Case Study

Maternal Health In Tanzania: Stuck Between Public Promises and Budgetary Realities

December 2015 | By Peter Bofin

On paper, Tanzania is committed to reducing maternal, newborn, and child deaths. In practice, however, women giving birth often lack access to the basic obstetric care needed to prevent avoidable fatalities.

The White Ribbon Alliance (WRA) Tanzania has been dedicated to advocating for better maternal health for years. When they discovered that even experts find it impossible to determine how much districts in Tanzania spend on maternal health, they started a campaign targeting key players in the budgetary process. The campaign aimed to win greater transparency of maternal health spending and to get the government to uphold its commitment to provide emergency obstetric health procedures in half of all local health centers.

A number of important lessons emerge from WRA Tanzania’s campaign: the need to aim for achievable and measurable targets gleaned from broad public commitments; the usefulness of marshaling evidence; and the strengths of planning a multi-level campaign through power analysis. But the case study offers warnings too – notably the importance of critically evaluating how promises can be feasibly implemented given the requirements and restrictions imposed by the budgetary process itself.




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