieved with mutual accountability and transparency at all levels.To this end, while efforts are being made to finalise the national guidelines for maternal and perinatal death surveillance and response, another accountability mechanism was also launched together with the Sharpened One Plan, namely the Tanzania RMNCH Scorecard – which draws from the Pan-African ALMA scorecard used by African Leaders for ending malaria deaths. This RMNCH Scorecard, driven off the national health management information system, uniquely will enable administrations at all levels – national, zonal, regional and council – to keep track of where progress is being made, and where it is not, against key reproductive, maternal, newborn and child health indicators. A quite spontaneous and most powerful part of the national launch was when the President personally handed over copies of the Sharpened One Plan and national RMNCH scorecard to each of the regional commissioners representing all regions of Tanzania. He made it clear these would form part of the regional briefings to be given to the President when he made his regional visits. Potentially this could be a breakthrough in realising the vision of ensuring our health facilities are equipped to save mothers and babies lives – it is our conviction that regional leadership has an exceptional role to perform in championing improved maternal and newborn survival, as so powerfully demonstrated by the late regional commissioner for Mara region Gabriel John Tuppa, who was posthumously recognised by the President for his inspirational efforts to transform the enormous challenges facing Mara’s mothers and babies.Hon. Jackson Msome, DC Musoma, receives an award from the President on behalf of the late Mara RC John TuppaThere is no other time like NowThe time has to be now for directing all efforts to ensure the Sharpened One Plan is delivered. We all have a duty to take action to save mothers and babies lives. It is totally unacceptable that so many thousands of our mothers and babies die needlessly every year. We have developed the roadmap for how to save 18,000 mothers and babies lives over the next 600 days. The legacy of the Sharpened One Plan must be the kick-start to a transformation for our mothers and babies survival, and never be assessed as a tragically missed opportunity.