Pneumonia has been a particularly vexing problem in Tanzania — accounting for 15% of child deaths in 2016, despite the presence of an efficacious WHO recommended first line treatment — Amoxicillin Dispersible Tablets (Amox DT). The government has been able to achieve significant declines in child mortality rates for malaria and HIV/AIDS in recent years, but rates for pneumonia have only dipped slightly. With its goal of reducing child mortality by 80% by 2030, the government has prioritized efforts to address childhood pneumonia.
Since 2015, Results for Development has been supporting the government of Tanzania in implementing a holistic market shaping program focused on increasing access to Amox DT in the public and private sectors, by utilizing holistic market shaping approaches as well as evaluation and adaptive learning modalities to address the identified barriers to access to Amox DT.
These briefs summarize key findings from analysis and interventions undertaken in the program so far as well as recommended further action.
Key actions on the public sector to date include: (i) Establishing an aligned policy environment to ensure Amox DT is included on national medicine lists and all relevant treatment guidelines; (ii) Strengthening ownership and sustainability of procurement processes by supporting the transition from an external procurement agency to the country’s national procurement agency; (iii) Sourcing and administration of catalytic financing complemented by government-led resource mobilization through the implementation of co-financing agreements and (iv) Strengthening quantification and supply planning methods to accurately account for Amox DT needs in the country. These activities have contributed to a marked increase in availability of Amox DT across public health facilities from 25% in 2016 to 90% in 2022 as well as a corresponding decrease in Amox DT stockouts, from 59% in 2017 to 14% in 2022.
On the private sector key actions to date include ensuring a well-enabled policy environment; developing a holistic Pediatric amoxicillin market view which has been shared broadly with partners to increase transparency across the supply chain; and piloting the impact of ADDO (Accredited Drug Dispensing Outlet) sensitization efforts on improving knowledge, stocking, and dispensing behaviors. These activities have resulted in an increase in the number of registered Amox DT suppliers from one to eight since 2014, and a 6-fold increase in import volumes of Amox DT from 2016-2020 in the private sector.
R4D Staff who contributed to the briefs
Private Sector Policy Brief: Cammie Lee, Nelsha Haji, Yangzom Tshewang, Sarah Wangilisasi, Kimberly Churchwell, Pili Mmbaga
Public Sector Policy Brief: Cammie Lee, Aalia Chatur, Yangzom Tshewang, Taylor Salisbury, Sarah Wangilisasi, Kimberly Churchwell
