Tanzania: Improving Access to Health Care for Women and Children

Women in Tanzania face challenges accessing adequate and proper health care services, partly as a result of inadequate funding for healthcare facilities and limited access to information. Mary Mwanyika-Sando, an Aspen Institute 2013 New Voices Fellow, has dedicated many years to Tanzania’s public health sector. She graduated from the University of Dar es Salaam’s Muhimbili University College of Health Sciences in 2004 with a degree in medicine. She then worked as a physician at an HIV/Aids clinic in Dar es Salaam for 18 months before joining Management and Development for Health (MDH)-an organization that collaborates with the government of Tanzania to address public health problems such as HIV/Aids, and maternal, neonatal and child health issues. As the maternal and child health coordinator, Mwanyika-Sando oversees the expansion of health care services to Tanzanian women and children. She is currently pursuing her master’s degree in public health at the Harvard School of Public Health. Mwanyika-Sando sat down with AllAfrica’s Leon Ong’onge to discuss her work at MDH and how the Aspen Institute fellowship will help her pursue her goals in Tanzania’s public health sector.

How did you come to be involved in the effort to improve maternal and child health in Tanzania?

Since I was a child I have always liked to help people, and I came to realize that I would be best able to help people as either a doctor or a nurse. I did my medical training at the University of Dar es Salaam and was interested in becoming an obstetrician-gynecologist because I recognized that the people with the greatest need for health care services are women and children.

During my internship at the Department of Obstetrics and Gynecology at the Muhimbili National Hospital (MDH), I realized that the women who came in had bad outcomes; either they had medical problems they had to live with for the rest of their lives, or they unfortunately lost their lives because of pregnancy-related complications. I realized that the bad outcomes were not necessarily or primarily due to inadequate facilities, but perhaps because the women came in late in their pregnancies. Rather than marrying myself to individual patient care, I decided to be part of the solution to a bigger population, so I joined MDH.

What are some lessons that you have learned from your experiences?

One of the things that I have learned is that where there is a will and commitment, there is a way. If people share a vision and are committed to it, things can really turn around. I look at women who really inspire me like President Joyce Banda of Malawi who has taken it upon herself to improve the condition of women. I think if everyone speaks that language, things will really turn around over time.

How important have MDH partnerships with the President’s Emergency Plan for Aids Relief (PEPFAR), the Elton John Aids Foundation and other donors been to your work?

A lot of Tanzania’s health care budget comes from donor aid. Almost 90 percent of our HIV-related care, services and support are from foreign aid; only 10 percent comes from the government. Our partners have funded construction, training and capacity-building projects. PEPFAR provides antiretroviral (ARV) drugs to about 60-70 percent of the 350,000-400,000 HIV-infected people living in Dar es Salaam, enabling them to receive the right treatment and adequate counseling.

Right now if you walk into medical wards, you can’t really tell that a patient has HIV because people are clinically stable. Our partners have also supported construction of better maternal and child health clinics that offer patients more privacy.

How will the Aspen Fellowship help you achieve your goals?

I know it will sharpen my skills to become a better advocate for my country, for my program, and for something that is really close to my heart: maternal and child health. My selection is also an inspiration because of the message that it sends: that we can work together as partners to improve our health systems.

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