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Thursday, April 19, 2018

SUMMARY OF THE BUDGET SPEECH FOR THE FINANCIAL YEAR 2018/19 DELIVERED BY THE MINISTER OF HEALTH, COMMUNITY DEVELOPMENT, GENDER, ELDERLY AND CHILDREN, HONOURABLE UMMY A. MWALIMU (MP)









SUMMARY OF THE BUDGET SPEECH FOR THE FINANCIAL YEAR 2018/19 DELIVERED BY THE MINISTER OF HEALTH, COMMUNITY DEVELOPMENT, GENDER, ELDERLY AND CHILDREN, HONOURABLE UMMY A. MWALIMU (MP)

A. INTRODUCTION

1.          Honourable Speaker, following the report tabled by the Chairperson of the Parliamentary Standing Committee for Social and Community Development, which reviewed the budget of the Ministry of Health, Community Development, Gender, Elderly and Children, I now request your Parliament to receive and discuss the Ministry’s implementation report as well as the Ministry’s priorities for 2018/19. I would also like to request your esteemed House of Parliament, to accept and approve the estimated recurrent and development expenditures for the Ministry of Health, Community Development, Gender, Elderly and Children for 2018/19.

2.          Honourable Speaker, first and foremost I would like to first and foremost, to thank The Almighty God for giving me the privilege to address this parliament. I would like to take this opportunity to humbly thank His Excellency, Dr John Pombe Joseph Magufuli, the President of the United Republic of Tanzania for his strong leadership. His guidance has provided me with clear vision when undertaking my responsibilities on improving health and social welfare services for our country. In addition, I congratulate His Excellency President for his continued support on prioritizing the health sector particularly by giving emphasis to construct local pharmaceutical industries. His Excellence emphasis will lead to the Tanzanians health improvement as an important means to reach middle-income country.

3.          Honourable Speaker, I would like to extend my sincere gratitude to the Honourable Samia Suluhu Hassan, the Vice President of the United Republic of Tanzania for being a champion of health services improvement especially in the efforts to fight Tuberculosis, Maternal and Child Health, Non-Communicable diseases and Adolescent Health.   My Ministry will continue to use her advice, influence and experience to ensure a healthy population that is free of preventable diseases.
4.          Honourable Speaker, I would like to take this opportunity to thank Honourable Kassim Majaliwa (MP), the Prime Minister of the United Republic of Tanzania for his exemplary leadership that has contributed to improved government performance and hence improved health services provided by the Ministry. I would like to applaud him for his speech, which has provided us with a vision on how the Government will implement its obligations in 2018/19.
5.          Honourable Speaker, I would like to congratulate you in person for undertaking your duties diligently in leading the National Assembly of the United Republic of Tanzania. I would like as well to congratulate Honourable Dr Tulia Ackson Mwansasu (MP) for undertaking her duties meticulously. I also congratulate all the Chairs of the Parliament for managing well the discussion in the National Assembly.

6.          Honourable Speaker, I would like to take this opportunity to extend my sincere gratitude to the Parliamentary Standing Committee for Social Development and Services under the adept leadership of the Chairperson Honourable Peter Joseph Serukamba, (MP) and the Vice Chairperson Honourable Juma Nkamia (MP) for the guidance during the preparation of this budget. I also thank all Honourable Members of Parliament for your advice and cooperation that aim to improve health services and social welfare. Thank you very much. I promise that the Ministry will earnestly take your recommendations given in the implementation of our duties to serve the Tanzanians.

7.          Honourable Speaker, please accept my sympathy to all Tanzanians whom have lost their relatives and friends due to many reasons including illness, accident and natural disasters. I sympathize with those admitted in hospitals and in their households and also to the survivors of abuse and gender based violence. I pray to our Almighty God to give them a quick recovery so that they can continue with their responsibilities of building our Nation towards Industrialization.
8.          Honourable Speaker, after the above introductory remarks, I would now like to present to your esteemed House of Parliament the progress of activities implemented in the 2017/18 financial year, priorities for the year 2018/19 together with funding request that will allow the implementation of the Ministry’s obligations for year 2018/19.

B:      THE REVIEW OF BUDGET IMPLEMENTATION AND DEVELOPMENT PLAN FOR THE YEAR 2016/17 FINANCIAL YEAR

9.          Honourable Speaker, the Ministry has continued to undertake its mandate as guided by the national and international Policies, Strategies and Plans, which include the Sustainable Development Goals (2015-2030), National Development Vision 2025, the Five Years Development Plan (2016/2017 – 2020/2021), Ruling Party (“Chama Cha Mapinduzi”) Manifesto (2015-2020), Health Policy (2007), Health Sector Strategic Plan IV (2015 – 2020), and agreed priority milestones in Joint Annual Health Sector Review (JAHSR), National Elderly Policy (2003), Social Development Policy (1996), Child Development Policy (2008), Women and Gender Development Policy (2000), Non-Governmental Organization National Policy (2001).
10.      Honourable Speaker, In 2017/18 through vote 52, my Ministry in collaboration with other Ministries, Departments and Agencies and Development Partners planned to implement the following priorities in order to improve the provision of health services
a.    Strengthen Preventive, Curative and improve equity on service delivery,
b.   Strengthen Reproductive, Maternal, Newborn and Child Health in order to reduce maternal and child mortality,
c.    Improve availability of medicine, medical equipment, reagents and vaccines in health facilities,
d.   Improve Health Training Institutions infrastructure with the aim of increasing availability of Human Resource for Health,
e.    Strengthen country’s medical specialized services through construction, expansion, rehabilitation of infrastructure including health equipment installation at Muhimbili National Hospital (MNH), Muhimbili Orthopaedic Institute (MOI), Jakaya Kikwete Cardiac Institute (JKCI), Benjamin Mkapa Hospital (BMH), Ocean Road Cancer Institute (ORCI), Mirembe and Kibong’oto Specialized Hospitals, Bugando, KCMC, Mbeya and Mtwara Zonal Referral Hospitals,
f.     Improve Public Private Partnership in health service delivery provision
g.   Improve availability of nutritional services at community level and health facilities,
h.   Improve use of Information, Communication and Technology in strengthening health services provision
i.     Sensitize citizens enrolment to Health Insurance with the aim to ensure all citizens get quality health services
11.      Honourable Speaker, through Vote 53, the Ministry planned to implement the following interventions:
a)   To coordinate implementation and monitoring of the National Plan of Action to End Violence Against Women and Children  (2017/18 - 2021/22);
b)   To strengthen accessibility of rights, development and welfare of the child including children in conflict with the law;
c)   To facilitate destitutes elderly and most vulnerable children to acquire basic services;
d)   To sensitize community to build self-help spirit to participate in development;
e)   To educate community especially women to initiate and join various economic groups including SACCOS and VICOBA;
f)    To facilitate provision of social welfare services in elderly homes, retention homes, Approved School and National Children Home Kurasini; and
g)   To improve teaching and learning environment in Community Development  Training and Social Welfare Institutes.



REVENUE AND EXPENDITURE -VOTE 52
12.      Honourable Speaker, sources of revenue in vote 52 of my Ministry include income from revenue collection from Health Facilities, various Agencies, Boards and Councils that are under the Ministry, fees from Health Training Institutions, imprests retirements, sales of receipt books, sales of tender documents and collections from the services rendered by the Institutions and Agencies under the Ministry. Up to March 2018, the Ministry and its agencies collected TZS 162,891,572,942.00, which is equivalent to 72% of TZS 227,041,160,573.00 as estimated target for 2017/18. These achievements were contributed by: use of banks when making payments for health services, revenue collection sensitization, introduction of effective control mechanisms, improved working morale, strengthened health insurance services and improved use of Information, Communication and Technology in managing collection.
13.      Honourable Speaker, during the financial year 2017/18, a total of TZS 1,077,701,892,000.00 was approved by your Parliament as budget to implement various activities.  From the total approved budget, TZS 291,895,940,000.00 equivalent to 27 of the total budget was allocated for Recurrent Expenditure, whereas TZS 785,805,952,000.00 was allocated for Development Expenditure.
14.      Honourable Speaker, Up to March 2018, the Ministry had received a total of TZS 617,507,623,167.00, which is 57 percent of the approved budget. Out of the received amount, TZS 216,736,325,825,824 equivalent to 74 percent was for Recurrent Expenditure. Out of the received amount for recurrent expenditure, TZS 68,814,900,939, which is equivalent to 73.3 % of allocated budget, was for Other Charges and TZS 147,921,424,885.00 equivalent to 26.7 percent was for Personnel Emolument. In addition, the Ministry received TZS 22,500,000,000 for goods and services and abroad treatment payment.
Up to March 2018, the Ministry received TZS 400,771,297,343.00 equivalent to 51 of the approved budget for development. Out of the received budget for development, TZS 79,756,079,206 equivalent to 24 percent was from domestic sources and TZS 321,015,218,137.12 equivalent to 71 percent was received as External Financing. In addition, the Ministry received TZS 82,515,009,463.82 and send these funds to PO-RALG to refurbish health facilities in order to provide Comprehensive Emergency Obstetrics, Neonatal and Children Care (CEmONC). Out of funds sent to PO-RALG, TZS 63,015,009,462.82 was received from the World Bank and TZS 19,500,000,000.00 was received from the Health Basket Fund.
Revenue and Expenditure – Vote 53

15.      Honourable Speaker, in the year 2017/18, the Ministry through Vote 53 projected to collect a total of Shs. 2,101,874,000.00 as revenue from tuition fees payable by students enrolled in eight Community Development Training Institutes (CDTIs) namely: Buhare, Uyole, Rungemba, Mlale, Misungwi, Ruaha, Mabughai and Monduli; selling of tender document; and NGOs registration fees. Up to 31st March 2018, revenue amounting to Shs. 1,775,466,155, which is equivalent to 84 percent of the projected amount, was collected.

16.      Honourable Speaker, in the year 2017/18, a total of Shs. 37,909,880,000 has been approved for the Ministry (Vote 53). Out of that Shs.19, 142,252,240 were for Personnel Emolument (PE), Shs. 16,161,349,760 was for Other Charges (OC) and Shs. 2,606,278,000 was for Development Budget. Up to 31st March 2018, a total of Shs.18, 352,527,400 equivalents to 48 percent of the budget was released and spent. Out of that, Shs. 8,848,331,727 equivalent to 55 percent was for OC, Shs. 8,470,927,127 equivalent to 44 percent was for Personnel Emolument (PE) for the Ministry and institutions under the Ministry; and Shs. 1,033,268,546 equivalent to 40 percent was for Development projects.
17.      Honourable Speaker, the progress made in the implementation of Ministry’s priorities from July 2017 to March 2018 is as follows:
IMPLEMENTATION OF RESPONSIBILITIES UNDER THE DEPARTMENT OF HEALTH
PREVENTIVE SERVICES
Immunization and Vaccine Development
18.      Honourable Speaker, In 2016/17, the Ministry provided stewardship in children immunization services in order to ensure the national and global targets are met. Data from January to December 2017 shows that 101.2 percent of children targeted for the essential immunization were vaccinated. In December 2017, the Government of Tanzania was congratulated for reaching the highest target of 97 percent of children immunization on pentavalent vaccine according to 2016 statistics. The Global target through the World Health Organization (WHO) is to reach 90 percent of children immunized with pentavalent vaccine. The WHO and development partners congratulated the Government of Tanzania for reaching the target and for getting third position in WHO Afro Region after Zambia which attained 99 percent followed by Rwanda that attained 98 percent.

19.      Honourable Speaker, Cervical Cancer is the leading cause of cancer thus led to high rates of deaths among women. Data from Ocean Road Cancer Institute in 2016/17 indicate that 32.8 percent of cancer incidence in the country is due to cervical cancer followed by breast cancer with the incidence of 12.9 percent. I am pleased to inform you that vaccination to girls aged 9 to 14 years can prevent cervical cancer. In 2017/18, the Government started to provide HPV vaccine to prevent cervical cancer. In 2018, the Government is immunizing HPV vaccine to all girls aged 14 due to the availability of the vaccine directly from the manufacturers. The Government targets to reach 616,734 girls with HPV vaccination by December 2018. The vaccination is safe and it is so far used in various African countries including Rwanda, Uganda, South Africa, Zambia and Lesotho. Through your Parliament, I urge parents and guardians with children to ensure girls with recommended age for HPV vaccination are immunized against cervical cancer.

Sanitation and Environmental Health

20.      Honourable Speaker, the Ministry has continued with the coordination of National Campaign of Sanitation and Environmental Health which is implemented by all councils in order to control disease outbreak particularly cholera. Activities for sanitation and environmental health are highlighted on paragraph 22 to 24 of budget speech.

21.      Honourable Speaker, the Ministry has continued with the efforts to control Cholera outbreak in the country. From July 2017 to March 2018, there were 4,508 cholera cases and 92 deaths were reported in Songwe, Dodoma, Ruvuma and Mbeya. I would like to urge Leaders from all regions to ensure efforts control of Cholera outbreak remains a permanent priority in all plans.

Reproductive, Maternal and Child Health

22.      Honourable Speaker, In the efforts to strengthen Reproductive, Maternal and Child Health, the Ministry has continued with the five years (2016 to 2020) implementation plan which aims to strengthen reproductive, maternal, child and adolescent health. In addition, the plan aims to reduce mortality due to maternal causes to 292 per 100,000 by 2020. In order to implement the plan, the Ministry will focus in three main areas: family planning services, antenatal care and obstetrics services.

23.       Honourable Speaker, Family planning services are essential in improving maternal and child health and also to reduce deaths related to maternal causes. From July 2017 to March 2018, the Ministry procured and distributed family planning commodities to health facilities. Family planning services was provided to 519,817 clients through outreach services and whereas 424,595 clients received the services from health facilities.



24.      Honourable Speaker, the availability of health services during pregnancy is important intervention to reduce maternal deaths since most complications can be prevented, diagnosed and treated provided pregnant women attend antenatal clinic and attended by skilled attendants within twelve weeks of pregnancy. In 2017/18, the Ministry continued to ensure that antenatal services are provided together with educating pregnant mothers the importance of attending antenatal clinic. By March 2018, data from health facilities indicate that 81.7 of pregnant women attended antenatal clinic at least once through the entire gestation period. The target is to reach 70 percent of pregnant women attending at least 4 times throughout the gestation period. I use this opportunity to emphasize to all pregnant women to attend antenatal clinic as advised by service providers.

25.      Honourable Speaker, In 2017/18, the Ministry in collaboration with development partners has continued to sensitize and emphasize pregnant women to deliver from health facilities. The aim is to ensure the number of women delivering from health facilities is increasing to 68.5 percent per month by March 2018 from 64 percent in 2015/16. I would like to emphasize that all pregnant women countrywide to deliver from health facilities in order to reduce maternal and child mortality and complications.

26.      Honourable Speaker, reduction of under five mortality is among the Ministry’s priorities. According to One Health Plan for Maternal and Child Health (2016-2020), by 2020, the Government is determined to reduce neonatal mortality to 16 from 21 per 1,000 live births, infant mortality ratio to 25 from 45 per 1,000 live births and under five mortality ration from to 40 from 54 per 1,000 live births.

27.      Honourable Speaker, the Ministry in collaboration with stakeholders has continued to improve infrastructure at health facilities to enable provision of Comprehensive Emergency, Obstetrics and Neonatal Care (CEmONC) to pregnant women. The Ministry in collaboration with PO-RALG is improving infrastructure to provide CEmONC services in 208 health facilities (as stated in the PO-RALG budget speech). By March 2018, infrastructure improvement was at different stage of implementation. This improvement is done in the following areas: operating theatres, maternity wards, health laboratory and staff houses. The number of public health facilities providing CEmONC services will increase to 283 out 527 facilities once the infrastructure improvement is completed,

28.      Honourable Speaker, My Ministry has continued with the efforts to control reproductive cancers including cervical cancer, breast cancer and prostate cancer. In order to ensure availability of diagnostic and curative services for early signs of cervical and breast cancer, the Ministry in collaboration with stakeholders has established 100 newly established facilities for early detection and treatment of cervical cancer in Mbeya, Mwanza, Songwe, Geita, Dodoma, Singida, Manayara, Arusha, Tanga, Lindi, Mtwara, Simiyu, Mara and Ruvuma.

HIV Control
29.      Honourable Speaker, From July to December 2017, 5,164,297 individuals were tested and received results of their HIV status. Among those tested, 145,104 equivalent to 2.8 percent were HIV positive and ARV’s was initiated to them. According to December 2017 statistics, there were 965,081 individuals on ARV’s which is 69 percent of 1,400,000 that are estimated to be living with HIV in which 55,034 equivalent to 5.7 percent are children. According to the above statistics, Tanzania is remained with 21 percent to reach the global target of 90 percent of individuals living with HIV to be initiated of ARV’s. The Ministry has put in place various mechanism to ensure the target is reached.

30.      Honourable Speaker, The Ministry has continued to provide services for Prevention of Mother to Child Transmission of HIV (PMTCT). By December 2017, a total of 1,967,260 equivalent to 98 percent of 1,993,639 pregnant women had HIV counselling and testing. Among those, 79,242 pregnant women equivalent to 4 percent were HIV positive. Among those tested positive, 79,240 pregnant mothers equivalent to 99.9 percent were initiated with ARV’s. The current status of Mother to Child Transmission of HIV is 4.9 percent compared to 12 percent in 2011.


Control of Tuberculosis and Leprosy

31.      Honourable Speaker, The Ministry is continuing with efforts to control Tuberculosis (TB) and Leprosy. From July 2017 to March 2018, the Government procured and distributed health commodities fro Tuberculosis and Leprosy. In order to ensure the Government improves Tuberculosis services to children, my Ministry launched a new TB treatment regimen for children. This new regimen is improved combined therapy (RHZ/RH), which has good taste of fruits and it dissolve easily in water thus no need to be broken down for correct dosage.

32.      Honourable Speaker, My Ministry has expanded diagnostic services for TB by using gene-Xpert machines. The machines are distributed to all district hospitals in order to increase diagnosis of TB cases. In 2017/18, the Government in collaboration with stakeholders procured and distributed 189 gene-Xpert machines compared to 66 machine that were in the country in 2015. These machines are distributed to all Zonal and Regional Referral hospitals, district hospitals and in some of large health centres. The technology in this machine allows the results to be obtained within two hours instead of 24 hours results from the microscope. In addition, the machines have the ability to diagnose multiple drug resistant TB.

33.      Honourable Speaker, Through the Government commitment to collaborate with the Private Sector in fighting against Tuberculosis particularly to increase diagnosis of TB cases from 40 to 70 by 2020, my Ministry distributed five (5) gene-Xpert machines to private hospitals in Dar es Salaam. The hospitals that received the machines in which each one costs TZS 38 million are Agakhan, Hubert Karuk, Regency Medical Centre, TMJ and Hindu Mandal. The Ministry distributed the machines in these Hospitals since they are seeing a large number of patients and also their willingness to diagnose and treat TB cases. In addition, this partnership aligns with the vision of our fifth phase government under the leadership of His Excellency Dr. John Pombe Magufuli, The President Of The United Republic of Tanzania of reaching every household with quality health services. Let me use this opportunity to congratulate the Private Sector for their participation to fight against TB in the country.

34.      Honourable Speaker, My Ministry has continued with the effort of increasing the provision of treatment of Multi Drug Resistant TB (MDR-TB). From July 2017 to March 2018, the Ministry increased 41 health facilities and makes a total of 63 health facilities that provide decentralized MDR-TB treatment services compared to only one-facility Kibong’oto Specialized services in 2015. The regions that provide decentralized MDR-TB include Dar es Salaam, Kagera, Geita, Mtwara, Lindi, Mbeya, Pwani, Morogoro, Tanga, Unguja, Tabora, Kigoma, Mwanza, Arusha, Rukwa and Simiyu. In addition, the Ministry has initiated short term MDR TB treatment regimen from twenty to nine months.

35.      Honourable Speaker, in the efforts to fight against Leprosy, the Ministry investigated Leprosy at the community level in six regions that have high incidence of Leprosy cases i.e. Geita (Chato), Lindi (Liwale), Mtwara (Nanyumbu), Morogoro (Kilombero) and Tanga (Mkinga and Muheza). In the exercise, 500 individuals were tested whereby 54 individuals equivalent to 10.8 percent were diagnosed with Leprosy and were initiated treatment, and approximately 300 individuals were given preventive treatment.

Malaria Control
36.      Honourable Speaker, Malaria has continued to be the leading cause of mortality. From January to December 2017, statistics indicates that 5,592,844 individuals had malaria where 4,421 died from the disease. In order to reduce malaria cases, the Ministry has continued with the implementation of various interventions to fight against the disease. These interventions include procurement and distribution of medicines, medical equipment and reagents in health facilities. In order to prevent malaria transmission particularly in special groups i.e. pregnant women and children, the Government distributed 4,726,763 long lasting insecticide nets at no cost through school children and in antenatal and children clinics.

37.      Honourable Speaker, In the implementing the directive from President of the United Republic of Tanzania, Hon Dr. John Pombe Magufuli of eliminating malaria by using larvicide, the Ministry in collaboration with PO-RALG has coordinated the distribution of 236,420 liters of biolarvicide in all councils. The implementation of this intervention is on different stages at council level.

Control of Neglected Tropical Diseases

38.      Honourable Speaker, Through the implementation of various interventions mentioned from paragraph 48 to 49 of budget speech, 93 councils have succeeded to reduce transmission of filariasis and elephantiasis thus being removed from the list of councils participating in preventive exercise according to WHO guideline. This is a great achievement where approximate 20,446,532 are not at a risk to get transmission of those diseases.

Nutrition Services

39.      Honourable Speaker, In the fight against malnutrition in children, my Ministry in collaboration with nutrition stakeholders has provided vitamin A drops to children from six months to five years together with deworming of children from one to five years. In addition, the Ministry has continued to treat malnourished children by increasing the number of health facilities providing malnutrition treatment, improving infrastructure in facilities admitting malnutrition cases, strengthening system to improve availability of food, medicines and equipment to diagnose nutritional status and capacity building to service providers.

Health Promotion

40.      Honourable Speaker the Ministry has continued with health promotion and sensitization to community on prevention and undertaking periodic health checks in order to maintain good health. The Ministry through Health Education Unit has developed communication strategy, which will enable quick response in case of emergency or disease outbreaks. Capacity building has been provided to Regional Health Management Teams that are bordering other countries.

CURATIVE SERVICES
Registration of health care facilities
41.      Honourable Speaker, the Ministry continued to ensure availability of health services through public, private and faith based owned health facilities. By March 2018, there were a total of 7,437 health care facilities compared to 7,284 in June 2017. Further, in the period from July 2017 to March 2018, a total of 153 private health facilities were registered.

Improving the Provision of Specialised Services
42.      Honourable Speaker, in year 2017/18, among the priorities of the Ministry included improving and strengthening provision of specialised services to reduce referrals abroad and cost associated with it. By March 2018, number of patients that were referred abroad for treatment was 103 compared to 304 patients in 2016/17. This is a result of improved specialized services in referral hospitals under the Ministry. A total of 1,090,863 patients were attended in MNH, MOI, JKCI, ORCI, BMH, Mirembe Mental Hospital, Kibong’oto Hospital, Mbeya Zonal Referral Hospital, KCMC and Bugando Medical Center. Details of patients attended is shown in Attachment Number 2 of the budget speech.

Muhimbili National Hospital (MNH)
43.      Honourable Speaker, in year 2017/18, MNH renovated the building and procured equipment for kidney transplant which started in November 2017. Five patients are planned to get renal transplant by April 2018. This has reduced renal transplant cost from an average of TZS 100 Million abroad to TZS 20 Million when it is done in the country.

44.      Honourable Speaker, the hospital has started cochlea implant transplant in which by March 2018, six patients received the service to improve hearing. The service is given at a cost of TZS 36 Million compared to TZS 80 to 100 Million when patients were referred abroad.

Muhimbili Orthopaedic Institute (MOI)
45.      Honourable Speaker, in February 2018, the institute managed for the first time to conduct laparoscopic spine surgery in collaboration with Doctors from BLK, India. The surgery that was very successful aimed also to build capacity of Doctors at MOI. Further, the institute finalized phase 3 expansion and procurement of equipment using TZS 16.5 Billion received end of financial year 2016/17. Implemented interventions are listed in paragraph 64 of the speech.

Jakaya Kikwete Cardiac Institute (JKCI)
46.      Honourable Speaker, the JKCI attended a total of 42,029 patients with cardiac problems. 111 patients underwent surgery of which 52 were adults and 59 children. Further 157 patients had cardiac catheterization surgery. The institute can now offer cardiac specialized services at 85 percent that were initially referred abroad. This has reduced Government cost to refer patients abroad in which by March 2018 only 12 cardiac patients were referred compared to 43 patients in 2016/17.

Ocean Road Cancer Institute (ORCI)
47.      Honourable Speaker, the Ministry continued to improve services for cancer patients in which the institute procured new radiotherapy equipment worthy TZS 473,363,437.50 This has improved number of patients receiving treatment per day from 30 to 70. The institute continue with installation of Linear Accelerator 2 and CT Simulator that were procured at cost of TZS 9.5 Billion. Once the installation is completed it will reduce patients’ treatment waiting time from 6 to 2 weeks and improve treatment outcome. In addition, 7 staff are in training abroad.

48.      Honourable Speaker, in year 2017/18, the institute has started private services with 4 VIP rooms and 20 private rooms. This will improve service and increase revenue.

Benjamin Mkapa Hospital - Dodoma
49.      Honourable Speaker, in improving provision of specialised services, on 22nd March 2018, the hospital in collaboration with TOKUSHIKAI Medical Group from Japan conducted renal transplant for the first time to 51 years old patient. The patient is doing well and has been discharged home. The hospital has established an ICU services. Availability of medicines has been at 95.2 percent for the period from July 2017 to March 2018.

Mirembe Mental Health Clinic
50.      Honourable Speaker, the Mirembe Mental Health Hospital and Isanga Institute have continued to provide services to mental health patients and availability of medicines have improved into 90 percent for essential mental health drugs.

Kibong’oto TB Referral Hospital
51.      Honourable Speaker, in year 2017/18, the hospital continued to provide diagnostic and treatment services for Tuberculosis, Multi Drug Resistant Tb, HIV and other infectious diseases. Further, the hospital has trained 239 (Medical Doctors, Nurses, Laboratory Technologists and Pharmacists) from different regions building capacity to initiate MDR-TB treatment.

Mbeya Zonal Referral Hospital
52.      Honourable Speaker, the hospital has continued to improve infrastructure for provision of specialized services as elaborated in paragraph 82 of the speech. Availability of medicines has been at 95 percent.

Bugando Medical Center (BMC)
53.      Honourable Speaker, the Lake Zone Referral Hospital, Bugando has continued to provide specialized services in 8 regions in West Lake Zone namely Mwanza, Geita, Mara, Kagera, Simiyu, Kigoma, Shinyanga, and Tabora. In the period from July 2017 to March 2018, the hospital conducted 72 surgeries for patients with large intestine and stomach cancers, Nose, Ear and Throat together with spine diseases. A total of 131 patients with cervical cancer received radiotherapy. In addition, the hospital procured a CT Scan (128 slice) at a cost of TZS 1.7 Billion from own source.

Northern Zone Referral Hospital (KCMC)
54.      Honourable Speaker, the hospital continued to improve provision of specialized services to people in northen regions of Kilimanjaro, Arusha, Manyar and Tanga. A total of 1,123 cancer patients were managed in which 47 received palliative care.

Regional Referral Hospitals

55.      Honourable Speaker, the oversight and coordination of Regional Referral hospital that were initially done by the PORALG has been shifted the Ministry. There are 28 Regional Referral Hospitals. In the period from July 2017 to March 2018, a total of 1,637,835 patients received treatment in these hospitals.

56.      Honourable Speaker, the Ministry has set long and short term targets to ensure that specialised services are provided in the Regional Referral Hospitals. These services include general surgery, Obstetrics and Gynaecology, Paediatrics and Child Health, Internal Medicine, Dentistry and Radiology.

Non-Communicable Diseases (NCDs)

57.      Honourable Speaker, I would like to inform your esteemed Parliament that there has been an increase in Non-Communicable Diseases in the country. Study done by NIMR in 2012 has shown that, 26 percent of Tanzanians have obesity, 26 percent have high levels of cholesterol, 9.1 percent have Diabetes Mellitus and 25.9 have Blood Pressure. In addition, the study showed that 25 percent of population participated in the study live sedentary life.

58.      Honourable Speaker, the Ministry has continued with the fight against NCD focus being prevention since Prevention is better than cure. Let me congratulate your esteemed parliament for establishing Parliamentarians Platform to fight against NCD in order improve their knowledge for prevention of NCD.

Blood Transfusion Services
59.      Honourable Speaker, The National Blood Transfusion Services (NBTS) has continued with the collection, storage and distribution of safe blood in health facilities. From July 2017 to March 2018, NBTS collected 233,953 bottles of safe blood, which is 101 percent of the target. I would like to use this forum, to thank all the individuals that donated blood. In addition, I would like to urge all Tanzanians to donate blood frequently in order to save patients lives particularly for pregnant women and under five children.

Availability of Medicines, Medical Equipment and Reagents

60.      Honourable speaker, My Ministry has continued to ensure medicines; medical equipment and reagents are available in health facilities. Availability of health commodities at MSD has continued to improve and reach an average of 81 percent availability of essential health commodities. In addition, availability of immunization health commodities is 92 percent whereas for ARVs commodities are 100 percent.

61.      Honourable speaker, The Ministry in collaboration with the Ministry of Industries and Trade called stakeholders meeting that aim to sensitize local entrepreneurs to construct pharmaceutical industries following the directive from Honourable Dr John Pombe Magufuli, the President of United Republic of Tanzania. A total of 430 stakeholder attended the meeting and 38 investors shoed interest to construct industries that will produce Intravenous Infusions, syringes, and health commodities consumables. The construction of local pharmaceutical industries will lead to financial savings by the government from foreign pharmaceutical procurement; In addition, this initiative will increase local pharmaceutical production from 6 percent and reduce pharmaceutical imports from 94 percent.




HEALTH SERVICE QUALITY ASSURANCE
62.      Honourable speaker, the Ministry has continued with Star Rating assessment. From July 2017 to March 2018, the Ministry conducted a second star rating reassessment of primary health facilities in 14 regions (Dar es Salaam, Iringa, Geita, Kagera, Katavi, Kigoma, Mara, Mwanza, Pwani, Tanga, Tabora, Singida, Simiyu and Shinyanga). The results of the reassessment show that, 446 facilities (4.7%) scored zero star and 749 facilities (19.4%) scored 1-4 star compared to the initial assessment of 2016 where 1,233 facilities (33%) of 3,713 facilities scored 0 star and 62 facilities (2%) scored 3 and above rating. These results show improved quality of health service delivery in primary health facilities where majority of the population are getting their services.

HUMAN RESOURCES FOR HEALTH
63.      Honourable Speaker, the Ministry in collaboration with National Council for Technical Education (NACTE) to ensure provision of quality training for the health care cadres not receiving degree. From July 2017 to March 2018, a total of 16,214 students were enrolled in public and private training health institutions in nursing, allied health and community health programs.
64.      Honourable Speaker, the Ministry in collaboration with various development partners continued to provide in service short and long term sponsorship to employees. From July 2017 to March 2018, 376 employees received local and abroad scholarships in Masters Program particularly specialized training in surgery, obstetrics and gynaecology, paediatrics, internal medicine and radiology.
65.      Honourable Speaker, In 2017/18, the Ministry received 3,152 employment permits from the Presidents Office – Public Service Management and Good Governance.
66.      Honourable Speaker, my Ministry has continued to improve working environment for public service employees particularly those working in hard to reach areas. From July 2017 to March 2018, the Ministry completed 30 staff houses in hard to reach areas of 3 councils (Manyara, Kiteto and Simanjiro) from the Global Fund Health Systems Strengthening (HSS) Program. The completed construction of these houses has increased the number of houses to 480 under the Global Fund HSS program.
HEALTH CARE FINANCING
67.      Honourable Speaker, the Government endeavours to ensure the targets for Universal Health Coverage (UHC) are reached. In order to reach UHC, each citizen is required to receive health services without financial hardship. The target is to ensure by 2020, 70 percent of the population are enrolled in Health Insurance Fund. Currently, 32 percent of the population is enrolled in various Insurance Funds. I would like to request Honourable Members of Parliament to continue to educate all citizens the importance of enrolling and pay for health insurance in order to get health services without any financial hardships.

68.      Honourable Speaker, the Ministry in collaboration with PO-RALG has started the implementation of transferring funds directly to the health facilities known as Direct Health Facility Financing (DHFF) instead of transferring funds to LGAs. This initiative aims to improve efficiency in funds utilization and improve effectiveness of health service coverage.

INFORMATION AND COMMUNICATION TECHNOLOGY

69.       Honourable Speaker, the Ministry continued to implement eHealth Strategy 2013-2018. In year 2017/18, the Ministry in collaboration with President’s Office Regional Administration and Local Government and Bill and Melinda Gates Foundation through PATH initiated Digital Health Investment Recommendation Roadmap. The Roadmap outlines priorities in in use of electronic systems aiming at improving health services at all levels of service provision and importance of data collection and correct use of data in health sector. In addition, the Ministry have installed electronic immunization information system in 1303 health care facilities in Arusha, Kilimanjaro, Tanga, Manyara and Dodoma regions. A total of 3,258 health care workers have been trained on how to use the system.

IMPLEMENTATION OF DEVELOPMENT PROJECTS FUNDED

70.       Honourable Speaker, in year 2017/18, the Ministry allocated TZS 785,805,952,000 for implementation of development projects. Out of these TZS 336,300,000,000 were from domestic sources while TZS 449,505,952,000 were from external sources.

Projects implemented with domestic resources
71.       Honourable Speaker, the Ministry received at total of TZS 74,756,079,206.00 (domestic resources) between July 2017 and March 2018 for implementation of development projects highlighted in paragraph 128 of the Budget Speech.

Projects implemented with external resources
72.       Honourable Speaker, in the period between July 2017 and March 2018, the Ministry received TZS 403,530,227,600.94 from external resources that included cash and medical commodities (medicines, equipment and reagents) as elaborated below:

Health Basket Fund
The Health Basket Fund funded implementation of interventions listed in paragraph 129 of the Speech.

Result Based Financing
73.       Honourable Speaker, from July 2017 to March 2018, the Ministry in collaboration with PORALG renovated a total of 1,325 public owned health facilities in Shinyanga, Mwanza, Coast, Tabora, Simiyu, Kigoma, Kagera and Geita regions. In addition, a total of TZS 3,425,162,919 was disbursed to Regional and Council Health Management Teams for service provision incentive payment at both levels.

Improving CEmONC services

74.       Honourable Speaker, one of the government priorities in the financial year 2017/18 is reducing maternal and neonatal mortality. The Government in collaboration with development partners have started infrastructure improvement plan to enable selected health centres to provide comprehensive emergency maternal, obstetric and neonatal care services. A total of 208 health centers will benefit using TZS 40,000,000,000.00 from World Bank, TZS 19,500,000,000.00 from Denmark. Funds were disbursed to district councils for implementation and the Ministry and PORALG are providing oversight. In addition, the Ministry in collaboration with PORALG is finalizing a list of additional 21 health centres that will be renovated using Health Basket Fund funds.

Global Fund to fight AIDS, TB and Malaria

75.      Honourable Speaker, from July 2017 to March 2018, the Ministry received from the Global Fund TZS 303,238,541,795.37 that includes cash and medical commodities for the fight against AIDS, Tuberculosis and Malaria.
THE BUDGET IMPLEMENTATION FOR INSTITUTIONS UNDER THE MINISTRY
Medical Stores Department (MSD)

76.       Honourable Speaker, in financial year 2017/18, the MSD continued to implement he government directive to procure directly from the manufacturers using Framework Agreement. Total of 110 manufacturers have contracts with the MSD, out of which 10 are local manufacturers. This arrangement has resulted into price reduction of 109 medicines by 40 percent. Further, the MSD has continued to improve its distribution in order to ensure constant availability of medicines at health care facilities by 100 percent. Through the GFATM support, a total of 181 fleets have been procured and His Excellence Dr John Pombe Magufuli, the President of the United Republic of Tanzania inaugurated on 26th March 2018.

National Health Insurance Fund (NHIF)

77.       Honourable Speaker, the NHIF continued to implement different strategies in order to increase members. As a result of implementing the strategies from July 2017 to March 2018, the Fund have managed to enrol 167,791 new members from both public and private sectors that is 97 percent of the target. The beneficiaries have therefore increased from 3,491,400 members in 2016/17 to 3,619,697 members in March 2018, which is seven percent of all Tanzanians. This shows that, members have increased at an average of 10 percent and beneficiaries have increased by 7 percent over a period of five years.

78.       Honourable Speaker, the Ministry in collaboration with PORALG and NHIF have continued to implement Community Health Fund (CHF). In the period from July 2017 to March 2018, new family enrolled into CHF was 66,026 and this making up a total of 2,096,692 families compared to 2,030,666 families that were recruited in year 2016/17. Further, beneficiaries have increased from 12,183,996 in 2016/17 to 12,580,149 beneficiaries in March 2018, which makes up a total of 25 percent of all Tanzanians.

79.       Honourable Speaker, in the period from July 2017 to March 2018, a total of 199,954 pregnant women and 20,998 children were enrolled in NHIF through Tumaini la Mama Initiative. This makes a total of 875,375 women who have benefited from 2012 in Mbeya, Tanga, Lindi, Mtwara and Songwe regions. In addition, paragraph 141 to 144 of the Speech describes other NHIF achievement during this financial year.

Tanzania Food and Drug Authority (TFDA)

80.       Honourable Speaker, the Ministry through TFDA is implementing a new five years strategic plan (2017/18 – 2021/22). The TFDA processed applications for registration of new product manufacturers/processors and outcome of the audit and inspection is shown in paragraph 146 and 147 of the budget speech. Further, the TFDA continued with community education through radio, television, newspapers and social media.
81.       Honourable Speaker, in year 2017/18, electronic registration system have been developed and in operation. This has reduced registration-processing time. In addition, the TFDA have successful put the information on registered products in the web site hence accessible through www.tfda.go.tz/portal/registered-products.

Government Chemist Laboratory Authority (GCLA)
82.       Honourable Speaker, in year 2017/18, the institution that was Government Chemist Laboratory Agency was changed to be Government Chemist Laboratory Authority through Act. No. 8 (2016). In order to improve its performance, the Authority has signed three contracts to procure laboratory equipment worthy TZS 1.4 Billion that are expected to be delivered before June 2018. In addition, renovation of the DNA laboratory at Headquarters in Dar es Salaam has started and completion is expected by June 2018.

Tanzania Food and Nutrition Centre (TFNC)

83.           Honourable Speaker, the TFNC continued to implement its mandate to improve provision of nutrition services in the country. In implementing the Government target to reduce infant mortality, the TFNC coordinated Vitamin A Mass Drug Administration to children aged 6 to 59 months together with drugs for intestinal helminths for children aged 12 to 59 months. Emphasis this time around was to regions that have not reached WHO proposed target of 90 percent.

National Institute for Medical Research (NIMR)

84.            Honourable Speaker, the Ministry through NIMR continued to conduct research. These include researches on HIV Vaccines trial, alternative medicines, mother and child health, malaria and Tuberculosis. Outcomes of these researches have helped in planning interventions for these diseases. Further, NIMR in collaboration with stakeholders have conducted an assessment on availability of safe water and clean environment in health facilities where delivery services are provided. Results of the study showed that, 19 percent of health facilities use unsafe water sources; 46.5 percent of the tested water had various bacteria; 42 percent of labour wards had no facility for hand washing and 10 percent had poor toilets which increase chances for contacting infection.

85.           Honourable Speaker, the Ministry is planning to work on the findings of the researches with aim of improving preventive services in collaboration with PORALG in order to ensure that local government authorities set aside budget to implement the reported weaknesses.
IMPLEMENTATION OF RESPONSIBILITIES UNDER COMMUNITY DEVELOPMENT

Women Empowerment
86.      Honourable Speaker, the Ministry in collaboration with the President’s Office – Regional Administration and Local Government Authorities (PO-RALG) has continued to coordinate implementation of the interventions under the Women Development Fund (WDF). In the year 2017/18, the Ministry continued to advocate and mobilize Local Government Authorities to ensure allocation of five percent of their revenues from own internal sources to WDF. From July 2017 to February 2018, a total of 170 out of 185 LGAs contributed Shs. 7.3 billion to the WDF compared to Shs. 8.9 billion for the 2016/17 allocations. The amount of funds contributed to the Women Development Fund in the year 2017/18 is equivalent to 26 percent of the planned total contributions of Shs. 28.3 billion in the corresponding year. In addition, the allocation benefited a total of 4,365 Women Groups with 39,449 women entrepreneurs through soft loans. I believe that by the end of June 2018 the contributions by LGAs to the WDF will increase to meet the target. I therefore, call upon District Executive Directors from all LGAs to contribute to the WDF as planned.

87.      Honourable Speaker, The Ministry in collaboration with Mtwara District Councils has empowered four women’s groups with 20 members on entrepreneurship skills and business management, record keeping, savings and repayment of loans. A total of Shs. 69 million from Ministry’s WDF was given directly to the women groups in Mtwara Region. The loans provided enabled them to construct two dams and to fence them for the purpose of fish farming, increase the areas for horticulture from four acres to eight acres and increase infrastructures/building for poultry farming.

88.      Honourable Speaker, during the year 2017/18, the Ministry in collaboration with PO-RALG coordinated sensitization of women to start and join income generating groups (SACCOS na VICOBA)  during pretesting of the implementation of the Sensitization Guideline for Women to Establish and Enrol in Economic Groups at Rombo District Council in Kilimanjaro and Mvomero District Council in Morogoro Regions. As a result of the sensitization, a total of 88 groups with a total of 1,807 (Female 1,517 and Male 1,807) were established. These groups have facilitated members to contribute and increase the capital to a total of Shs. 50 million and enabled them to invest in various business and income generating activities including farming and livestock keeping.

89.      Honourable Speaker, in the year 2017/18, the Ministry launched and coordinated implementation of the programme of Mentoring Groups. This programme aims at helping inexperienced women entrepreneurs by linking them with the experienced and beneficiaries of WDF and women’s economic groups which are performing well so that they can learn. The programme is being implemented in six Regions in Pwani, Kigoma, Songwe, Katavi, Rukwa and Mbeya. For the period of July 2017 to March 2018, a total of 30 Women entrepreneurship were linked to 25 groups which are performing well in these regions. Furthermore, through this programme, a total of 1,131 women has been trained in entrepreneurship and products improvement and linked with TFDA, TBS and SIDO for the purposes of getting assistance and advice on management of their business and products.

90.      Honourable Speaker, the Ministry in collaboration with different stakeholders; SIDO, EOTF and NEEC continued to facilitate involvement of women in International Trade Fair.  In the year 2017/18, a total of 1,183 Women Entrepreneurs from 26 Regions of Tanzania were enabled to participate in National Trade Fair (Nane nane), the participants managed to learn different skills for improving their products and obtain experience on market from other participants.

91.      Honourable Speaker, the Ministry through Tanzania Women’s Bank continued to provide financial services including soft loans with low interest rate and training in entrepreneurship especially to women in  7 Regions namely; Dar es Salaam, Mwanza, Dodoma, Iringa, Ruvuma, Njombe na Mbeya. In the year 2017/18, 6,237 Entrepreneurs (Female 5,097 and Male 1,140) have been given loan compared to 6,267 Entrepreneurs (Female 4,596 and Male 1,671) in the year 2016/17. These efforts enabled 87,063 Entrepreneurs (Female 71,744 and Male 15,319) to get loan from year 2010. In addiction, in the year 2017/18, the bank issued loans amounting to Shs. 10.1 billion compared to Shs. billion 13.3 in the year 2016.  The total amount of loan issued by the Bank since 2010 to March, 2018 amounts to Shs. 131.9 billion.

92.      Honourable Speaker, the Women’s Bank opened 244 credit centres for provision of soft loans and training to Women Entrepreneurs in Dar es Salaam (115), Mwanza (46), Dodoma (27), Mbeya (5), Iringa (9), Ruvuma (24) and Njombe (18) Regions in the year 2017/18 as compared to 88 credit centres opened in 2016/17 equivalent to 177 Percent increase. The Tanzania Women’s Bank also sensitized the communities on the importance of income saving through by opening savings bank accounts.  In the year 2017/18, a total of 10,415 (Female 7,811 and Male 2,604) were opened and by the end of March, 2018 accounts were opened in two branches of Tanzania Women’s Bank (Mkwepu and Mjasiriamali Branches) from year 2009. In these two branches, 65,419 accounts were women accounts equivalent to 74 Percent, 20,961 accounts were for men and 2,017 accounts were for Companies.

93.      Honourable Speaker, Gender based violence is still a challenge in the country. According to the Police Crime Report of 2017, incidents of gender-based violence were 41,416 in year 2017 compared to 31,996 incidents in year 2016.  In order to solve this problem the Ministry has been coordinating the implementation of National Plan of Action to end Violence Against Women and Children (2017/18 – 2021/22). The goal of this plan is to reduce the incidence of gender based violence in Tanzania by 50 percent in the year 2022. In the year 2017/18, the Ministry in collaboration with stakeholders has trained Women and Children Protection Committees in the Regions and Local Government on how to deal with Violence against Women and Children. In addition, a total of 52 Coordinators of women and children protection committee from Regional Secretariats have been trained to coordinate interventions on Gender Based Violence. Also Women and Children Committees from 19 Local Government Authorities of Kasulu (W), Kasulu (TC), Kibondo, Kakonko, Kibaha, Ludewa, Kaliua, Wanging’ombe, Rungwe, Kyela, Mbeya (DC), Kiteto, Mkuranga, Busega, Busenga, Dodoma (M), Uyui, Tabora (M) and Rufiji have been trained on protection of violence against women and children.

Community Development
94.      Honourable Speaker, The Ministry has continued encouraging communities to participate in development activities in their localities and getting them involved in development projects through labour contribution and use of locally available resources. In a period between July 2017 to March 2018, Ministry has conducted substantial sensitizations in 11 regions; Iringa, Dodoma, Mwanza, Pwani, Kigoma, Katavi, Rukwa, Songwe, Mbeya, Kagera and Shinyanga. Through that; construction of Mondo Health Centre, in Misungwi District (Mwanza) has been accomplished; construction of water dam Maghangu Mpwapwa (Dodoma) has been done; construction of Ufyambe Dispensary (Iringa); construction of Secondary School and Health Centre – Uvinza (Kigoma); construction of Secondary School and Health Centre – Mpanda (Katavi); construction of Health Centre –  Sumbawanga (Rukwa); construction of Health Centre – Mbozi (Songwe); construction of Secondary School – Mbeya Municipal (Mbeya) has been completed; cash contribution and facilities by local community for staff house construction responsible for Elderly Resident House (Kagera); launching of One Stop Centre for GBV and Child Abuse Kahama District (Shinyanga); construction of classrooms Chambasi Village, Kisarawe (Pwani). All these projects cost a total of 229,127,100 Tanzanian Shillings, out of which 112,341,250 Tanzanian Shillings equivalent to 49.03 percent is in kind community contribution and save part of the money that could initially be used for the projects. In addition, it has brought a sense of project ownership among community members and ensures sustainability.

95.      Honourable Speaker, In the year 2017/18, 175 community development experts from 26 regional secretariats and 184 from Local Authorities were capacitated on how to motivate communities to participate in country industrialization initiatives, implementation of National Plan of Action to End Violence Against Women and Children  (2017/18 - 2021/22) and on women economic empowerment particularly on production of agriculture, livestock and fisheries products that will then produce raw materials to feed micro and small industries in their respective areas.

96.      Honourable Speaker, Ministry has continued supervising and coordinating production of Community Development experts in its 8 Community Development Training Institutes (CDTIs) namely; Buhare, Mlale, Misungwi, Rungemba, Mabughai, Ruaha, Uyole and Monduli. These institutes are offering Community Development training in Certificate and Diploma levels. In 2017/18, a total of 1,588 students (984 females and 604 males) were admitted compared to 3,248 students (1,987 females and 1,261 males) admitted in 2016/17. Moreover, in 2017/18, a total of 3,320 students (1,947 females and 1,373 males) graduated in all 8 CDTIs compared to 3,694 graduands (2,228 females and 1,466 males) in 2016/17.

97.      Honourable Speaker, Ministry has reviewed curriculum for community development training to produce competent graduates to meet the existing labour market demand as well as the evolving science and technology. The reviewed curriculum will be used in 6 CDTIs of Buhare, Ruaha, Uyole, Mlale, Monduli and Rungemba. On the other hand, curriculum on Community Development and Civil Engineering was reviewed in 2016/17.

Non-Governmental Organizations
98.      Honourable Speaker, the Ministry have continued to coordinate Non Governmental Organizations through creation of enabling environment for NGOs to operate effectively and efficiently in bringing sustainable national development. From July 2017 to March 2018 a total of 192 NGO’s were registered. Out of the 21 NGOs were registered at International level, 162 National levels and 9 District level. This made up a total number of 8,211 NGO’s registered from 2005 to March 2018. These NGOs have contributed towards improving social services delivery in sectors of Health, Education, Water, Environment, Agriculture, Human rights, Good Governance, Gender Development, Livestock and Fisheries, Wildlife and Energy.

99.      Honourable Speaker, in ensuring that NGOs operates in accordance to laws, rules and regulations of the country, the Ministry conducted verification exercise of NGOs whereby 4,868 NGOs were verified. However, during the process the Ministry identified 513 NGOs that were registered under other legislations and incorporated them under the NGOs Act No. 24, 2002. The exercise has strengthened coordination of NGOs in the areas of transparency, information sharing and accountability.

Child Rights and Development
100.   Honourable Speaker, Violence against children is still a major problem in the country. According to the Crime and Traffic Incidents Statistics Report of 2017, the incidents of child abuse were 13,457 compared to 10,551 incidents in 2016, which is equivalent to an increase of 28 percent. We believe that the increase is due to the ongoing Parenting Education to families, which has been provided by the Government. The training has raised awareness to community to understand the importance of reporting incident of violence in the relevant authority. In addressing the problem, the Ministry in collaboration with stakeholders has continued to implement the National Plan of Action to End Violence Against Women and Children (2017/18 - 2021/22). In 2017/18, the activities implemented included to provide education on the impact of cultural and cultural practices such as Female Genital Mutilation, teenage pregnancy and early marriages in various group in communities. A total of 13,020 community members were provide education on the effects of harmful traditional practices; whereby 8,546 students, 476 teachers, 56 traditional leaders, 64 religious leaders, 38 “ngariba”, 168 bodaboda drivers, 3,600 parents/guardians and 72 community and local authority from Shinyanga, Mara, Tabora, Lindi, Dodoma, Tanga, Dar es Salaam and Katavi.

101.   Honourable Speaker, The Ministry in collaboration with the stakeholders has continued to provide care for victims of child abuse through the Child Help Line. In 2017/18, a total number of 18,464 calls were received about violence against children. Out of which 1,072 (female 621 and Male 451) children calls concerns were facilitated through access to different services (food, school supplies, legal services and health) compared to 441 children (female 325 and Male 96) who received the services in 2016/17 which is equivalent to an increase of 143 percent.

102.   Honourable Speaker, The Ministry has continued to take action to prevent child abuse by building the capacity of 1,192 caregivers of victims to violence on how to handle cases of children who has experienced violence. The service providers include: Regional Police Investigators, Regional Police, Military Police Officers, Community Development Officers, Social Welfare Officers and members of child protection teams from 15 Councils in 7 regions.

103.   Honourable Speaker, Girls have been experiencing various obstacles in achieving their goals including: teenage pregnancy and early marriages. According to the Maternal and Child Health Survey and Tanzania Malaria Indicators of 2015/16, teenage pregnancy is 27 percent. The leading regions are Katavi (45%), Tabora (43%), Dodoma (39%), Morogoro (39%) and Mara (37%). In dealing with child marriages and teenage pregnancies, the Ministry has launched a campaign to end teenage Pregnancy in primary and secondary schools “Mimi msichana najitambua Elimu ndio Mpango Mzima”: The campaign was launched during the commemoration of International Day of the Girl Child which was done in Tarime - Mara on 11/10/2017. The campaign aims at promoting awareness to girls in primary and secondary schools to focus on their education, self-awareness and reporting of any violations of their rights. In addition, 13,284 community members, (8,546) students, (476) teachers, (110) religious leaders, 90 traditional and influential leaders, (38) ngariba, (261) bodaboda drivers, (3,600) parents/guardians and (113) community and local authority leaders from Shinyanga, Tabora, Lindi, Dodoma, Dar es Salaam, Tanga, Mara and Katavi were given education about the effects of pregnancy and childhood.

104.   Honourable Speaker, in ensuring that children participate fully in their development issue, in 2017/18 the Ministry has continued to facilitate child participation in junior councils and girls' clubs that aimed at preventing teenage pregnancies and increase their participation in the development agenda. The total of 13 children's councils and 600 clubs in primary and secondary schools have been established for the period from July 2017 to March 2018, with a total of 1,669 councils and 2,000 clubs.



The Early Childhood, Care and Development Services
105.   Honourable Speaker, the Ministry continued to support and coordinated the provision of Early Childhood, Care and Development Services in the country for the year 2017/18 to children under 5 years in the Day Care Centres for both public and private owned. From July, 2017 to March, 2018 a total of 139 were registered and issued with licences as compared to 270 Day Care Centres registered and issued with licences in the year 2016/17. This makes a total of 1,046 Day Care Centres which have been registered in the country. Furthermore, a total of 6,075 children (girls 4,018 and boys 2,057) were registered in Day Care Centres in the year 2016/17 as compared to 4,450 children (girls 3,097 and boys 1,353) in the year 2015/16.

106.   Honourable Speaker, in order to ensure that the care givers provide required care and support to children registered in these day care centres, the Ministry trained a total 600 care givers from Municipalities of Ubungo, Temeke, Ilala and Kigamboni. Care givers were trained on early childhood care and development and the establishment and management of day care centres. In addition, the Ministry directed the owners of the Day Care Centres to recruit and deploy qualified care givers as per the government guidelines and directives. Up to March, 2018, a total of 1,882 care givers were deployed as compared to 1,652 care givers who were deployed in the year 2016/17 equivalent to an increase of 14 percent.

107.   Honourable Speaker, in the year 2017/18, the Ministry continued to produce experts on early childhood care and development through Kisangara Training Institute of Social Welfare. A total of 83 students were enrolled for certificate course of Early Childhood Care and Development (58 females and 25 males) compared to 56 students (females 39 and 17 males) who were enrolled during the year 2016/17. In additional, a total of 52 students (35 females and 17 males) graduated in the year 2017/18 compared to 8 female graduates in the year 2016/17.

Child Welfare Services
108.   Honourable Speaker, in the year 2017/18 the Ministry in collaboration with Civil Society Organizations (CSOs) continued to ensure that the Most Vulnerable Children access their basic care, support and protection services. A total of 6,132 Most Vulnerable Children (2,972 girls and 3,160 boys) received basic care, support and protection services from 157 children’s homes owned by both government and private owned children’s homes compared to 4,515 Most Vulnerable Children (2519 girls and 1,996 boys) in the year 2016/17. Out of the Most Vulnerable Children cared for in these homes, a total of 78 children (43 girls and 35 boys) are cared for in the National Children Home Kurasini. Furthermore, for the period of July, 2017 to March, 2018, a total of 14 licences were issued compared to 50 licences which were issued for the same period in the year 2016/17, this makes a total of 157 registered children’s homes in the country, including one national owned children home. The rest of these children’s homes are privately owned. I would like to take this opportunity to call upon all children’s home managers who have not registered their homes to do so immediately in their respective councils.

109.   Honourable Speaker, in the year 2017/18, the Ministry in collaboration with the Railway Children Africa (RCA) conducted assessment of the children living and working in streets in 12 councils namely Ilala, Kinondoni, Temeke, Kigamboni, Ubungo, Arusha, Iringa, Mbeya City, Mbeya DC, Dodoma DC, Nyamagana MC na Ilemela MC. A total number of 6,393 (1,528 girls and 4,865 boys) working and living on the streets were identified from December 2017 to January, 2018. Out of identified children, a total of 1,385 children (410 girls and 975 boys) were living and working in the streets during the night time. The Ministry is currently implementing the strategy (Community Based Rehabilitation Programme) to ensure that children living and working in the street are reunified with their families. Out of identified children, a total of 952 children (83 girls and 869 boys) have been reunified with their families.

110.   Honourable Speaker, The Ministry continued to ensure that children who are in conflict with the law, access basic rights including; legal services and education in five retention homes of Mbeya, Moshi, Tanga, Arusha and Dar es Salaam. In 2017/18, a total of 291 children in conflict with the law (13 females and 278 males) were facilitated with basic services such as food, shelter, clothes, medical services and education including legal services compared to 255 children (18 females and Me males) in 2016/17 equivalent to an increase of 14 percent. In addition, the Ministry in collaboration with Roman Catholic Church Arch Diocese of Dar es Salaam improved the infrustructure at Dar es Salaam  retention home by drilling the borehore well together with instalation of water tank with capacity of 10,000 litres.

111.   Honourable Speaker, the Ministry in collaboration with the Ministry of Constitution and Legal Affairs has diverted a total of 126 children (24 female and 102males) from the formal criminal system by rehabilitating their behaviour and reunifying them with their families compared with 72 children (8 female and 64 males) diverted in 2016/17 equivalent to an increase of 67 percent. Likewise, in 2017/18, the Ministry continued to provide basic needs (food, shelter, clothes and medical services) including rehabilitation of behaviour, education and training to 35 male children who committed  criminal offences residing at Irambo Approved School in Mbeya compared to 72 children in 2016/17. In 2017, Irambo Approved School ranked number one in National Standard VII Mock Examination at Mbeya DC and all children passed the Standard VII National Examination.

112.   Honourable Speaker, In 2017/18, the Ministry in collaboration with PORALG continued to ensure that children are cared at the family level according to the Law of the Child Act No. 21 of 2009 by providing foster care and adoption services. The Ministry facilitated the foster care services to 44 children (24 females and 20 males) compared to 54 children (21 female and 33 male) in 2016/17. Moreover, 17 children (8 males and 9 females) were adopted in 2017/18 compared to 21 children (11 female and 10 male) in 2016/17.

113.   Honourable Speaker, the Ministry continued to recruit Fit Persons in order to provide care, support and protection to most vulnerable children. This effort enabled the identification of 187 Fit Persons in 19 councils by 2017/18. Up to March, 2018, a total of 243  has been cared by Fit Persons in 19 councils which are; Magu DC, Kasulu DC, Kasulu TC, Musoma DC, Iringa MC, Iringa DC, Mufindi DC,  Njombe DC, Makete DC, Mbeya Jiji, Mbeya DC, Mbarali DC, Hai DC, Temeke DC, Arusha DC, Kakonko DC, Kibondo DC, Misenyi DC na Chunya DC. Fit Persons are selected by community members within the community to care for Most Vulnerable Children.

Elderly Welfare Services
114.   Honourable Speaker, the Ministry continued to coordinate accessibility of basic services to destitutes elderly. In 2017/18,  total of 517 destitutes elderly (Ke 250 na Me 267) cared  in 17 government elderly homes provided with basic services such as  - food, shelter, clothes and medical services compared to 465 destitutes elderly (221 female and 244 male) in 2016/17 equivalent to an increase of 11 percent. In addition, the Ministry continued to improve environment for provision of social welfare services at 17 gonernment owned erlderly by constructing the dormitory with the capacity to accommodate  20 destitutes elderly (10 female and 10 males) at Kolandoto elderly home and facilitate of 10 tri-motor cycle, kitchen utensils and first aid kits in all 17 elderly homes.

115.   Honourable Speaker, the Ministry in collaboration with PO-RALG has facilitated  506,943 elderly (female 220,312 and male 286,631) to acquire health identity cards for free medical services for the period of July, 2017 to March, 2018 compared to 74,590 elderly who acquired health identity cards in 2016/17. This effort makes a total of 581,533 elderly (female 254,793 and male 326,740) who acquired health identity cards which is 35 percent of 1,657,206 elderly identified in all Councils. Provision of health identity cards for free medical a service is a transitional stage towards acquire National Health Insurance Cards which will facilitate smooth accessibility of free Health services. In addition, during the commemoration of the International World Elderly Day held in Dodoma on 01/10/2017 whereby a total of 320 elderly undergone medical check up and advice.

Marriage Disputes Reconciliation and Maintenance to Children
116.   Honourable Speaker, in the year 2017/18 the Ministry through Marriage Reconciliation Board which is under the Commissioner for Social Welfare and Social Welfare Offices at the council levels has continued to provide reconciliation and counselling services to families. For the period of July, 2017 to March, 2018, a total of 13,382 marriage disputes were received and reconciliated in various councils and under the Commissioner Marriage Reconciliation Board compared to 8,454 marriage disputes in the year 2016/17. Out of marriage cases received, 11,326 cases equivalent to 85 percent were reconciliated, 1,397 equivalent to 10 percent were sent to court and 659 cases equivalent to 5 percent are still in progress.

117.   Honourable Speaker, in ensuring that children receive basic services from their parents, the Ministry continued to work on maintenance cases reported in the country. For the period of July, 2017 to March, 2018, a total of 11,815 maintenance cases were received. Out of received cases, a total of 4,965 maintenance cases were children in matrimonial and 5,708 were affiliation cases. In addition, out of maintenance cases received, 10,673 cases were closed and 1,142 cases were referred to court compared to 12,406 cases closed in 2016/17 (matrimonial cases 6,557, affiliation cases 4,133 and 1,716 cases refereed to court).

NATIONAL AND INTERNATIONAL COOPERATION
118.  Honourable Speaker, the Ministry in collaboration with PO-RALG and sectoral stakeholders will continue to commemorate various National and International Community and Social Welfare Services for the aim of sensitizing and convey message to the public. Some of those days are; Women, Children, Family, Elderly and Girl Child Days

IMPLEMENTATION OF RESPONSIBILITIES OF INSTITUTIONS UNDER COMMUNITY DEVELOPMENT 
Tengeru Institute of Community Development
119.   Honourable Speaker, in 2017/18, Tengeru Institute of Community Development registered a total of 1,169 students equivalent to 86 per cent increase compared to 628 students registered in 2016/17. Out of registered students, 486 were enrolled at Certificate level, 83 Diploma and 600 Bachelor Degree. Likewise, 684 students graduated in 2017/18 compared to 609 students graduated in 2016/17 which is 12 per cent increase.

120.   Honourable Speaker, Institute has conducted three major researches; Baseline Survey in Kikwe Village – Arumeru District, Vulnerability of Children in Informal Sector – Arumeru District (Children working on Public Markets) and Challenges Confronting Community Development Officers in Local Government Authorities.  Findings of these researches will improve trainings on community development as well as implementation of community development activities in Local Government Authorities (LGAs).

Institute of Social Welfare – Kijitonyama
121.   Honourable Speaker, the Institute of Social Welfare – Kijitonyama continued to offer social welfare training at certificate, diploma, bachelor’s degree, postgraduate diploma and master’s degree. In the year 2017/18, a total of 1,185 students (female 811 and male 374) were enrolled in different courses. Out of students enrolled, 421 students were enrolled at certificate level, 409 students at diploma level, 315 students at degree level, 28 students at postgraduate diploma level and 12 students at master’s degree level. In addition, a total of 1122 students (female 722 and male 400) graduated in the year 2016/17 in various levels and courses compared to 1,172 students (female 789 and male 383) graduated in the year 2015/16 with an increase of 4.2 percent.
C: THE MINISTRY’S PRIORITIES IN YEAR 2018/19
122.   117. Honourable Speaker, in year 2018/19, the Ministry through Vote 52 (Health Department) has set the following priorities in order to improve health care services in the country;
             i.        To strengthen immunization services for children to maintain the high coverage in order to prevent children from diseases that can be prevented with vaccination.
            ii.        To strengthen preventive services for diseases that are prevented through adhering to cleanliness regulations including clean environment such as diarrhoeal diseases.
           iii.        To strengthen preventive services against non-communicable diseases such as Cardiac diseases, Diabetes Mellitus and cancers through raising public awareness to prevent themselves from risk behaviour and build a habit to exercise regularly.
          iv.        To strengthen maternal and child health services in the country in order to reduce maternal and neonatal mortality through renovation of neonatal care units in seven Regional Referral Hospital and postnatal wards and ICU in five RRH in the regions with highest maternal mortality.
            v.        To reduce HIV/AIDS, TB and Malaria new infections.
          vi.        To improve availability of safe blood including construction of satellite blood banks.
         vii.        To improve availability of medicines, equipment and reagents in all public health facilities in the country.
        viii.        To strengthen availability of specialized services in RRH, Zonal Referral Hospitals and National Special Hospital.
          ix.        To improve quality of services provided in the public health facilities.
            x.        To improve health training institutions infrastructure in Nursing Training Institutions of Nachingwe, Kibondo, Kagemu, Kondoa, Same and Kiomboi; Clinical Officers Training Institutions of Tanga, Mpwapwa and Ngudu; Assistant Medical Officer Training Institutions of Kibaha and Tanga; Singida Laboratory Training Institution.
          xi.        To improve Informationa communication Technology in order to improve availability of data in health sector.
         xii.        To strengthen health financing system and increase coverage of pre-payment schemes towards universal health coverage-UHC.


123.   Honourable Speaker, to implement the highlighted priorities in Vote 52 for year 2018/19, the interventions are listed in paragraph 199 to 205 of the budget speech. However, I would like to mention high priority interventions below:
             i.        Procure and distribute children vaccines andHPV vaccines for girls between 9 and 14 years in which TZS 30 Billion is allocated.
            ii.        Scale up TB case identification countrywide. A total of TZS 5 Billion is allocated.
          iii.        Renovate and construct neonatal care units in seven RRH of Dar es Salaam, Katavi, Geita, Rukwa, Kilimanjaro, Iringa and Kigoma. A total of TZS 900 Million is allocated for this activity.
          iv.        To expand maternity ward and establish ICU in RRH in five regions of Mbeya, Shinyanga, Morogoro, Coast and Kigoma, TZS 1 Billion will be used.
           v.        To improve availability of safe blood through construction of Satellite Blood Banks in 12 regions of Manyara, Katavi, Rukwa, Ruvuma, Njombe, Tanga, Arusha, Coast, Singida, Songwe, Geita and Simiyu in which TZS 4.3 Billion is allocated.
          vi.        To procure and distribute Sulphadoxine+Pyrimethamine anti malaria for pregnant women and all other lifesaving medicines for pregnant women. A total of TZS 8.5 Billion is allocated.
         vii.        To procure and distribute beds, mattresses, bed sheets and delivery beds in which TZS 4.9 is allocated.
       viii.        To improve medicines, equipment and reagents availability. A total of TZS 270 Billion is set aside.
          ix.        To continue with renal transplant services at Muhimbili National Hospital and Benjamin Mkapa Hospital.
           x.        To continue with cochlear transplant services at MNH.
          xi.        To procure and install modern cancer diagnostic and treatment equipment at Ocean Road Cancer Institute in which TZS 14.5 Billion is allocated.
         xii.        To continue with construction of bunkers and procurement of radiotherapy equipment for Mbeya Zonal Referral Hospital.
       xiii.        To procure and distribute 27 ambulances in order to improve referral system in the country.
       xiv.        To renovate RRH in which a total of TZS 20 Billion is allocated.
        xv.        To continue with construction of RRH in regions with no RRH namely Simiyu, Katavi, Songwe, Mara and Njombe in which TZS 10 Billion is allocated.
       xvi.        To renovate health training institutions and a total of TZS 8 Billion is allocated.

MINISTRY’S PRIORITIES FOR THE YEAR 2018/19 -
VOTE 53

124.   Honourable Speaker, In the year 2018/19, Ministry through vote 53 will implement the following priorities:
(i)          Improve gender equality and women empowerment;
(ii)         Strengthen accessibility to the social welfare services and rights to elderly and children;
(iii)        Facilitate implementation of the National Plan of Action to end Violence Against Women and Children in order to reduce it by 50%.
(iv)        Improve teaching and learning environment at Tengeru Institute of Community Development and Institute of Social Welfare – Kijitonyama;
(v)         Improve buildings and infrastructure in Elderly Homes, National Children Home - Kurasini, Retention Homes and Approved School - Irambo;
(vi)        Enable friendly environment for NGOs to contribute in national development initiatives; and
(vii)       Sensitize community to build self-help spirit to participate in development.

125.  Honourable Speaker, In order to implement the priorities for the year 2018/19, the Ministry will implement the following activities:

Promoting Gender Equality and Women Empowerment

126.  Honourable Speaker, the Ministry will continue to implement various interventions in promoting gender equality and women empowerment by undertaking the following activities:
(i)      To coordinate sensitization of women to initiate and join various economic groups including SACCOS and VICOBA and link them with loans opportunities;
(ii)     To mainstream gender issues in the Policy, Plans and Sectoral Strategies; and
(iii)    To eliminate gender based violence especially against women by implementing the National Plan of Action to end Violence Against Women and Children (2017/2018 – 2021/22).

Community Development
127.  Honourable Speaker, in implementation of the priorities for 2018/19, the Ministry will do the following:
(i)      Continue to revive community self-esteem and morale on participating in implementation of development projects in their localities;
(ii)     Evaluate Community Development Policy of 1996; and
(iii)    Improve learning and teaching environment in Community Development Institutes.

Non-Government Organizations
128.   Honourable Speaker, The Ministry will continue to enhance enabling environment for NGOs effective participation in contributing towards social welfare and national development through implementing the following:
                     i.        Register Non-Governmental Organizations;
                    ii.        Monitor implementation of NGOs undertakings to ensure their contribution towards development and to comply with NGOs Act, No.24, 2002; and
                  iii.        Evaluate performance of the NGOs Policy of 2001.
Child Rights and Development
129.   Honourable Speaker, during the year 2018/19, the Ministry will continue implementing various measures/interventions to ensure that children obtain their rights by implementing the following:
(i)        Assessing the implementation of the Child Development Policy of 2008;
(ii)      Strengthening the status of the child's basic rights; Assessing the implementation of the 2008 Child Development Policy;
(iii)     Promote awareness of the community in protecting child rights, welfare of the development; with
(iv)     Continuing to implement the National Plan of Action to End violence Against Women and Children in 2017/18 - 2021/22.

Social Welfare Services
130.  Honourable Speaker, in the year 2018/19 the Ministry in collaboration with partners will continue to implement the following:
(i)  To facilitate rehabilitation of infrastructures at Mwanzage, Bukumbi and Misufini elderly homes;
(ii)    To complete construction of Mtwara Retention Home and rehabilitate Mbeya and Arusha Retention Homes;
(iii)  To strengthen child protection services;
(iv)  To facilitate the accessibility of early childhood care and development services;
(v)   To provide basic services to most vulnerable children and children in conflict with the law;
(vi)  To register homes for most vulnerable children
(vii)To improve the accessibility of rights and services to the destitute elderly.

Human Resource for Community and Social Welfare Sector
131.  Honourable Speaker, the Ministry will continue to oversee provision of community development and social welfare training at eight Community Development Training Institutes (CDTIs), Kisangara Institute of Social Welfare, Tengeru Institute of Community Development and Institute of Social Welfare – Kijitonyama. In the year 2018/19, the Ministry will implement the following activities:
     (i)        To enroll 6,848 students. Of whom 3,653 students will be enrolled at eight CDTIs, 50 students at Kisangara Institute of Social Welfare, 1,200 students at Tengeru Institute of Community Development and 1,945 students at Institute of Social Welfare – Kijitonyama;
    (ii)       To facilitate provision of on-job training to lecturers and tutors at Master’s and PhD levels;
   (iii)       To improve infrastructures at Mlale, Misungwi and Uyole CDTIs; and
  (iv)        To employ tutors and lecturers at CDTIs, Kisangara Institute of Social Welfare, Tengeru Institute of Community Development and Institute of Social Welfare – Kijitonyama.

ACKNOWLEDGEMENTS
132.   Honourable Speaker, I would like to take this opportunity to express my appreciation to Denmark, Canada, Ireland, Switzerland and South Korea together with UNICEF and World Bank for their contribution to the Health Basket Fund which has contributed largely in improving health services in the country. In addition, special thanks should go to WHO, GAVI and GFATM for their huge contribution in implementation of the health sector strategic plan. Further, I would like to thank China, Cuba, Spain, India, Italy, Japan, United States of America, Egypt, Sweden, United Kingdom, Germany and France that have continued to support the health sector through various modalities.
133.   Honourable Speaker, I would like to also thank all other International organizations for the support and collaboration to improve the health sector. They are all listed in paragraph 214 to 216 of the budget speech.

134.   Honourable Speaker, in my current role as a Minister, I have received great support from the management and employees of the Ministry of Health, Community Development, Gender, Elderly and Children. I would to thank Honourable Dr Faustine Ndungulile (MP), Deputy Minister of Health, Community Development, Gender, Elderly and Children for his collaboration in implementation of my responsibilities as a Minister. I also thank Dr Mpoki M. Ulisubisya, Permanent Secretary (Health) and Ms Sihaba Nkinga, Permanent Secretary (Community Development, Gender, Elderly and Children) for their contribution while executing my duties. In addition, I would like to thank Prof. Muhammad Bakari Kambi, the Chief Medical Officer, Commissioners, Directors and Head of Sections in the Ministry. My gratitude also goes to the Director of Muhimbili National Hospital, Prof. Lawrence Museru, Director of Muhimbili Orthopaedic Institute (MOI), Dr. Respicious Boniface Rwezimula; Directors of Jakaya Kikwete Heart Institute, Prof. Mohamed Janabi; Directors of Ocean Road Cancer Institute, Dr Julius Mwaiselage; Directors of Benjamin Mkapa Hospital, Dr Alphonce Chandika; Directors of Kibong’oto Special Hospital, Dr Riziki Kisonga; Directors of Mirembe Mental Health Hospital, Dr Erasmus Mndeme; Directors of Mbeya Zonal Referral Hospital, Dr Godlove Mbwanji; Directors of KCMC Zonal Referral Hospital, Dr Gilead Masenga. Directors of the Institutions under my Ministry, Regional and District Medical Officers, Medical Officers In charge in Hospitals, Health Centres and Dispensaries, Principals of Health Training Institutions which are under the Ministry and all the employees under the Ministry and Faith Based Organizations, Voluntary Organizations and Private Sector. I thank all other sectors that we collaborate with in providing health, community development and social welfare to all citizens for their collaboration. I urge them to continue focusing on the principals of quality services and work diligently for the benefit of our nation.

135.   Honourable Speaker, may I now express my sincere gratitude to my family for their love, patience and encouragement that have enabled me to implement my duties of serving the nation. I also take this opportunity to thank the people of Tanga region for their cooperation and commitment in developing our region. I would like to assure you that I will continue to serve you diligently in order to accelerate development in our region.


THE FUND REQUEST FOR THE IMPLEMENTATION OF PLANNED ACTIVITIES FOR THE YEAR 2017/18

Vote 52- Health

Revenue
136.   Honourable Speaker, for the year 2018/19, the Ministry has estimated to collect revenue amounting to TZS 240,042,508,157.00. From this amount the institutions under the Ministry will collect TZS 220,267,010,057.00 while TZS 19,775,498,100.00 will be collected from the Ministry’s Headquarters.

Recurrent Expenditure

137.   Honourable Speaker, for the year 2018/19, the Ministry estimates to use TZS 304,473,476,000.00 for recurrent expenditure. From this amount, TZS 88,465,756,000.00 will be used for Other Charges expenditure whereas TZS 216,007,720,000.00 will be used for Personnel Emolument expenditure.




Development Projects

138.   Honourable Speaker, for the year 2018/19, the Ministry estimates to use TZS 561,759,999,000.00 for the Development Projects. From this amount, the domestic source is TZS 184,956,999,000.00 whereas from external source is TZS 376,800,000,000.00.

The Total Budget estimates for 2018/19 in vote 52 is TZS 866,233,475,000.00

139.   Honourable Speaker, the total Budget that is requested for the Ministry for 2018/19, is TZS 898,374,124,000.00

140.    Honourable Speaker, The Ministry budget speech is also available at the Ministry of Health, Community Development, Gender, Elderly and Children Websites www.moh.go.tz and www.mcdgc.go.tz

141.   Honourable Speaker, I beg to Submit.




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