Editorial by By Charles Makakala
President Samia Suluhu Hassan is on a three-day state visit to China at the invitation of her Chinese counterpart, Xi Jinping. The visit is intended to strengthen bilateral ties and finalise contracts between the two nations.
Coming shortly after President Xi’s re-election for the third term, the trip carries huge symbolic importance. The Tanzanian delegation has undoubtedly taken note of that.
Any visit to China by a leader from a developing nation is usually something to look forward to. The Chinese have perfected the art of diplomatic flattery, taking a page from the Soviets. Leaders are greeted with elaborate ceremonies and awarded dubious honours. Many of them succumb to such tricks, selling their people’s birthrights as a result.
Tanzanians have a reason to keep President Hassan in their prayers. A visit to China is a time of great trials for African officials. China’s hospitality comes at a price. This time around, the Chinese must have the multibillion-dollar Bagamoyo SEZ and Tazara SGR projects firmly in their sights.
Xi visited Tanzania barely a month after assuming office in 2013. With his emblematic Belt and Road Initiative (BRI) in mind, his goal was to secure Bagamoyo port for China. His priorities are unchanged: the port will connect eight African markets to China’s economy. It remains to be seen whether the Chinese conditions will be better than those Magufuli rejected.
Tanzanians will have a few things on their wish list as well. They have been quite adept at accumulating loans. And they are not done. They still need more funds for SGR, DART, and so on. The current cash crunch in China notwithstanding, China is still a solid bet for most of these projects.
But the Chinese are not just good at massaging people’s egos so that they can smoothly rip them off. They excel at so many other things. Lately, they specialise in producing “world’s firsts” and “world’s biggest” in many fields. As a result, a trip to China presents a marvellous opportunity to observe how serious others are about the business of development.
For example, the Chinese have built the most comprehensive high-speed railway network in the world. It can accommodate trains travelling at speeds of up to 430kph. The network not only helps to decongest cities by allowing people to live far from heavily crowded places, but also allows for investment in distant locations.
Tanzania is similarly making valiant efforts to improve its transport systems. However, its priorities are all over the place. One is often left wondering what the point of what is being implemented is. Ultimately, vast sums of money are squandered on pointless projects.
China is also constructing a network of canals to carry water from the wetter south to the dry north. When complete, the project will transport 12 trillion gallons of water to 45 million people living thousands of kilometres away. It is the most ambitious and costliest undertaking of its kind in the world.
On the other hand, Dar is reeling from yet another round of water rationing, once again blamed on Mother Nature. The depressing sights of women and children walking about with empty water buckets have returned. Worse still, Dawasa issued a timetable saying that water would be cut once per week, but it is now a sixth day since I last saw a drop of water from Dawasa.
This madness must end.
President Hassan and her delegation should stay in China longer to see how things are done if that means things will improve here. The Chinese are doers, not talkers; they are strategic, not pathetic. Tanzania might benefit from a few leaders like that.
But China was not always like this. Once upon a time, China was all talk and no walk. Its leaders, particularly Deng Xiaoping, had to instil an entirely new leadership mindset. Even when China was the fastest-growing economy in the world, Deng wanted it to do more. That prompted him to come out of retirement at the age of 87.
“All I see on TV are ceremonies—our leaders must think they’re TV stars,” he declared. “The meetings are excessive, the speeches are repetitive, no new ideas. We should give priority to deeds, not to words.”
Doesn’t this sound familiar? Nevertheless, the tours that Deng made turbocharged China. The decade that followed was unprecedented in Chinese economic history.
In The End of Poverty, Jeffrey Sachs captures what happened well:
“We arrived at night and drove for miles past campfires. Each of these was a building under construction. There was no crane in sight. The multi-storey buildings were going up by hand. I learned what a 9 percent growth rate means: an economy that is growing around the clock, making up for 550 years of lost time.”
On this side, doesn’t it feel like our leaders have conspired to lose those 550 years first before they get serious?
In 1978, Deng commissioned four study tours to Europe, Japan, and Hong Kong. The reports became the cornerstone of his economic policy. Deng asserted unequivocally that “we are backward, many of our ways of doing things are inappropriate, and we need to change”.
Common sense is the most valuable asset that any leader can possess.
Tanzania could use its own Deng Xiaoping. That is why I hope President Hassan will take her time in China. Probably a month or two. We could use a massive dose of Chinese economic pragmatism.
But just that, if you catch my drift.
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Inside Tanzania’s Life-Saving Birthcare Model
Tanzania is winning the battle against maternal and newborn deaths, as the latest numbers reveal a significant decline.
“Tanzania is committed to reducing maternal and newborn mortality and ensuring safe deliveries as part of the national development plan. The Safer Births Bundle of Care is one of the key strategies supporting this effort,” said Dr. Benjamin Kamala, the Senior Research Scientist at Haydom Lutheran Hospital and Principal Investigator for the program, leading its implementation across five regions in Tanzania.
A groundbreaking study published in the New England Journal of Medicine shows that the innovative health program in Tanzania – centered on regular, on-the-job training for healthcare workers – reduced maternal deaths by 75% and early newborn deaths by 40%. The three-year study, conducted across 30 high-burden healthcare facilities in Tanzania, tracked approximately 300,000 mother-baby pairs under the Safer Births Bundle of Care (SBBC) programme. The programme focuses on improving care for mothers and babies during the day of birth, the critical time when a woman goes into labor and delivers her baby.
Maternal health is a key focus of the United Nations Sustainable Development Goals (SDGs), specifically Target 3.1, which aims to reduce the global maternal mortality ratio to fewer than 70 deaths per 100,000 live births by 2030.
Tanzania’s program combines continuous, simulation-based training for frontline healthcare workers alongside innovative clinical tools to improve labour monitoring (fetal heart rate monitoring) and newborn resuscitation.It also uses data to drive ongoing improvements, ensuring that healthcare workers have the skills, confidence, and competence to manage birth-related complications for both mothers and newborns.
“We work closely with healthcare workers, equipping them with the necessary tools to improve the quality of care, ensuring they can effectively manage both mothers and babies during and after childbirth,” Dr. Kamala said, which helps them build on over a decade of innovative research and collaboration to improve care during childbirth.
“To give you a sense of the scale of the burden of maternal and newborn mortality in Tanzania when the Safer Births Bundles of Care program was in early development in 2015/16, there were around 556 maternal deaths per 100,000 live births and 25 neonatal deaths per 1,000 live births,” he said.
The published study demonstrates the “transformative impact” of the Safer Births Bundle of Care program conducted across 30 hospitals in five high-burden regions of Tanzania, where there were about 300,000 mother-baby pairs.
Maternal deaths at the start of the program were recorded at 240 per 100,000 live births, with postpartum hemorrhage and hypertensive disorders being the leading causes of death, he said. Over the 24-month study period, this number dropped to approximately 60 per 100,000 live births, representing a 75% reduction. The number of newborn deaths – which are primarily due to breathing difficulties and complications related to prematurity – declined by 40% – from 7 deaths per 1,000 live births to 4 deaths per 1,000 live births.
“These results are remarkable,” Dr. Kamala said.
According to Dr. Kamala, the 75% reduction in maternal deaths was not expected, and a key lesson was the important role of the in-situ team simulations – including for postpartum bleeding – with reflective debriefings that trained facilitators led.
“This seems to be a major part of the success of the program,” he said. “We are delighted by these results and hope that other countries adopt and scale the Safer Births Bundle of Care program… Beyond the numbers, the Safer Births Bundle of Care program has fostered a dramatic culture shift in our healthcare system,” he said. “Healthcare workers are now more confident and better equipped to handle birth-related complications for both mothers and babies.”
Maternal death drop
Dr. Kamala attributed the 60-70% reduction in newborn deaths in Geita and Manyara to several factors.
“Firstly, Manyara was the first site for implementation, giving the region more time to adapt and experience the impact of the program. Most importantly, both regions had a high burden of stillbirths and neonatal deaths, making them ideal targets for focused intervention. As a result, newborn deaths decreased by 60-70%, showcasing a clear positive impact on newborn survival,” he said.
Dr. Kamala said another possible explanation is the differences in the culture of practices, where some health facilities reported inaccurate data due to the fear of blame and shame. However, with the project’s implementation, reporting became more accurate after mplementation. Some regions, such as Tabora, reported an increase in the number of referrals to the study hospitals from other care centers after the program was implemented. These were more likely to be late admissions, which increase the likelihood of poor health outcomes, he said.
After the implementation of the program, there was a 40% decrease in newborn deaths within the first 24 hours after birth, according to the study.
Dr. Kamala said Tanzania’s remarkable progress in reducing maternal mortality by 80% is driven by strategic investments and innovative programs focused on improving maternal and child survival rates.
“Over 2,000 new healthcare facilities have been developed, free health services are being provided to expectant mothers and children under the age of five, and emergency obstetric care – including better transport to hospitals in rural areas are helping to ensure timely, life-saving interventions.
“Most importantly, the Ministry of Health works in collaboration with healthcare workers, hospitals, and development partners to strengthen the skills of frontline healthcare workers, which has been a key factor in driving this progress.
“Political leadership, alongside strategic partnerships and financing, has been crucial in driving progress in maternal and newborn health,” he said.
The program was made possible by the support of the Global Financing Facility for Women, Children, and Adolescents, Norad, UNICEF, and Laerdal Global Health, as well as the Ministry of Health and Haydom Lutheran Hospital. Their partnership and investment enabled the scaling of the Safer Births Bundle of Care to 30 hospitals and supported the research. “The government has now scaled the program to over 150 sites, and there are plans for further expansion to three regions this year and then nationally,” he said.
Dr. Kamala outlined key policy recommendations for other governments can adopt to prioritize maternal health.
“Firstly, it focuses on cost-effective and relatively simple interventions that are essential to preventing maternal and newborn deaths. For example, stronger primary healthcare that is delivered in the community and a well-trained healthcare workforce are also critical. Additionally, working in close collaboration with national, regional, and local health authorities is key.”
He said Tanzania’s approach, where the Safer Births Bundle of Care program was successfully scaled and sustained by aligning the initiative with national guidelines for obstetrical and newborn care. In addition, the creation of mentorship programs and regular supervision has helped to sustain the results.
Looking ahead
Tanzania now plans to expand to three new regions in 2025, followed by a nationwide rollout.
The success of the program has attracted interest from other countries, with Botswana, Ethiopia, Lesotho, and Namibia expressing interest in adapting the program to their healthcare system. In Nigeria, the program has already been launched in two states, Gombe and Borno, marking a significant step in its scaling.
Source: allafrica.com
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