1

KEYNOTE SPEECH BY H.E. JAKAYA MRISHO KIKWETE,

PRESIDENT OF THE UNITED REPUBLIC OF TANZANIA
ON MATERNAL, NEWBORN AND CHILD HEALTH
SUMMIT POST-2015, TORONTO CANADA, 29 MAY 201
Right Honorable, Stephen Harper, the Prime Minister of Canada
and our kind Host;
Your Majesty Queen Rania of ordan;
Your Highness, the !ga "han;
Melinda #ates, Co$%hair of the &ill ' Melinda #ates (oundation;
)r* Margaret Chan, )ire%tor$#eneral of the +orld Health
,rgani-ation;
Mr* !nthony .ake, /0e%uti1e )ire%tor of the 234C/(;
)istinguished #uests;
.adies and #entlemen,
A!!"#$%&'%()
Once again allow me to commend Rt. Hon. Stephen Harper,
Prime Minister of Canada for conceiving the idea to convene this
Summit on maternal, newborn and child health. I congratulate him
also for the wonderful organiation. Prime Minister Harper has
demonstrated e!emplar" leadership on this all important matter from
the Mus#o#a $%&% '( Summit to the )* Commission on Information
and +ccountabilit" for ,omen-s and Children-s Health and through
several other initiatives to this Summit. I am sure I spea# on behalf
of man" people on this planet when I sa", we sincerel" appreciate his
invaluable contribution and as# him to continue to do the good wor#.
I am delighted to .oin "ou this morning and spea# at this
important session on /0oing More 1ogether 'loball"/. I subscribe to
the idea that doing more together globall" is the best thing to do. Our
past and recent e!perience in addressing issues of women2s and
children2s health have not suggested otherwise. It is imperative that
we build upon this e!perience of wor#ing together as we do the
2
countdown to the $%&3 M0's deadline, and prepare for the post $%&3
phase.
T&)*&)%&+ W,#"# W# C&-# F"(- &). W,#"# &"# W#
/0%ellen%ies, .adies and gentlemen,
1anania-s e!perience in implementation of M0' 4 and 3 has
taught us man" lessons as we travel towards the $%&3 deadline and
chart the path towards post $%&3 development agenda. I sa" so,
because, the results tell the stor" about the successes made and the
targets not "et met that deserve attention going forward.
+s we e!amine this e!perience, it is important to note that,
1anania was worse off before the proclamation of the M0's than
where we are toda". +t the dawn of the new millennium maternal
mortalit" was at /00 per 100,000 live births, infant mortalit" rate was
115 per 1,000 live births and under five mortalit" rate was at 191 per
1,000 live births. 1he coverage of contraceptives was 0 !#"$#)', and
onl" 1.9 !#"$#)'&2# of women gave birth at the health facilities
under the care of s#illed health professional.
,hen the M0' 4 and 3 targets were announced it appeared to
be too ambitious goals for us to attain. ,e were tas#ed to lower the
maternal mortalit" rates to 191 deaths per 100,000 5from /003 live
births, neonatal mortalit" to 19 deaths per 1,000 live births 54"(-
1196 and under five mortalit" to 5 deaths per 1,000 live births 5from
1913 b" $%&3.
1oda", less than 500 da"s towards the deadline, 1anania
maternal mortalit" rates in $%&% were 5 deaths per 100,000 live
births, neonatal rate was 21 620123 deaths per 1,000 live births and
under five mortalit" is at 5 deaths per 1,000 live births. 1he use of
contraceptive has increased to $7 !#"$#)' from 0 !#"$#)' and women
who give birth at health facilities and attended b" s#illed midwives
are 51 !#"$#)'.
Indeed, in the span of &4 "ears, comparativel", a lot of ground
has been covered and much has been achieved. 1anania has met the
3
M0' target for under8five mortalit" rate, we are close to meeting
neonatal mortalit" rate target. 9ut, we are far from meeting the target
with regard to maternal mortalit" rate which has been cut b" 5
!#"$#)' but for short of the e!pected 05 !#"$#)' cut as stipulated in
the M0' 3.
It is ver" clear from these statistics that there has been progress,
but not good enough particularl" with regard to mothers. ,or# is still
in progress to accelerate the pace of implementation. +s alluded to
earlier, I am hopeful that we ma" be able to meet the newborn target
b" $%&3 but not as hopeful with maternal mortalit" and s#illed health
wor#ed.
W,&' ,&7 W("8#. W#99
/0%ellen%ies, .adies and #entlemen;
1hese hard won results have been achieved through a number of
interventions underta#en through concerted efforts b" our
government, families and communities. 9ut, support from our
development partners including bilateral and multilateral donors as
well as the private sector: private foundations and the wider civil
societ" communit" has made a huge difference.
,hen I got into office in $%%3, I made a promise to ma#e health
care one of the top priorit" agenda of m" administration. ,e
immediatel" undertoo# a comprehensive review of the situation in the
health deliver" s"stem. Subse;uentl", we come up with the *ew
*ational Health Polic" of $%%7 and designed the Primar" Health
Services 0evelopment Program 5$%%78$%&76 to implement the Polic".
,e also put in place a number of polic" instruments including Health
Sector Strategic Plan III, Roadmap to +ccelerate Reduction of
Maternal, *ewborn and Child 0eaths, Immuniation Costed Plan,
<amil" Planning Costed Plan, Human Resources for Health Strategic
Plan and now the Sharpened Plan to +ccelerate Reduction of
Maternal, *ewborn and Child 0eaths.
4
1hese Polic" and Program were aimed at addressing access to
health care and service deliver" and capacit" related bottlenec#s. ,e
gave ourselves the overarching ambition to improve access to health
care within a radius of 3 #ilometers from where people live. It meant
building health deliver" facilities where the" don-t e!ist particularl"
in the rural areas. +lso, we undertoo# to provide all health facilities
with the re;uisite e;uipment, medicines and s#illed health personnel.
1o implement these ambitious plans and programmes, the
government raised the health budget fivefold from 201 :%99%()
7,%99%)27 6US .(99&"7 100 -%99%()3 in $%%7 to 1. '"%99%() 7,%99%)27
5US .(99&"7 /50 -%99%()6 in $%&=. 1his investment has paid off in
man" respects. Some 1,50 new dispensaries, 122 new health centers
and 19 new hospitals have been built. Considerable improvement has
been done with district, regional and onal hospitals as well as the
national hospital at Muhimbili.
Since $%%7, we have upgraded facilities in man" of the old
dispensaries to enable them to underta#e birth related services. ,ith
health centres, we are building capacit" to perform cesarean section.
,e have e!panded training and emplo"ment of health professionals.
,e have improved on the availabilit" of medical e;uipment and
medicines including vaccines.
9esides, addressing the accessibilit" challenge we also
undertoo# specific measures which helped in reducing maternal and
child mortalit". ,ith regard to child mortalit" measures included
sustained high immuniation coverage, improved malaria control,
increased coverage of Integrated Management of Childhood Illnesses,
>itamin + coverage to over 90 !#"$#)' and improved nutrition
including breast feeding. 9esides the above measures, other measures
include dealing with asph"!ia, pregnanc" and birth related
complications, infections, premature birth.
,ith regard to mothers, measures included improved perinatal
care, coverage of intermittent preventive treatment for malaria,
anaemia etc. improved access to sender s#illed health personnel.
5
,hat is re;uired of all of us now is scaling up on these
interventions. ,e commit ourselves to continue to increase the health
budget. ,e will continue to wor# closel" with partners and friend of
1anania in this endeavour. <or, I believe with continued support
from partners and friend li#e Canada and man" nations in the
developed world, private foundations, the )* and its agencies 5,HO,
)*IC?<, )*<P+6 as well as 9ill and Melinda 'ates <oundation,
+ga @han <oundation and several others, we should be able to do
more and achieve more.
W&; F("<&".
/0%ellen%ies, .adies and #entlemen;
I have shared with "ou our e!perience, our challenges and our
optimism for the da"s ahead of us. ,e have come a long wa" as far as
maternal, new born and child health is concerned. ,e have
demonstrated how far we have gone with little resources and capacit"
constraints. ,hat is clear is that, the issue we are confronting is not
about not #nowing what needs to be done, nor lac# of interest or
political will to do it. It is, in essence, a function of capacit"
constrains which are associated with the low level of development we
are in our being a developing countr".
Our e!perience, gives us no reason to lose hope or renege on our
commitment. I am personall" committed to see acceleration in
interventions, more accountabilit" and better results with regard to
women-s and children-s health deliver" b" $%&3 and be"ond. 1he
recent introduction of the Maternal, *ewborn and Child Health Score
card spea#s volumes about our resolve to do better in this regard. In
conclusion, allow me to sa" that with improved health s"stems, more
resources and accountabilit", we can punch above weight.
<ortunatel", the world we live in has enough resources, wealth,
technolog" and people of goodwill. If we continue to wor# together in
6
this noble course as demonstrated at this High Aevel Summit, our
ob.ective will be realied in no time. Saving women and children
lives is and must remain a shared responsibilit". 1his fight must be
won, and win comprehensivel". Aosing is not an option.
I than# "ou for "our #ind attention.