Information sources for the Strategic Plan

Just a footnote on documentary sources for the College's Strategic Plan, illustrated with pix of assorted crabs Rose and I saw on beaches around Zanzibar.

crab.

During my work here I’ve relied heavily – too heavily I’m sure – on documents in English produced for the Zanzibar Ministry of Health funded by various NGOs and development agencies and often written by outsiders. Danida, the Danish development agency, has been funding ‘capacity building’ at the Ministry for several years. As a consequence of this, there is very good data on public health and an impressive body of research on health needs, To sum up the public health situation, average life expectancy in Zanzibar is 52.  

hermit crab

There is also very good data on the workforce and a Training Plan that is invaluable to my task. There is also an annual review of Government spending on health, which is published in English. Health is a devolved function in Zanzibar, the Government revenue contribution comes from its share of Tanzanian national revenue, which the Government of Zanzibar then decides how to spend.

crab holes

The 2010 health public expenditure review says: 

·         ‘Development Partners’ paid 54.4% of the costs of public sector healthcare, the Government 43%. DP contribution is falling as Global Fund spending is reduced.

·         In Zanzibar in 2010 health was 6.8% of Government spend. This is expected to fall for 2011 as 2010 was an exceptional year due to a large contribution to health from Muli Lateral Debt Relief .

·         To cover recurrent public sector health costs, Government spend would need to be 10.8%. The Government’s strategic plan for health commits to contribute 12% of the its budget. Donor recipient nations have signed up to a target Government spend of 15% of GDP (the Abuja target).

·         WHO recommends minimum per capita spend of over $40 a year, in Zanzibar spend in 2010 was less than $19, the lowest since 2005.

pink coconut crab

·         As much as 12% of the Zanzibar Government’s contribution to health went on medical care for Zanzibaris overseas: a few got an awful lot (there is little specialist medical care in Zanzibar).

blue coconut crab

·         Charges to patients made little overall contribution in 2010 but contributed over 60% to the running costs of the largest hospital, in Stone Town.

·         Charges are due to rise significantly in 2012/13 to sustain health inome.

hermit crabs going to the sea

The Public Expenditure Review paper recommends that it would be helpful if the Government of Zanzibar was more explicit about the priority it attaches to health ….

more wildlife..



That's all for now!