Tanzania has ratified and abides to legal treaties indicating the obligation of the state to provide essential maternal health care as a basic human right. Nevertheless, the quality of maternal health care is disproportionately low. The current study sets to understand maternal health services’ delivery from the perspective of rural health workers’, and to understand barriers for and better strategies for realization of the right to quality maternal health care. Semi-structured in-depth interviews were conducted, involving 11 health workers mainly; medical attendants, enrolled nurses and Assistant Medical Officers from primary health facilities in rural Tanzania. Structured observation complemented data from interviews. Interview data were analyzed using thematic analysis guided by the conceptual framework of the right to health. Three themes emerged that reflected health workers’ opinion towards the quality of health care services; “It’s hard to respect women’s preferences”, “Striving to fulfill women’s needs with limited resources”, and “Trying to facilitate women’s access to services at the face of transport and cost barriers”. Health system has left health workers as frustrated right holders, as well as dis-empowered duty bearers. This was due to the unavailability of adequate material and human resources, lack of motivation and lack of supervision, which are essential for provision of quality maternal health care services. Pregnant women, users of health services, appeared to be also left as frustrated right holders, who incurred out-of-pocket costs to pay for services, which were meant to be provided free.

/pdf/an-account-for-barriers-and-strategies-in-fulfilling-women-s-1ob973gqt3.pdf

An account for barriers and strategies in fulfilling women's right to quality maternal health care: a qualitative study from rural Tanzania.

Access to affordable and clean water has remained a challenge globally. Most states in Africa states have championed the provision of water to its citizens through state driven approaches. Despite the evidence that community water supply has contributed positively more than any other single approach to provision of water supply in Africa, it is still regarded as an informal approach. Most states in Africa still prefer other conventional approaches like Concession and Affermage in Francophone Africa and Commercialization through Management contracts in Anglophone Africa at the expense of the community water management. Either the state has not used the right approach or has neglected the community. Using evidence from Kenya, Tanzania, Malawi, Ghana and Nigeria, the paper has argued that the failure by the governments to acknowledge the disconnect between the community needs and state priorities has been responsible for the poor state of water provision in Africa.

/pdf/community-management-and-water-service-delivery-in-africa-62zkro95r8.pdf

Community Management and Water Service Delivery in Africa

This article expounds that the involvement of the private sector in water supply in Dar es Salaam is not perceived to be a panacea to the water problems facing the urban poor. This is chiefly because they have consistently experienced poor water supply regardless of the service providers. The article reveals that public provision of water to the urban poor have been grappling with huge demands for water resulted from poor water infrastructure, high operation costs, mismanagement, illegal connections, poor urban planning and limited investment in water supply services just to mention few. These bottlenecks have proven to be too stubborn even for business principles under privatisation to reverse. As a result the urban poor turn to informal alternatives which cost them dearly financially and health wise. Reversing the situation requires the public and private sectors to massively invest in the water infrastructure development and improve its management to meet the huge water demands of the urban poor.

Perceived Impact of Private Sector Involvement in Water Supply on the Urban Poor in Dar es Salaam

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Perceived Impact of Private Sector Involvement in Water Supply on the Urban Poor in Dar es Salaam