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Quality of life and social well beingA Presentation to Annual policy dialogue meeting, Friday 27th Jan 2012
REPOA
1
Outline
• Key messages • Progress against targets by key areas
- Education - Health and Nutrition - Water and Sanitation- Social Protection
• Conclusion
Quality of life and social well beingA Presentation to Annual policy dialogue meeting, Friday 27th Jan 2012
2
Education Indicators • Literacy rate among population 15+• Net enrolment at pre-primary, primary, secondary and higher
education• Percent of cohort completing standard VII• Percentage passing PSLE and CSEE• Transition rate from standard VII to Form I• Pupil/teacher ration and pupil/textbook ratio
Quality of life and social well beingA Presentation to Annual policy dialogue meeting, Friday 27th Jan 2012
3
Quality of life and social well beingA Presentation to Annual policy dialogue meeting, Friday 27th Jan 2012
Key messages
• The country has achieved significant progress in enrollments at all levels from primary to tertiary.
• Enrollments in primary education significant but less than desired.
• Persistent high levels of illiteracy among adult population especially rural women.
• There are “serious” concerns over quality of education in primary and secondary education
• Drop out rates for primary schools are increasing - Poor learning outcomes among primary school pupils
- Performance of secondary students in CSEE in recent years has been dismal
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Quality of life and social well beingA Presentation to Annual policy dialogue meeting, Friday 27th Jan 2012
(A)Education
(i) Adult literacyMKUKUTA target: 80% by 2010
• The country had almost wiped out illiteracy in the 1980 after achieving universal primary education.
• Greater improvements of literacy among women than men since 2004/05.
• Significant regional variation
• More illiteracy in the rural areas especially among rural women.
TDHS 2004/5 TDHS 2010Men 80% 82%
Women 67% 72%
5
Quality of life and social well beingA Presentation to Annual policy dialogue meeting, Friday 27th Jan 2012
6
(ii) Net enrollment at primary education MKUKUTA target: 99% by 2012
• Substantial progress from 66% in 2001 to the peak of 97% in 2007 • Gradual reduction to 94% in 2011 (figure 1).
2003 2004 2005 2006 2007 2008 2009 2010 2011 Target 2012
82
84
86
88
90
92
94
96
98
100
88.5
90.5
94.8
96.1
97.3 97.2
95.995.4
94
99
Year
Net
enr
olm
ent r
ate
(%)
7
Quality of life and social well beingA Presentation to Annual policy dialogue meeting, Friday 27th Jan 2012 • Overall gender parity in access to education has been achieved. Data 2011 NER (Boys) = 93.7 NER (Girls) = 94.2
(iii) Percent of cohort completing standard 7 MKUKUTA target: 90% by 2010 • By 2011, only 63% of those enrolled in standard 1 seven years of age completed standard 7
at the age of 13 years.• A worrying picture. • High drop out rate – especially due to truancy• Significant drop out even before finishing first four years of education.
(iv) Percent of students passing the primary school leaving examinations MKUKUTA target: 60% by 2010
• Fluctuated around 50% over the past four years • Overall girls tends to perform more poorly compared to boys (except in Kilimanjaro region)
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Quality of life and social well beingA Presentation to Annual policy dialogue meeting, Friday 27th Jan 2012
(vi) Pupil teacher ratio Recommended ratio: 40:1• By 2011, PTR in primary school was 48:1.• There are significant concerns related to quality of education. • Tests conducted in 2011 by UWEZO on basic numeracy and literacy showed poor learning
outcomes indicating urgency to improve quality of tuition• Concerns on quality of education are also manifested in Secondary education. • Poor performance in form four examinations.
Higher education • Significant increase in the number of public and private universities in recent years • Sustained uptrend in the numbers of students in higher learning an increase of 350% in the
last ten years
Quality of life and social well beingA Presentation to Annual policy dialogue meeting, Friday 27th Jan 2012
Health Indicators
• Infant mortality rate• U5 mortality rates• Immunisation• Stunting and wasting• Maternal mortality rate • Births attended by skilled personnel • HIV prevalence 15-24• Persons with advanced HIV infections receiving ARV• TB treatment completion rate
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Quality of life and social well beingA Presentation to Annual policy dialogue meeting, Friday 27th Jan 2012
Key messages (continues)
• Overall health status of the population as measured by life expectancy at birth shows gradual improvement over the years.
• There has been significant improvements in child survival over the past ten years.
• Improvements in life expectancy and child survival are largely due to improvements in Tanzania’s health system.
• Child malnutrition and maternal health remain problematic areas in the health sector.
• There is a growing burden of communicable and chronic diseases.
10
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Quality of life and social well beingA Presentation to Annual policy dialogue meeting, Friday 27th Jan 2012
B) Health
(i) Life expectancy at birth • Gradual increase over the years.
Year Life expectancy
1967 42
2002 51
2010 58
• Increases associated with reduction in child mortality. • In turn, child survival rates is due to improvements in Tanzania healthcare system e.g.
- Better malaria control- Vitamin A supplementation
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Quality of life and social well beingA Presentation to Annual policy dialogue meeting, Friday 27th Jan 2012
(ii) Maternal HealthMKUKUTA target: Reduced maternal mortality to 265 deaths per 100,000 births by 2010.
• Modest decline since 2004/5 TDHS 2004/5 TDHS 2010
578 454
• Factors contributing to poor maternal health
- Poor nutrition - Malaria - High workload among expectant mothers - Low utilization of family planning - Teenage pregnancies
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Quality of life and social well beingA Presentation to Annual policy dialogue meeting, Friday 27th Jan 2012
(c) Water & Sanitation Goal 3
Increased access to clean, affordable and safe water, sanitation, decent shelter and safe and sustainable environment
Indicators for water and sanitation
• Proportion of population with access to piped or protected water as their main drinking water source
• Percentage of households with basic sanitation facilities • Percentage of schools having adequate sanitation facilities
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2007/2008 2008/2009 2009/2010 2010/201130%
40%
50%
60%
70%
80%
90%
100%
65%
57.80%
0.479
90%
86%
0.81
0.55
MKUKUTA Targets - Rural Routine data - RuralSurvey data - Rural Linear (Survey data - Rural)MKUKUTA Targets - Urban Routine data - Other urban areasSurvey data - Urban including Dar es Salaam Linear (Survey data - Urban including Dar es Salaam)Linear (Survey data - Urban including Dar es Salaam) Routine data - Dar es SalaamLinear (Routine data - Dar es Salaam) Linear (Routine data - Dar es Salaam)
Perc
enta
ge o
f pop
ulati
on
Quality of life and social well beingA Presentation to Annual policy dialogue meeting, Friday 27th Jan 2012
Figure 45: Proportion of population with access to water supply and MKUKUTA targets, by residence, 2007/08-2010/11
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2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/120
50
100
150
200
250
300
350
400
450
500
51.5
387.1
68 41.6
119.6
428.6
Foreign Funds (DPs) Local Funds (GoT) Total Development Budget
TZS
billi
ons
Quality of life and social well beingA Presentation to Annual policy dialogue meeting, Friday 27th Jan 2012
Figure 49: Foreign and local development financing to water sector, 2005/2006 to 2011/2012 (TZS billions)
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Sanitation
Quality of life and social well beingA Presentation to Annual policy dialogue meeting, Friday 27th Jan 2012
Total Total Total Urban RuralTDHS
2004/05HBS 2007 TDHS 2010
0%
20%
40%
60%
80%
100%
80.6 85.0 79.4 78.6 79.7
3.84.8
0.9 1.9 0.62.6
2.8
5.1
15.3
1.6
12.97.5
13.72.0
17.8
No toilet
Flush/pour flush toilet
Ventilated improved pit latrine
Pit latrine
Perc
enta
ge o
f hou
seho
lds
Figure 47: Household access to basic sanitation, 2004/05, 2007 and 2010
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Quality of life and social well beingA Presentation to Annual policy dialogue meeting, Friday 27th Jan 2012
Goals 4 & 5
• Goal 4: Adequate social protection and provision of basic needs and services for vulnerable and needy
• Goal 5: Effective system to ensure universal access to quality and affordable public services
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Quality of life and social well beingA Presentation to Annual policy dialogue meeting, Friday 27th Jan 2012
Indicators
• Proportion of children in child labour
• Proportion of children with disabilities attending primary school
• Proportioned of orphaned children attending primary school
• Proportion of eligible elderly people accessing medical exemptions in public facilities
• Proportion of population reporting satisfaction with health facilities
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Quality of life and social well beingA Presentation to Annual policy dialogue meeting, Friday 27th Jan 2012 • Children with disability and orphans attending primary schools
– NPS used a small sample of disabled children and found that 57.6% of these were enrolled compared to the 82.3% for children without disabilities
– No differences in access to education for pupils who have lost one parent. A gap is observed where the children have lost both parents
% Enrolled
Total 81.8%
Non-orphan 81.5%
Father deceased 87.3%
Mother deceased 83.6%
Both parents deceased 72.3%
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Quality of life and social well beingA Presentation to Annual policy dialogue meeting, Friday 27th Jan 2012
• Eligible elderly people accessing medical exemptions – Data for the indicator not available in HMIS– Available information points to limited implementation of user fee
exemption regime– Example of best practice available. e.g in Morogoro municipality
MORETEA is working with the LGA to issue local ID cards to older people
– Possible approaches for working with private facilities are proposed
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Quality of life and social well beingA Presentation to Annual policy dialogue meeting, Friday 27th Jan 2012
• Proportion of population reporting satisfaction with health facilities– No new data available – In 2008, 64 % reported to be satisfied with health
services provided – New data in 2012 (Views of the People and Afro
barometer Surveys)