The Top Ten Investments for Tanzania Children

There has been a 25 percent drop in child mortality and we are making good progress towards the child survival Millennium Development Goal. Even so, more than 445 children under 5 years die every day— and over 140 are less than one month old.* Every hour a woman dies due to complications during pregnancy or childbirth. Investing in affordable solutions will save thousands of lives.

• We need a better health system with more staff, better equipped health facilities, better monitoring and supervision, and greater accountability. All health related policies, laws, guidelines and frameworks need to put women and children first.
• We must expand investment in inexpensive interventions that save lives. We should make sure that :

o All households receive long lasting insecticide treated mosquito nets to reduce malaria,

o All children are protected from vaccine –preventable diseases,

o All parents know how to treat killer-diseases like diarrhea with ORS and zinc.

o All parents know about the importance of giving nothing but breast-milk to babies until they are six months old.

• Everyone, including the poorest families should have access to health services. Every mother must have the opportunity to give birth with a skilled birth attendant.
• All households have access to safe drinking water, adequate sanitation facilities and pursue hygienic practices.
• Local health committees should be revived to ensure community involvement and accountability in the delivery and quality of health services.

More than a third of Tanzanian children do not reach their physical and mental potential because of malnutrition. Malnutrition is a cause in more than one third of child deaths—over 40,000 Tanzanian children under-five will die in 2010 from causes related to malnutrition. The most damage is inflicted during pregnancy and in the first two years of a child’s life and action must therefore focus on this period of life. Good nutrition in children and women is essential for a strong economy. The new focus on agricultural development has opened an opportunity for nutrition to be placed at the heart of Tanzanian progress.

• Inexpensive fortified foods must become widely available in Tanzania. The standards and regulations for fortified foods must be enforced.
• Every health facility should provide essential nutrition services for children and women, including vitamin A and iron supplements, counselling on how best to feed young children and other family members, and treatment for malnutrition.
• Every district should have a district nutrition officer who has overall responsibility for the delivery of nutrition services for children and women.
• Support household food production of nutritious fruits and vegetables and animal husbandry so that households have better access to nutritious food throughout the year.
• Safety nets and social cash transfers must reach vulnerable pregnant women and children under the age of two so that resources reach children at the most critical age for ensuring good nutrition and healthy development.

Four out of five schools have no functioning hand-washing facilities. Many schools have more than 50 pupils per toilet. Three out of five schools have no on-site water supply. Many health facilities are in a similar critical situation. Improving hygiene and sanitation in schools will reduce illness, improve attendance and help to ensure more children, especially girls, complete their education. Water supplies and toilets in health facilities are vital for reducing infections and saving lives.

• All schools should have functioning hand washing facilities, toilets and hygiene education and meet government standards.
• Children need to be engaged as environmental advocates, promoting and practising better hygiene at school and at home.
• All schools should have girl friendly facilities to cater for their particular needs. Girls need to understand the inevitable transformation their bodies undergo upon reaching puberty.
• Every financed water project at village level should include water supply for schools and health facilities.
• Water, sanitation and hygiene services must be improved in the poorest communities especially. In urban areas, for example, this may include subsidies for public water kiosks and improved pit latrine emptying systems.

Early childhood programmes are at the forefront in the fight against poverty. Children from the poorest communities are at greater risk of disease and malnutrition and do less well in school. Early childhood programmes focused on the poorest families help parents to provide a better start for their children and help close the gap between rich and poor. Investments in early childhood give a seven-fold return and are much more cost-efficient than investing in remedial programmes later in a child’s life.

• Parents in the poorest communities should get the help they need to make sure their children get the best start in life. Support for community-based parenting and early childhood development programmes will help ensure children grow up healthy, well-nourished and well-prepared for school.
• Early childhood development should be included in the teacher education curriculum. A national in-service training programme for early childhood development practitioners should be established. Priority in training should be given to those working in the poorest communities.
• Local committees should be established at district and ward level that will monitor the availability and help improve the quality of early childhood development centres.

Only just over half of students pass the primary school leaving exam. Less than one in ten students in rural areas enrol in secondary school. Well-educated school leavers are essential for sound economic development. The national in-service teacher training programme can reverse currently dismal school results. Active learning in the classroom will improve student-teacher relations and motivate more students to complete their education.

• Working with partners, a substantial increase in funding must be made available for primary and secondary education especially for teacher training, teacher salaries and incentives, for more textbooks, school buildings and non-formal education.
• School results can improve through support for the national in-service teacher training programme. This will introduce more active child-centred teaching and learning methods and reduce over-crowded classrooms. Incentives should be provided to teachers working in difficult or remote areas.
• The quality of education can further improve by introducing annual inspection for all schools. Accountability of head teachers and teachers should include attendance, completion, performance and the adoption of child-centred teaching methods. These issues should be tracked through routine school monitoring.

Schools must be safe-havens for children. Too many experience fear, humiliation and beatings that undermine their ability to learn and leads many children to drop-out early. Integrating and expanding sport in schools can help reduce violence, and improve discipline, student-teacher relations and school attendance among other benefits.

• Protect children from violence in schools by passing and enforcing laws against school violence. Ensure those responsible for keeping children safe deliver on their promises and fulfill their duties.
• Support the establishment of student councils and elected student representation in school governance in primary and secondary schools. School councils enable students to participate in resolving conflicts, learn about and exercise their rights as well as their responsibilities to the school community.
• Make sure children have the opportunity to safely and confidentially report violence and abuse by other students and teachers. Ensure those responsible for violence and abuse including teachers and students are held accountable.
• Introduce sport into the school curriculum and into In-Service Teacher Training Programmes.

Important advances have been achieved in reducing HIV prevalence. Yet one in every ten new infections occurs in babies even though more than 90 per cent of these infections could be prevented. Girls are also much more vulnerable to HIV infection than boys. Every new infection in a teenager represents a failure to provide a young person with the necessary knowledge, information, skills and services that will enable them to protect themselves. Stigma and discrimination continues to undermine women’s access to services.

• Work with all partners to expand services and treatment that will virtually eliminate mother to child transmission of HIV by 2015. Ensure all children with HIV and AIDS get the treatment they need.
• Pledge significant resources to protect young people, especially adolescent girls, from HIV and AIDS by supporting the national HIV prevention programme.
• Support the establishment of youth-friendly health services and effective life-skills programmes that will inform and empower girls in particular and reduce their vulnerability to HIV and AIDS.

In 2010, over 6,000 girls dropped out of school due to pregnancy and the number seems to be growing every year. Early pregnancy endangers both the young mothers and their infants. Reducing pregnancy and ensuring the rights of all girls to education is vital in the fight against poverty.

• Help girls protect themselves by increasing their knowledge of reproductive health issues and high-risk behaviour. Ensure boys are also involved in programmes that aim to reduce teenage pregnancy
• Help to reduce poverty by ensuring schools support and implement the new guidelines that enable girls who have become mothers to continue their education.
• Expand vocational training for all out-of-school children. For girls this can help reduce poverty and the economic dependence that sometimes leads to high risk behaviour.

Sexual, physical and emotional violence is common for most children growing up in Tanzania. One in three girls and one in seven boys experience at least one incidence of sexual violence before turning eighteen. Rates of physical violence are higher, 72% of girls and 71% of boys experience being punched, whipped, kicked, or threatened with a weapon like a gun or knife at least once over their childhood. One quarter of all Tanzanian children are emotionally abused. The structures and systems to protect children from violence, abuse and exploitation are either weak, under resourced or non-existent in Tanzania.

• Invest in the development of a child protection system that addresses legal protection, behaviour change and social welfare. Ensure police, lawyers, judges, social workers, wardens etc. are well trained in the application of the Law of the Child. The public needs to understand their roles and responsibilities for child protection in their communities.
• Invest in services for children that will protect the most vulnerable including:

o Family-based support for children living in poverty that will help reduce exploitation of children in hazardous labour and commercial sex work and minimize institutionalization of children.

o Specialist services that are needed to both prevent and respond to child abuse. This includes sufficient qualified social workers and counselors which is essential to assist children who have experienced violence.

• All children must have birth certificates which protect their rights to vital services for children and help protect them from trafficking and exploitation.
• Ensure children in the justice system receive the special treatment they need and where appropriate, be diverted from the formal judicial process. Invest in alternative community-based prevention and rehabilitation of children who commit offenses and reduce custodial sentences. No child should be placed in prison with adults.
• Ensure regular and public release of data that exposes the situation of vulnerable children both through abuse and exploitation and in the criminal justice system
• Ensure children can participate in key decisions affecting their welfare including the transformation of the Baraza la Watoto into a national, registered and representative child-led organization.

The majority of children with disabilities are denied their right to education. Too many are locked away and kept in inhuman conditions.

• Urgently complete and enforce laws relating to persons with disabilities. Collaborate with partners to ensure appropriate budget allocation for implementation including the establishment of a coordination body on disability.
• Increase the availability of disability-specific services, including community based rehabilitation programmes, rehabilitation centres and specialised medical services, and trained staff so that all children with disabilities can access the necessary rehabilitative services and devices.
• Make sure that all programmes and services including schools, health services, transportation and communications, are accessible to and include persons with disabilities as both participants and beneficiaries.