Yet important gaps remain. Too many pneumonia cases are still not correctly diagnosed at the facility level, and access in the private sector remains limited. Addressing these challenges will be critical for sustaining progress and ensuring that more children receive timely, effective treatment.

This policy brief outlines six priority actions the Ministry of Health can take to build on recent progress, strengthen pneumonia diagnosis and treatment, and sustain access to essential medicines as Tanzania works toward its 2030 child mortality goals.

For more on the collaboration between the Government of Tanzania and R4D to expand access to childhood pneumonia treatment, see the accompanying impact brief.

Additional resources:

Implementation and lessons

• Supporting Tanzania’s Ministry of Health to improve commodity availability through bottom-up quantification
• Sustainable health commodity financing: Lessons from Tanzania’s transition from donor funding

Research and analysis

• Correct diagnosis of childhood pneumonia in public facilities in Tanzania
• Increasing the role of the private sector in pediatric pneumonia treatment in Tanzania

The post Policy Brief: 6 Actions to Reduce Child Mortality from Pneumonia in Tanzania appeared first on Results for Development.

Over the past decade, Results for Development (R4D) has partnered with the Government of Tanzania and other stakeholders to help expand access to this life-saving treatment. Through a coordinated market shaping effort that addressed financing, supply planning, policy alignment, and supplier engagement, Tanzania has strengthened the systems needed to ensure Amox DT is consistently available in health facilities. These efforts also supported a transition from donor-financed procurement to sustainable domestic financing.

This impact brief highlights how government leadership and targeted market shaping interventions helped expand access to pediatric pneumonia treatment and reduce child mortality while strengthening the systems that sustain it. It also shares lessons for countries and partners working to improve access to essential medicines.

For recommendations on how to continue building on this progress, see the accompanying policy brief.

Additional resources:

Implementation and lessons

• Supporting Tanzania’s Ministry of Health to improve commodity availability through bottom-up quantification
• Sustainable health commodity financing: Lessons from Tanzania’s transition from donor funding

Research and analysis

• Correct diagnosis of childhood pneumonia in public facilities in Tanzania
• Increasing the role of the private sector in pediatric pneumonia treatment in Tanzania

The post Impact Brief: Reducing Child Mortality in Tanzania by Increasing Access to Pediatric Pneumonia Treatment appeared first on Results for Development.

Access to essential medicines and other health products is fundamental to achieving Universal Health Coverage (UHC) and improving population health. But recent shifts in global financing — including the reduction of donor support — have exposed the fragility of many domestic systems, resulting in stockpiling, shortages, and inequitable access to life-saving commodities.

Results for Development’s (R4D) recent analytic work revealed that these challenges stem not only from insufficient funding, but from deep systemic disconnects. Without addressing these underlying system weaknesses, simply allocating more funds or trying to ringfence funds with budget lines will not ensure that essential medicines reach those who need them.

Ensuring sustainable, equitable access to essential health commodities requires governments to act across multiple, interconnected domains. They must:

• Set priorities for which services and products to fund
• Forecast needs based on population health and demand
• Shape markets to ensure high quality products are available at affordable prices
• Allocate resources effectively within budgets
• Align payment and pricing systems so that financial flows support reliable supply
• Ensure funds flow smoothly through financing arrangements to reach product suppliers and health care providers
• Procure and distribute products efficiently to the point of care

When any one of these links breaks down, it can cause cascading effects across the system — resulting in stockouts, inefficiencies, and high out-of-pocket costs.

R4D’s Integrated Approach: Bridging Health Financing, Market Shaping and Supply Chain

R4D has long been a leader in both health financing and market shaping, two fields that have often evolved separately. Recognizing the need for a new, integrated perspective, R4D has brought these areas together to understand how their interactions and linkages to supply chains can make or break access to essential commodities.

This intersectional approach was at the heart of R4D’s multi-country rapid assessment, conducted in Ethiopia, Ghana, Nigeria and Tanzania with support from the Gates Foundation. The assessments mapped the critical connections between health financing, market shaping, and supply chain functions and policies — and highlighted where critical misalignments lead to inefficiencies and gaps that undermine access, but also where there are promising practices that can be built on and shared.

Four country-specific briefs, one overview brief and a full report, can be found below:

• Overview Brief — Building Integrated Systems for Financing Essential Medicines and Other Health Products: From Silos to Systems (4 Pages)
• Full Report — A mapping of domestic systems for financing essential medicines and other health products (33 Pages)
• Ethiopia Brief — Opportunities to align supply chain, market shaping and health financing functions and policies (16 Pages)
• Ghana Brief — Opportunities to align supply chain, market shaping and health financing functions and policies (15 Pages)
• Nigeria Brief — Opportunities to align supply chain, market shaping and health financing functions and policies (17 Pages)
• Tanzania Brief — Opportunities to align supply chain, market shaping and health financing functions and policies (16 Pages)

The post Building Integrated Systems for Financing Essential Medicines and Other Health Products — From Silos to Systems appeared first on Results for Development.

Dr. Bear has contributed to global market shaping and scale-up efforts since the early 2000s, beginning with GAVI’s PneumoADIP and the Hib Initiative, where she co-led the country support mechanism, providing technical assistance to Ministries of Health for vaccine rollout and impact evaluation. At USAID (2009–2015), she led the development of flagship U.S. Government health initiatives — including the Global Health Initiative, Ending Preventable Child and Maternal Deaths Action Plan, and the Global Health Security Agenda. While based in Bangladesh and Mali, she oversaw catalytic investments in cold chain systems, digital health, health workforce, and governance. She collaborated closely with ministries to co-design frameworks for scaling high-impact interventions as part of national health sector strategies.

From 2016 to 2019, Dr. Bear led strategic and evaluative work that shaped major global health investments. She revised USAID’s maternal and child health investment frameworks to align with the SDGs, evaluated its flagship maternal and child health program, and designed a $1B successor strategy. She also led evaluation of the $3.5B Feed the Future nutrition portfolio, providing evidence that informed its Congressional reauthorization. Her advisory work includes digital health evaluations, such as a telecom-based health insurance product in Bangladesh that informed regional scale-up strategies. From 2019 to 2024, she led global portfolios managing integrated development programs across 25–45 countries, overseeing teams of 500–1,650 staff.

Dr. Bear holds degrees in social policy (BS, Northwestern) and public health (MPH, DrPH, Johns Hopkins). She has lived and worked for over a decade in Burkina Faso, Mali, Indonesia, Bangladesh and Palestine. She is fluent in French (professional) and English (native), and currently resides in Baltimore, Maryland.

The post Allyson Bear appeared first on Results for Development.

At Results for Development (R4D), Jeremiah is a senior program associate in the Market Shaping Practice where he provides both technical and programmatic support on the Improving Access to RMNCAH-N Procurement and Distribution Channel (Access PDC) project, as well as the Maternal and Child Wasting (MCW) and Multiple Micronutrient Supplement (MMS) projects to identify and address bottlenecks in scaling up access to reproductive, maternal, newborn, child and adolescent health and nutrition (RMNCAH-N) commodities in Nigeria and other low- and middle-income countries.

Throughout his career, Jeremiah has focused on contributing to improving access to essential health commodities at service delivery channels through trainings and supportive supervision of pharmacy focal staff across primary and secondary health facilities. He also contributed to developing training materials and supported in revising the 2023 Sokoto state essential medicines list. At R4D he contributed to analyzing states’ nutrition commodity procurement data which informed key messages on financing nutrition commodities in Nigeria.

Before joining R4D, Jeremiah worked with The Palladium Group as a facility management and logistics advisor on the USAID-Integrated Health Project where he supported over 220+ primary health care facilities in improving facility and financial management of the Basic Health Care Provision Fund, and accountability of the Drug Revolving Fund for sustainable access to essential health commodities in Sokoto State, Nigeria. He also worked with the Society for Family Health in north-central Nigeria as a demand creation representative where he contributed to scaling-up access to reproductive health commodities.

Jeremiah holds a bachelor’s degree in pharmacy from the University of Nigeria and is pursuing a master’s in public health at Ahmadu Bello University. He speaks fluent English, Igbo and Hausa languages.

Publications

• In Vivo Investigation of the Aqueous Methanol Extracts of Leaves of Millettia aboensis (Hook. F.) Baker (Fabaceae) for Anti-Inflammatory Potentials: doi.org/10.26538/tjnpr/v5i9.6 | Tropical Journal of Natural Product Research (TJNPR)

The post Jeremiah Chinedu Ilo appeared first on Results for Development.

She is a senior program associate at Results for Development (R4D), where she supports the Market Shaping Practice (MSP) Pneumonia project in Tanzania to increase access to Amoxicillin DT for children under 5. Her work involves conducting qualitative and quantitative research and analysis for projects across the MSP portfolio, communicating key findings and policy recommendations from research and analyses to internal and external audiences, and assisting in the development of knowledge management and communication strategies to promote the dissemination and uptake of R4D’s work.

Throughout her career, Monica has focused on contributing to improving access to quality pharmaceutical care and products through health promotion, counseling patients and working with other health professionals to foster rational medicine use. She has also been involved in public health programs aiming to strengthen health systems and specifically overseeing and capacitating private health sector engagement in public health initiatives.

Before joining R4D, Monica was a pharmaceutical systems officer at Apotheker Health Access Initiative — a local NGO operating in Tanzania. She supported over 140+ ADDOs (small drug shops) in the Afya-Tek project to improve quality of care and access to commodities for reproductive maternal newborn child and adolescent health. She has also participated in assessments of Tanzania’s private sector pharmaceutical supply chain and financing for health entrepreneurs.

The post Monica John appeared first on Results for Development.

The R4D-led program fully transitioned the procurement of amox DT to the government of Tanzania. Traditionally, the government of Tanzania has relied on external parties to procure amox DT, but when past programs have ended, the government has faced grave concerns about how to ensure an uninterrupted supply. With funding from Good Ventures, at the recommendation of GiveWell, R4D stepped in to address the funding cliff, but planned for a gradual transition to local funds and authority from the very beginning. After years of careful planning and partnership, R4D handed over the last box of amox DT.

R4D has also helped to strengthen capacity in other key areas, including forecasting, financing, supply, and regulatory aspects of the amox DT market. To date, through this partnership, a total of 13.6 million courses were made available for the treatment of childhood pneumonia; 1.6 million of these courses of treatment were fully funded by government-mobilized resources. By early 2022, amox DT is now in-stock in 90% of the facilities in Tanzania (compared to 48% in 2016).

To understand the impact of its market shaping interventions, R4D estimated, that in the absence of the program, amox DT treatment availability would be at 29%, 31%, 33%, and 35% in 2019, 2020, 2021, and 2022, respectively. This estimate takes into consideration factors such as underestimation of demand, incomplete disbursement of funds and supply planning challenges that were all representative of the amox DT landscape in Tanzania when R4D started its program. While these estimates look at data from 2017, R4D has also been tracking the current performance of a comparator commodity — the zinc/oral rehydration solution (ORS) co-pack which is used to treat diarrhea in children under 5. The two commodities share many similarities: the zinc/ORS co-pack is used for the same population as amox DT and entered the market in Tanzania around the same time as amox DT. It also faced similar market challenges, including limited registered suppliers and financing.

However, one of the key differences between the two commodities is that no market shaping support was provided to increase access to the co-pack. The availability of the zinc/ORS co-pack in public health facilities has not significantly changed, which may be connected to the lack of market shaping support; in fact, availability decreased from 64% in 2020 to 50% in 2022. While Zinc/ORS co-pack is not a perfect comparator medicine it can give us clues about the direction amox DT availability might have gone in (i.e., increased, decreased, stagnated) without R4D’s market shaping support.

“We’ve seen that there has been a significant reduction in mortality among children under 5 over the past 20 years,” said Nelsha Haji, a senior program officer in R4D’s Tanzania office. “One of the challenges we face is directly making the link of causation between our work and the government’s larger national priority of reducing child mortality. However, with the evidence we do have through R4D’s health facility survey results on amox DT availability and stockout numbers, as well as numbers on zinc/ORS co-pack for comparison, we do believe our work has contributed to this positive trend in reducing under 5 mortality — particularly over the past five years, when R4D ramped up its market shaping support for the government.”

Another key aspect of this program has been a focus on accurate diagnoses of pneumonia. As part of a clinical study conducted in 2017, R4D used 8 lung ultrasound machines to assess accuracy of pneumonia diagnosis across a sample of health facilities, learning that provider diagnosis accuracy was as low as 18%. Since then, R4D has been piloting various interventions to improve provider diagnosis and prescription behavior. To further support the government of Tanzania on improving provider diagnosis, the R4D Tanzania recently donated the machines used in the original study to 8 different district hospitals and health centers across the country.

To read a more in-depth story about this program, click here.

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About Results for Development
Results for Development (R4D) is a leading non-profit global development partner. We collaborate with change agents — government officials, civil society leaders and social innovators — supporting them as they navigate complex change processes to achieve large-scale, equitable outcomes in health, education and nutrition. We work with country leaders to diagnose challenges, co-create, innovate and implement solutions built on evidence and diverse stakeholder input, and engage in learning to adapt, iterate and improve. We also strengthen global, regional and country ecosystems to support country leaders with expertise, evidence, and innovations. R4D helps country leaders solve their immediate challenges today, while also strengthening systems and institutions to address tomorrow’s challenges. And we share what we learn so others around the world can achieve results for development too. www.R4D.org

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