Spotlight on social services under Magufuli

Dar es Salaam. During his campaigns for presidency in 2015, Dr John Magufuli—now president—vowed to extricate low income earners from grips of poverty, pledging to ensure prompt provision of social services such as water, healthcare, and free elementary education.

He also promised to end land disputes.

It is three years now; how has he fared in delivering his promises?

Health

President Magufuli so far boasts an improved healthcare delivery system, which employs modern technology at major referral hospitals, reduced cases of patients’ referrals abroad, medical breakthroughs and grand plans for Universal Health Coverage (UHC).

During Magufuli’s three years in office, Tanzania has witnessed ‘firsts’ in healthcare. For the first time, a kidney transplant surgery was performed successfully at the country’s national referral hospital, Muhimbili.

But also, for the first time in 24 years, doctors were able to separate conjoined twins. The Muhimbili National Hospital executive director, Prof Lawrence Museru, has since told the media that the facility is laying ground work for liver transplant surgery.

Despite major milestones at referral hospital level, the Magufuli’s administration still faces an uphill task to extend healthcare services to low-income earners.

Until today, only 30 per cent of Tanzanians are on health insurance cover, the rest (70 per cent) have to dig deep into their pockets to access health services. The government has already announced plans to build more public health facilities across the country as it embarks on the process of extending healthcare to remote regions.

The minister he appointed to lead the Health, Community Development, Gender, Elderly and Children ministry, Ms Ummy Mwalimu, said recently that the government was striving to ensure that at least 70 per cent of Tanzanians access health insurance by 2020, the year when Dr Magufuli, is expected to seek re-election for another five-year term.

According to Ms Mwalimu, the government wants to introduce mandatory health insurance, however, a section of the Tanzanians believe that the system will be another form of taxation.

Since many health facilities lack adequate supplies of drugs, doctors and beds, insurance schemes struggle to demonstrate what they can offer the public.

A health advocacy Non-governmental Organisation, Sikika, believes that healthcare delivery improvement will require a well-established financial management system and timely disbursement of budgetary allocations.

In the 2018/19 financial year, the parliament endorsed a Sh898.3 billion budget for the health ministry with a focus on enhancing maternal and child health, improving availability of medicines across the country and preventing diseases.

However, the budget was lower than the Sh1.1 trillion budget for 2017/18.

Sikika director of programmes Patrick Kinemo says the budget allocations for medicines in the 2017/18 was Sh260 billion, but only Sh80 billion had been released until last month.

He says, however, that recent surveys have found remarkable improvement in the availability of tracer medicines in hospitals across the country.

Looking ahead, as Dr Magufuli continues with his tenure, concerted efforts are needed to curb maternal and new-born mortality and devise ways of dealing with Non-communicable Diseases (NCDs).

Land conflicts

When he came into office, President John Magufuli ordered the Minister for Lands, Housing and Human Settlements Development, Mr William Lukuvi, to lower the land title deed premium levy from 2.5 to 1 per cent, among others, in an effort to ensure that majority of the Tanzanians secure the important documents.

Following the development, the government has so far issued more than 53,000 land title deeds that have been used as collateral in various financial institutions.

The Minister recently said that delays in issuance of title deeds was among the leading causes of land disputes in the country.

Areas such as Kilosa and Kilombero districts in Morogoro Region, Kilindi and Handeni districts in Tanga Region, and Mbarali district in Mbeya Region are some of the places that have experienced land conflicts between farmers and pastoralists in recent years.

In addition, efforts to address land conflicts is gathering momentum as the government has so far surveyed and demarcated land in over 1,840 villages across the country, this is according to the director general of National Land Use Planning Commission (NLUPC).

Under President Magufuli, the government has intervened to end land disputes and therefore reduced the number of cases related to land conflicts, particularly, in Morogoro where frequent clashes were reported, according to the Regional Commissioner, Mr Steven Kebwe.

Education

Before President Magufuli took office, many families did not enrol their children in secondary school because they could not afford school fees and related expenses, which could have cost up Sh100,000 per year.

However, in the last three years, there has been a significant increase in enrolment after the president abolished school fees and “contributions.” According to the government, secondary school enrolment has significantly increased.

Education budget increased to Sh1.406 trillion in the 2018/19 financial year, which is about five per cent higher than the previous Sh1.337 trillion budget.

However, education stakeholders have been raising their voices high for the government to embark on reforming education policies, improving teachers’ working conditions and bridging the existing gaps in education provision.

The Human Rights Watch, in its report, called for renewed momentum by the Tanzanian government to urgently review existing policies that conflict with its obligation to guarantee the right to secondary education, free from discrimination and all forms of violence.

Water sector

In the last three years, the government under President Magufuli has been striving to implement various water projects, including soliciting funding to kick-start some of the water projects that had stalled.

However, the rate of water access still falls far below what the population demands with implementation of projects facing a myriad challenges, including insufficient funds. Parliamentary reports show that out of Sh623.6 billion allocated during the 2017/18 financial year, they received Sh350 billion only by March.

Water budget was among the hotly debated issues in the 2018/19 budget where the Mlimba Constituency Member of Parliament, Ms Susan Kiwanga, railed against the government for moving at a snail’s pace in implementing water projects in rural areas.

Reported by John Namkwahe, Herieth Makwetta and Syriacus Buguzi