79932 Tanzania SABER Country Report EARLY CHILDHOOD DEVELOPMENT 2012 Policy Goals Status 1. Establishing an Enabling Environment Laws to promote the health and nutrition of women and young children in Tanzania are strong but current policies do not promote preschool enrollment strongly. Once approved, the draft Early Childhood Development (ECD) policy will need to be costed and increase access to scale, particularly for preprimary school. 2. Implementing Widely The scope of programs in Tanzania is adequate to provide all stakeholders with the services they need, but some interventions are not at scale. Interventions to reach children age 0-3 could be improved and expanded. Coverage of essential ECD services has increased in Tanzania in recent years but significant gaps in access remain between regions, urban and rural areas and socioeconomic groups. 3. Monitoring and Assuring Quality Data are available in Tanzania for some important indicators, but not all. There is not a comprehensive system to monitor children’s development across sectors and financial information is particularly scarce. Standards for early learning have been recently established but compliance is not adequately enforced. THE WORLD BANK TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 This report presents an analysis of the Early Childhood Forum, held in February 2012, demonstrated Development (ECD) programs and policies that affect Government commitment to the ECD agenda in young children in Tanzania.1 This report is part of a Tanzania, with high-level Government officials joining series of reports prepared by the World Bank using the civil society, practitioners and development partners. SABER-ECD framework2 and includes analysis of early Despite this commitment, the drafted Integrated Early learning, health, nutrition and social and child Childhood Development Policy (IECDP) is awaiting protection policies and interventions in Tanzania, along approval by Parliament. with regional and international comparisons. Tanzania is home to 7.6 million children age 0-6. Child SABER – Early Childhood Development and infant mortality have declined significantly in the SABER – ECD collects, analyzes and disseminates last decade. Access to necessary health interventions comprehensive information on ECD policies around the is improving, but malaria continues to be the leading world. In each participating country, multi-sectoral killer of children and the HIV/AIDS epidemic has information is collected on ECD policies and programs orphaned nearly one million children. Currently, through a desk review of available government 34percent of all children age 5-6 attend preprimary documents, data and literature, and extensive school. Though primary school enrollment is nearly interviews with a range of ECD stakeholders, including universal, late entry to primary school (typically at age government officials, service providers, civil society, 8) and the quality of available education remain development partners and scholars. The SABER-ECD serious challenges. The significant resource framework presents a holistic and integrated constraints and quality control issues which affect the assessment of how the overall policy environment in a delivery of health and education services across the country affects young children’s development. This entire population impact efforts to promote ECD. assessment can be used to identify how countries Efforts to increase access to ECD services and improve address the same policy challenges related to ECD, with coordination amongst Government agencies are the ultimate goal of designing effective policies to ongoing. The Inaugural Tanzania Biennial National ECD support young children and their families. Snapshot of ECD Indicators in Tanzania with Regional Comparison Tanzania Ethiopia Kenya Uganda Infant Mortality (deaths per 1,000 live births) 50 68 55 63 Under-5 Mortality (deaths per 1,000 live births) 76 106 85 99 Moderate and Severe Stunting (under-5) 42% 51% 35% 38% Net Preprimary Enrollment Rate (36 to 59 months, 33% 4% 29% 14% 2009/2010) Birth registration 2000-2010 16% 7% 60% 21% ________________________________________ 1 This report analyzes ECD policy in Tanzania mainland and does not include analysis of policies in Zanzibar. 2 SABER-ECD is one domain within the World Bank initiative, Systems Approach to Better Education Results (SABER), which is designed to provide comparable and comprehensive assessments of country policies. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 2 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 Box 1: A checklist to consider how well ECD is promoted at the country level What should be in place at the country level to promote coordinated and integrated ECD interventions for young children and their families? (**This requires coordination and planning across sectors**) Healthcare • Standard health screenings for pregnant women • Skilled attendants at delivery • Childhood immunizations • Well-child visits Nutrition • Breastfeeding promotion • Salt iodization • Iron fortification Early Learning • Parenting programs (during pregnancy, after delivery and throughout early childhood) • High-quality childcare, especially for working parents • Free preprimary school (preferably at least two years with developmentally appropriate curriculum and classrooms, and quality assurance mechanisms) Social Protection • Services for orphans and vulnerable children • Policies to protect rights of children with special needs and promote their participation and access to ECD services • Financial transfer mechanisms or income supports to reach the most vulnerable families (could include cash transfers, social welfare, etc) Child Protection • Mandated birth registration • Job protection and breastfeeding breaks for new mothers • Specific provisions in judicial system for young children • Guaranteed paid parental leave of least six months • Domestic violence laws and enforcement • Tracking of child abuse (especially for young children) • Training for law enforcement officers in regards to the particular needs of young children Box 1 presents an abbreviated list of interventions and outcomes: Establishing an Enabling Environment, policies that the SABER-ECD approach looks for in Implementing Widely and Monitoring and Assuring countries when assessing the level of ECD policy Quality. Improving ECD requires an integrated approach development. This list is not exhaustive, but is meant to to address all three goals. As described in Figure 1, for provide an initial checklist for countries to consider the each policy goal, a series of policy levers are identified, key policies and interventions needed in key sectors. through which decision-makers can strengthen ECD.3 Strengthening ECD policies can be viewed as a Three Key Policy Goals to Promote Early continuum; as described in Table 1, countries can range from a latent to advanced level of development within Childhood Development the different policy levers and goals. SABER-ECD identifies three core policy goals that 3 countries should address to ensure optimal ECD These policy goals were identified based on evidence from impact evaluations, institutional analyses and a benchmarking exercise of top-performing systems. For further information see “Investing Early: What Policies Matter� (World Bank, forthcoming). SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 3 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 Figure 1: Three Core ECD Policy Goals Policy Goals Policy Levers Outcome Establishing  Legal Framework an Enabling  Intersectoral Coordination Environment  Finance Effective ECD policies All children have Implementing  Scope of Programs the opportunity Widely  Coverage  Equity to reach their full potential Monitoring  Data Availability and Assuring  Quality Standards  Compliance with Quality Standards Table 1: ECD Policy Goals and Levels of Development Level of Development ECD Policy Goal Latent ooo Emerging oo Established o Advance  Non-existent legal Minimal legal framework; Regulations in some Developed legal Establishing an framework; ad-hoc some programs with sectors; functioning inter- framework; robust inter- Enabling financing; low inter- sustained financing; some sectoral coordination; institutional coordination; Environment sectoral coordination. inter-sectoral sustained financing. sustained financing. coordination. Low coverage; pilot Coverage expanding but Near-universal coverage Universal coverage; programs in some gaps remain; programs in some sectors; comprehensive strategies Implementing sectors; high established in a few established programs in across sectors; integrated Widely inequality in access sectors; inequality in most sectors; low services for all, some and outcomes. access and outcomes. inequality in access. tailored and targeted. Minimal survey data Information on outcomes Information on outcomes Information on outcomes available; limited at national level; at national, regional and from national to individual Monitoring and standards for standards for services local levels; standards for levels; standards exist for provision of ECD exist in some sectors; no services exist for most all sectors; system in place Assuring Quality services; no system to monitor sectors; system in place to to regularly monitor and enforcement. compliance. regularly monitor enforce compliance. compliance. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 4 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 parents. These regulations are in accordance with The Policy Goal 1: Establishing an International Code of Marketing of Breast Milk Enabling Environment Substitutes, an international resolution intended to  Policy Levers: Legal serve as a minimum requirement for all countries to protect infants and young children. Framework • Intersectoral Coordination • Finance National laws and regulations do not adequately An Enabling Environment is the foundation for the promote early learning. According to law, all children design and implementation of effective ECD policies.4 are guaranteed access to two free years of preprimary An enabling environment consists of the following: the school in Tanzania, but attendance is not compulsory. existence of an adequate legal and regulatory By law, all public primary schools must have at least framework to support ECD; coordination within sectors one preprimary classroom which children may attend and across institutions to deliver services effectively; free of charge; severe shortages of preprimary and, sufficient fiscal resources with transparent and classrooms at the school level and fees levied, efficient allocation mechanisms. however, are a constraint to universal preprimary enrollment. This issue is further exacerbated by Policy Lever 1.1: increased demand, which has lead to further Legal Framework overcrowding of classrooms. There are no compulsory parenting education or support programs for parents, though elements of parenting education are The legal framework comprises all of the laws and incorporated into some health, nutrition and regulations which can affect the development of young community-based programs. children in a country. The laws and regulations which impact ECD are diverse due to the array of sectors which Though national laws and regulations mandate the influence ECD and because of the different provision of free healthcare for pregnant women and constituencies that ECD policy can and should target, young children, shortages and user fees at the service including pregnant women, young children and parents delivery level limit access. Young children in Tanzania and caregivers. are required to receive a complete course of immunizations. Young children are also required to National laws and regulations promote appropriate attend periodic well-child visits and a referral system is dietary consumption for pregnant women and young in place to ensure that children and their families can be children. The iodization of salt is mandatory in directed to additional services, as needed. Pregnant Tanzania. The fortification of staples with iron is also women are required to have health screenings for mandatory and is managed and monitored by the Iron sexually-transmitted diseases and to be tested for Deficiency Control Program and the Food Fortification HIV/AIDS. Officially, healthcare for pregnant women Program. The Food (Control of Quality) Marketing of and young children is provided free of charge; at the Breast Milk Substitutes and Designated Products service delivery level, however, patients are often Regulations (1994) regulates the marketing of all breast charged for treatment. milk substitutes and feeding supplies and promotes the dissemination of evidence-based information to ________________________________________ 4 Enabling Environment references: Brinkerhoff, 2009; Britto, Yoshikawa & Boller, 2011; Vargas-Baron, 2005. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 5 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 Table 2: Comparison of parental leave policies in East Africa Tanzania Kenya Ethiopia Uganda 84 days of paid maternity 90 days paid maternity A minimum of 90 days 60 days of maternity leave at 100% of salary leave at 100% salary for paid maternity leave at leave at 100% of salary; 4 for women; three days of women; two weeks of 100% salary for women; days of paternity leave at paternity leave for paternity leave for no paternity leave for 100% of salary fathers. fathers. fathers. National laws and regulations could be strengthened the national level, Remand and Children's Homes are to better promote opportunities for parents and managed through the Ministry of Health and Social caregivers to provide care to newborns and infants Welfare (MoHSW). At the local level, Social Welfare during their first year of life. Women are entitled to 84 Officers (through District Councils) make up Early days of maternity leave according to the Employment Protection Teams that are tasked with ensuring the and Labor Relations Act (Article 33). This applies to welfare of children. women employed in both the public and private sector. Men are entitled to three days of paternity leave (Article 34). Given the high levels of employment within Box 2: Key Laws and Regulations Governing the informal sector in Tanzania, the vast majority of ECD in Tanzania women do not, in reality, benefit from paid maternity • Tanzania ratified the UN Convention on the leave. The Employment and Labor Relations Act also Rights of Children in June 1992. provides pregnant women and new mothers with protection, mandating breaks for nursing mothers and • The Law of the Child Act, No. 21 (2009) preventing the dismissal of pregnant women. Table 2 guarantees children age 0-18 access to a presents information on parental leave policies in minimum of services in health, education, neighboring East African countries. nutrition and social protection. National laws and regulations promote child • The Child Development Policy (2008) protection and care for disadvantaged children. The • The Education and Training Policy registration of children at birth is mandatory in Tanzania • The Integrated Early Childhood Development and is overseen by the Registration Insolvency Policy (drafted 2010, awaiting approval) Trusteeship Agency (RITA) in the Ministry of Justice and Constitutional Affairs. The National Policy for Disability (2004) and The Education and Training Policy (2011) guarantee children with special needs access to inclusive education. The draft IECDP recognizes the Free temporary and long-term housing are provided for particular needs of children with special needs (Chapter abandoned children through Community-Based Care 2) and recognizes that the needs are multi-sectoral Support and Protection. This is included in the National (Chapter 8). Costed Plan of Action for MVC, The National Guidelines for the Establishment and Management of Children's The child welfare system in Tanzania covers children Homes and National Guidelines for the Provision and aged 0-18. In 2010, 779,250 children were enrolled in Management of Foster Parent and Adoption Services. the system, with 69,801 new cases entering in 2011. Specialized child advocates have been created as part of The number of children exiting the system is not the National Costed Plan of Action for MVCs. currently tracked. The Child Development Policy (2008) outlines provisions to provide the most vulnerable In 2009, the Government of Tanzania (GoT) launched the children (MVC) with ECD services; it is a national policy, first national survey of violence against children in the implemented at both the national and local level. At United Republic of Tanzania. It is a nationally SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 6 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 representative study of 3,739 young people aged 13 Tanzania. The responsibility for implementation and to 24. The study was designed to yield separate provision of ECD services is decentralized to the local estimates of experiences of sexual, physical and emotional violence experienced prior to turning 18. The study revealed that violence against children is a Box 3: Key Sectoral Policies with ECD Components serious problem in Tanzania: almost three-quarters of in Tanzania all children experienced physical violence and one- quarter experienced emotional violence. Nearly • The Primary Education Development three out of ten girls and one out of seven boys Programme II (2007-2011) experienced sexual violence. While the study did not • The National Road Map Strategic Plan to include specific details for levels of violence occurring Accelerate Reduction of Maternal, Newborn during a child’s earliest years, international research and Child Deaths in Tanzania (2008-2015) indicates that young children are particularly at risk for abuse. The detailed results of the survey have • The Tanzania Food and Nutrition Strategic Plan implications for policy planning in regards to social (2005/06-2009/10) and child protection and are currently being • The National Costed Plan of Action for Most considered by relevant GoT agencies and Vulnerable Children (2007-2010). stakeholders. Policy Lever 1.2: level to District Councils under the supervision of the Prime Minister’s Office – Regional and Local Intersectoral Coordination Government (PMO-RALG). Development in early childhood is a multi-dimensional There are national, costed plans within key social process.5 In order to meet children’s diverse needs sectors which include components of ECD service during the early years, government coordination is provision, including established coverage goals. essential, both horizontally across different sectors as Progress against established goals is monitored by well as vertically from the local to national levels. In the three relevant ministries: Ministry of Education many countries non-state actors (either domestic or and Vocational Training (MoEVT), the MoHSW and international) participate in ECD service delivery; for PMO-RALG. Results are reported in two key this reason, mechanisms to coordinate with non-state publications: The Basic Education Statistics Report actors are also essential. (BEST) and The Health Sector Performance Profile Report (HSPPR). These publications are available to Tanzania has a multisectoral ECD strategy that is still the general public and online. in draft form and has yet to be approved by Parliament. Tanzania’s ECD policy, the IECDP, was Tanzania has established an institutional anchor to drafted in 2010 after a multi-year consultative lead ECD policy and coordinate across sectors but process. It is a holistic policy which includes the the anchor does not seem to have the necessary sectors of education, health, nutrition and social and resources to fulfill its mandate. The Ministry of child protection. The IECDP is awaiting approval from Community Development, Gender and Children Parliament and, unfortunately, a costed (MCDGC) is the coordinating ministry for ECD in implementation plan cannot be developed until the Tanzania. Focal points have been established in other IECDP is approved. key ministries, including in: MoEVT, MoHSW, Ministry of Finance (MoF) and PMO-RALG. There is no ECD- With all social sector service provision, the central specific budget allocation or dedicated ECD staff Government is responsible for the design of policy in within the MCDGC. The infrequency of meetings and ________________________________________ 5 lack of progress to pass the IECDP and develop an Multi-dimensional process of ECD references: Naudeau implementation plan suggest that the MCDGC may et al., 2011; UNESCO-OREALC, 2004; Neuman, 2007. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 7 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 not have the resources necessary to fulfill its Network (AKDN), the Bernard Van Leer Foundation mandate and serve as a strong institutional anchor. (BVLF), Save the Children, Elma Philanthropies and the World Bank. In 2006, three national committees on ECD were established: The National Steering Committee, The The delivery of ECD services is somewhat integrated National Technical Committee and The National ECD at the sub-national level and at service delivery. Secretariat. As described in Figure 3 depicts the range of stakeholders involved in , these committees are tasked with: setting policies funding, managing, and monitoring ECD services in for ECD, establishing standards for service delivery, Tanzania. There are 113 districts in mainland Tanzania. In each district, district- and ward-level officials from monitoring access to ECD services and quality of ECD MoEVT are responsible for management and oversight services and playing a coordination role across of primary schools and associated preprimary schools. different entities and agencies. The Steering District representation for MoHSW is split between a Committee meets semi-annually to conduct business Health Officer and a Social Welfare Officer. The Health and the Technical Committee and ECD Secretariat Officer oversees health services provided in district meeting quarterly. When the Steering Committee hospitals, ward health clinics, and village health posts, approves a policy and/ or strategy, it is sent to the as well as services provided by volunteer health workers Cabinet Secretariat for approval. None of the at the community level. The Social Welfare Officer is committees produce periodic progress reports. In responsible for management and oversight of daycare addition to the formal mechanisms for coordination, centers (ECCE facilities for children prior to preprimary the ECD focal points within each ministry regularly school). A District Social Welfare Co(composed of communicate and this positive working relationship is officers from the district departments of MoEVT and noted by development partners as a key factor in the MoHSW) oversees implementation of health and social successful inter-sectoral coordination in Tanzania, welfare services in the district. At the ward level, the relative to neighboring countries. management structure includes the Ward Executive Officer (WEO), the Ward Education Coordinator (WEC), Mechanisms for collaboration between state and the Ward Health Coordinator (WHC) and the Ward non-state stakeholders exist. The Tanzania Early Community Development Officer (WCDO). Childhood Development Network (TECDEN) is a national umbrella organization for ECD in Tanzania, serving as All social sector service delivery in Tanzania is the official civil society representation for ECD service coordinated by PMO-RALG at the local level – this providers. TECDEN has network members in 14 out of institutional arrangement does ensure a degree of 30 regions in Tanzania mainland and Zanzibar. As intersectoral coordination at the level of ECD service described in Figure 2, TECDEN serves on the National delivery. PMO-RALG is, however, a relatively young ECD Secretariat as the civil society representative. Ministry, with some limitations in capacity. Efforts to design integrated interventions at the national level A group of development partners in Tanzania has could be improved. For example health workers formed an ECD Working Group (as described in Figure 2) currently deliver 17 core messages to new mothers and actively coordinates with the GoT on ECD matters. focused on key nutrition and health issues, such as This group originally came together to support the exclusive breastfeeding for the first six months and development of the IECDP and worked closely with the proper hygiene and care; messages on early GoT to finance and organize the Inaugural Biennial stimulation for young children could be more directly Tanzania ECD Forum, held in February 2012 in Arusha. incorporated into the core messaging. Key members of this group include: TECDEN, UNICEF, Children in Crossfire (CiC), Aga Khan Development SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 8 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 Figure 2: ECD Coordination at the national level in Tanzania LEAD MINISTRY ECD Policy at the National Level Ministry of Community Development, Gender Key Ministries and Children (MCDGC) Ministry of Education Prime Minister’s Office – Ministry of Health and Ministry of Social and Vocational Regional and Local Ministry of Finance Social Welfare Protection Training Government (MoF) (MoHSW) (MoSP) (MoEVT) (PMO-RALG) Development Three National ECD Committees Established Partners National ECD National ECD ECD Working National ECD Group Steering Technical Secretariat Committee Committee • Government representatives • MCDGC chair • Directors of key • Focal points from from National ECD • Permanent ministries MCDGC, MoHSW, Secretariat plus Secretaries of Key • Tasked with setting MoEVT, and TECDEN TECDEN, AKDN, Ministries (MCDGC, strategic direction of BVLF, WB, UNICEF, MoHSW, MoEVT) ECD initiatives ELMA, CiC and • Tasked with UNESCO. promoting intersectoal linkages Figure 3: Institutional arrangements across ministries from the national to local level Source: UNICEF: Evaluation of the UNICEF Early Childhood Development Programme with Focus on the Government of Netherlands Funding (2008-2010): United Republic of Tanzania Country Case Study Report (2011 SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 9 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 The burden of finance for ECD services is not Policy Lever 1.3: distributed evenly across various segments of society Finance and the cost of services remains a barrier to access. While preprimary school has officially been declared free, the government has made no resources available to While legal frameworks and inter-sectoral coordination are schools to expand coverage. Accordingly, even at many crucial to establishing an Enabling Environment for ECD, State schools, families are asked to pay fees and the adequate financial investment is key to ensure that number of children who can attend is severely constrained resources are available to implement policies and achieve by the number of places within existing classrooms. In service provision goals. Investments in ECD can yield high some schools, preprimary students are charged fees for public returns, but are often undersupplied without the following: personal school supplies, uniform, meals, government support. Investments during the early years transport, and medical services. Official data on the cost can yield greater returns than equivalent investments of these fees or variations between schools are not made later in a child’s life cycle and can lead to long- available. Enrollment in non-State preschools is increasing, lasting intergenerational benefits.6 Not only do indicating a willingness by parents to pay for preprimary investments in ECD generate high and persistent returns, education. they can also enhance the effectiveness of other social investments and help governments address multiple According to policy, pregnant women and young priorities with single investments. children should receive comprehensive free medical treatment, including for labor and delivery, The budget process for ECD allocations in Tanzania is immunizations, well-child visits, treatment for malaria, relatively transparent but information on specific diarrhea or pneumonia and HIV/AIDS related treatment. spending levels for ECD is not available consistently. Due to funding constraints, at the service delivery level, There is no national law or policy establishing a minimum many pregnant women and young children pay fees for level of funding for ECD and there are no mechanisms to consultations and for the cost of treatment. coordinate budgeting across ministries. Budgeting and information systems do not allow for an identification of The level of ECD finance is not adequate to meet the ECD-specific spending and it is not possible to disaggregate needs of the population It is difficult to quantify GoT spending for young children within sectors in a expenditures for ECD within sectors or in the aggregate, comprehensive manner. due to the way in which budgets are allocated and tracked. For example, the percentage of the education Explicit criteria are used to determine sub-national funding sector budget allocated to preprimary cannot be tracked. allocations within some sectors of ECD service provision. This funding is distributed through capitation grants to For example, funding for health worker salaries is primary schools, with no mechanism to monitor the determined by the size of the workforce at the sub- portion of each grant channeled towards preprimary national level; the formula for determining allocations for (anecdotal evidence suggests a nearly negligible amount recurrent finance items is: under-5 mortality (10 percent); of each capitation grant is allocated to preprimary at the total population (70 percent); number of poor residents school level). (10 percent); and, district medical vehicle route (10 percent). In the education sector, primary schools receive A large portion of the financing for social and child capitation grants (based on number of pupils served) and protection in Tanzania is provided by international are expected to finance preprimary school out of these development partners. The Government finances grants. There is not an explicit process for determining trained caregivers at the national level. Service funding allocations for nutrition at the sub-national level. providers at the district level are volunteers. In 2005, the Government allocated a one-time budget of TSH ________________________________________ 6 Finance references: Valerio & Garcia, 2012; WHO, 2005; 200 million for the construction of housing for MVC. Hanushek & Kimko, 2000; Hanushek % Luque, 2003. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 10 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 Table 3: Regional comparison of health expenditures Tanzania Ethiopia Kenya Uganda Out-of-pocket expenditure as a percentage of all private 42% 80% 77% 64% health expenditure Out-of-pocket expenditure as percentage of total health 14% 37% 43% 50% expenditures General government expenditure on health as a 6% 5% 5% 9% percentage of GDP Total expenditure on health per capita (2009, adjusted USD 48 USD 23 USD 33 USD 26 for purchasing power parity) Percentage of routine EPI vaccines financed by 18% 5% 48% 36% government Source: WHO Global Health Expenditure Database, 2010; UNICEF Country Statistics, 2010. In 2010, the GoT financed 18 percent of the cost of Policy Options to Strengthen Tanzania’s providing routine EPI vaccines to all young children. In Enabling Environment for ECD this same year, approximately 49 percent of total  Legal Framework – A significant amount of work has expenditures on health were financed from external been expended by various Government entities and sources. In 2009, 31 percent of all private health non-state stakeholder to develop the draft IECDP; expenditures went to the purchase of pharmaceuticals. this policy should be approved as a matter of urgency. Once approved, the critical next step will Table 3 presents regional comparisons of key health be the creation of a costed implementation plan. expenditure statistics in East Africa. Out-of-pocket  Intersectoral Coordination – Although the MCDGC expenditures account for a smaller proportion of total has been identified to serve as the institutional health expenditures in Tanzania (14 percent) than in anchor for ECD in Tanzania, it is unclear if it has the neighboring countries. Total expenditure on health per mandate and resources to fill this role. Similarly, capita is significantly higher in Tanzania than in any other the infrequent meetings of the three National ECD country in the region. The GoT finances a smaller Committees and the limbo status of the IECDP proportion of routine vaccines than the Governments of suggest that intersectoral coordination could be Kenya and Uganda but more than the Government of improved in Tanzania. Ethiopia.  Finance – The current policy which compels primary schools to finance preprimary education without The level of remuneration for ECD service providers is providing any additional funding for preprimary difficult to assess in Tanzania, though official wages for education limits children’s access to preprimary preprimary teachers in State schools are reasonable. school and compromises the quality of preprimary The pay scale for preprimary teachers (in State schools) school available. Schools already facing resource ranges from TSH220,200 (USD 139) to TSH649,440 (USD constraints divert minimal amounts of funding to set 413) per month. Gross National Income (GNI) per capita is up preprimary classrooms; as a result, often 1,420 adjusted for purchasing power parity (non-adjusted preprimary classrooms have the least qualified USD 530) in Tanzania. Though an annual starting salary of teachers and inadequate materials and are severely USD 1,668 for a preprimary teacher is above GNI per over-crowded. To remedy this, the Government could capita, in reality many preprimary teachers are paid by the consider a range of policies to improve finance for community and are paid significantly lower levels. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 11 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 Box 4: Relevant Lessons from International Experience ECD involves (at a minimum) interventions in health, Financing ECD nutrition, education, and social and child protection, Example from Mauritius: Conditional Cash Transfers and should target pregnant women, young children and (CCTs) to Promote ECCE Enrollment their parents and caregivers. A robust ECD policy should Summary: The Government of Mauritius has focused policy include programs in all essential sectors; provide efforts on increasing preprimary school enrollment in the comparable coverage and equitable access across last decade. In order to encourage parents to enroll their regions and socioeconomic status – especially reaching children, the Government provides all families with the most disadvantaged young children and their financial support contingent upon the child attending the families. final year of preprimary school (age 4 in Mauritius). The transfer amounts to USD 6 per month and has helped Policy Lever 2.1: achieve an 85 percent enrollment rate in preprimary school Scope of Programs for children age 3-5 in Mauritius. Provision is largely through non-State centers (17 percent of all preschools are State-managed), but the design and enforcement of quality Effective ECD systems have programs established in all essential sectors and ensure that every child control mechanisms has remained central to Government and expecting mothers have guaranteed access to policy efforts. the essential services and interventions they need to Key considerations for Tanzania: live healthfully. The scope of programs assesses  Incentivizing on-time enrollment in the last year of the extent to which ECD programs across key preprimary school (i.e. at age 6 in Tanzania) could sectors reach all beneficiaries. Figure 4 presents also help address the significant problem of late a summary of the key interventions needed to enrollment in primary school. support young children and their families via  It will be important to determine the appropriate different sectors at different stages in a child’s life. funding level to maximize effectiveness of policy. ECD programs are established to target relevant groups of beneficiaries in Tanzania but interventions preprimary education addressing both supply and demand to reach parents could be improved and expanded. constraints. These options include, for example: capitation Tanzania has a range of ECD programs established in grants to schools specifically for preprimary expenditures each of the essential ECD sectors: education, health, or cash transfers or vouchers for families contingent upon nutrition, and social and child protection. enrolling a child in preprimary school or accessing other Interventions are established that serve pregnant ECD services. Differentiating spending for ECD is also an women, young children and parents and caregivers. important tool to promote increased and more efficient As presented in Figure 5, interventions targeting finance for ECD. The key Ministries of MoEVT, MoH, parents and caregivers are limited. Some care MoSP, PMO-RALG and MCDGW cannot currently messaging is incorporated into health and education distinguish ECD spending within budgets; these Ministries programs, but there are no direct interventions could consider inserting line items for ECD into their targeting parents and caregivers. budgets or improving finance and information systems to be able to better track and monitor ECD spending. ECD programs are established in all essential areas of focus. A variety of interventions are established in Policy Goal 2: Implementing Widely all essential areas of ECD service provision, including  Policy Levers: Scope of Programs • in health, nutrition, education, and social and Coverage • Equity child protection. Key programs are summarized in Table 4, which shows that, while a range of ECD Implementing Widely refers to the scope of ECD interventions exist, coverage is not universal. programs available, the extent of coverage (as a share of the eligible population) and the degree of equity within ECD service provision. By definition, a focus on SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 12 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 Figure 4: Essential interventions during different periods of young children's development Figure 5: Scope of ECD interventions across sectors and beneficiaries Scope of ECD Interventions in Tanzania by Sector and Target Population Social and National Program for Most Vulnerable Children Child Protection Programs for children with special needs National Program for Care & Support of People Living with HIV Health PMTCT & Pediatric AIDS Care & Treatment Immunizations Sector Nutrition National programs for anemia, iodine and Vitamin A deficiency National Programs for maternal and child nutrition Education Public Preschools Parents/ Pregnant Children Children Children Caregivers Women 0-2 3-4 5-6 Target Beneficiaries SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 13 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 Table 4: Coverage of ECD interventions in Tanzania ECD Programs and Coverage in Tanzania Scale Number of ECD Intervention Pilot Universal Regions Covered programs coverage (out of 21) EDUCATION (STIMULATION AND EARLY LEARNING) State- sponsored preprimary education All No (Primary Education Development Programme II- preprimary classrooms attached to primary schools) (GoT) Community-based ECCE All No (Aga Khan Foundation is a key funder in some communities) HEALTH Newborn Care Program (GoT) All Integrated Management of Childhood Illnesses (GoT) All Growth Monitoring Program (GoT) All Immunizations All Yes NUTRITION National Program for Improving Maternal Nutrition (GoT) All Program for the Management of Acute Malnutrition (GoT) National Program for Control of Anemia (GoT) All National Program for Control of Iodine Deficiency (GoT) All National Program for Control of Vitamin A (GoT) All **Anti-obesity programs encouraging healthy eating/exercise None No PARENTING **Parenting integrated into health/community programs None No **Home visiting programs to provide parenting messages None No ANTI-POVERTY **Cash transfers conditional on ECD services or enrollment None No SOCIAL AND CHILD PROTECTION Programs for OVCs All No Interventions for children with special needs All No Interventions for children with special needs All No MULTI-SECTORAL OR COMPREHENSIVE Feeding programs in preprimary schools 7 No (World Food Program, operating in some districts) **A comprehensive system that tracks individual children’s needs and None No intervenes, as necessary and expecting mother have guaranteed access to Policy Lever 2.2: Coverage essential ECD services. Access to Early Childhood Care and Education (ECCE) in A robust ECD policy should establish programs in all Tanzania is limited. The GoT expansion strategy for essential sectors, ensure high degrees of coverage and preprimary schools has consisted of attaching preprimary reach the entire population equitably–especially the classrooms to existing primary schools. By law, each most disadvantaged young children–so that every child primary school must have at least one preprimary SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 14 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 classroom. As already discussed, this expansion has been The significant resource constraints and quality control financed out of the capitation grants provided to primary issues that affect the larger education sector affect schools, with no separate funding provided for early learning opportunities and efforts to promote preprimary schools. As a result of this limited funding, ECD. Another problem impacting education outcomes most preprimary classrooms are overcrowded and is the proportion of children starting primary school at a under-resourced- the average student-to-teacher ratio in late age. The age of primary school entry is 7 in preprimary schools is 100:1. Efforts to expand access to Tanzania (already fairly late by international standards); preprimary school in Tanzania should be considered in on average, however, most children enter primary light of recent trends in primary school enrollment. school at the age of 8.5 years. Tanzania is one of a number of Sub-Saharan countries which has achieved dramatic success increasing primary MoEVT tracks enrollment trends in preprimary school school enrollment rates in the last decade from 59 for children age 5 and 6 only. Enrollment in preprimary percent in 2000 to 96 percent in 2009. Unfortunately, school for this age group is currently 33 percent and this increase in enrollment was not met with a increased 45 percent between 2005 and 2010. commensurate increase in resources, resulting in overcrowded classrooms and a significant decline in As Figure 6 and Table 5 show, enrollment increased 42 quality and outcomes. Currently, 50 percent of all percent in State preprimary schools over this period and children in the 7th and 8th grade in Tanzania read at a 2nd by 191 percent in non-State preprimary schools. Despite grade level and 90 percent of all children who complete the substantial increase in non-State enrollment, as of secondary school fail their exit exams. A recent survey of 2010, non-State enrollment accounted for less than 5 secondary schools found that just 4 percent of all percent of all enrollment for children age 5-6. If data secondary schools in the country are equipped with the were available to track enrollment for children below bare minimum of facilities (defined as potable water, the age of 5, the relative proportion of enrollment in electricity, classrooms, a science laboratory and toilets). non-State ECCE would climb as all provision for children below the age of 5 is provided by non-State sources. Figure 6: Preprimary school enrollment trends 2005-2010 Preprimary School Enrollment, age 5-6 (2005-2010) 1,000,000 Children enrolled 800,000 600,000 400,000 200,000 0 2005 2006 2007 2008 2009 2010 Public Private Year SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 15 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 In comparison to other countries in East Africa, interventions and should be considered. While the 50 preprimary school starts at a later age in Tanzania and percent rate of exclusive breastfeeding for children lasts just three two years, as compared to three years until 6 months of age is high by international in neighboring countries. As Table 6 shows, gross and standards, there is still scope to improve – given the net enrollment rates are low across the region. The high returns to breastfeeding and low cost, improved portion of preprimary school provided via the private public information campaigns and interventions for sector is significantly lower than in all neighboring new mothers should be considered. Table 8 countries. summarizes access to nutrition interventions and outcomes for pregnant women and young children in Access to essential ECD health interventions in Tanzania, along with regional comparisons. Tanzania is better than in neighboring countries but could still be improved. Table 7 shows the level of access to a selection of essential ECD health Policy Lever 2.3: Equity interventions for young children and pregnant women in Tanzania with regional comparisons. As illustrated Based on the robust evidence of the positive effects ECD in Table 7, the level of access to essential health interventions can have for children from disadvantaged interventions is higher (or comparable) in Tanzania in backgrounds, every Government should pay special comparison with neighboring countries. In particular, attention to equitable provision of ECD services.7 One of Tanzania has had more success scaling up coverage of the fundamental goals of any ECD policy should be to ITNs for children below the age of 5 – given that provide equitable opportunities to all young children malaria is the leading killer of young children in and their families. Tanzania, this is a critical policy intervention. While Tanzania leads the region is access to skilled attendants at birth, the data indicate that less than Access to preprimary school is uneven in Tanzania. half of all women have access to a skilled attendant, Enrollment rates for girls and boys in preprimary school which is critical to ensuring safe deliveries. are nearly equivalent in Tanzania. Overall preprimary school enrollment levels vary considerably between Access to essential ECD nutrition interventions could different regions, however, with some regions be improved. Under-nutrition is the underlying cause significantly higher than the national average of 44 for an estimated one-third of all deaths of young percent and others well below. As Figure 7 shows, children worldwide. The period between conception Mwanza province has the highest preprimary and the age of two is a window of opportunity to enrollment rate, at 90 percent, and Dar es Salaam has address and prevent the damage that can be caused the lowest rate, at 19 percent. by under-nutrition. Nutrition interventions that begin in the prenatal period are essential. In Tanzania, 58 Access to essential ECD services in the sectors of percent of all pregnant women are anemic, signifying a health, nutrition and social protection is highly uneven need to increase outreach efforts to promote healthy by location and socioeconomic status. Using data from nutrition for pregnant women. Tanzania has achieved the Multiple Indicator Cluster Survey (MICS) in near universal coverage of Vitamin A supplementation Tanzania, access to ECD services can be compared for young children – the lessons learned from this based on wealth and by urban-rural location. success could potentially be applied to other nutrition ________________________________________ 7 Equity references: Engle et al, 2011; Naudeau et al., 2011. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 16 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 Table 5: Increasing enrollment in State and non-State preprimary schools 2005-2010 Number of Children in Enrolled in Preprimary schools (age 5-6) Year State Non-State Total 2005 624,204 14,387 638,591 2006 653,485 15,652 669,137 2007 775,313 19,698 795,011 2008 805,407 68,574 873,981 2009 851,084 45,062 896,146 2010 883,667 41,798 925,465 Increase 2005-2010 42% 191% 45% Table 6: Comparison of preprimary school provision in East Africa Tanzania Ethiopia (2010) Kenya Uganda (2010) (2010) (2009) Age of preprimary entry 5 years old 4 years old 3 years old 3 years old Duration of preprimary 2 years 3 years 3 years 3 years Gross enrollment rate 33% 5% 52% 14% Net enrollment rate 33% 4% 29% 14% Percentage of private enrollment 5% 95% 38% 100% Source: World Bank EdStats, UNESCO Institute of Statistics Table 7: Access to essential ECD health interventions in East Africa Tanzania Ethiopia Kenya Uganda Children below 5 with diarrhea receive oral rehydration/ continued 50% 15% 43% 39% feeding (2006-10) 1 year olds immunized against DPT 91% 90% 93% 60% Children below 5 with suspected pneumonia receive antibiotics (2006-10) No data 5% 50% 47% Children below 5 sleeping under insecticide-treated bed net (2006-10) 64% 33% 47% 33% Children below 5 with fever, receive anti-malarial drugs (2006-10) 59% 10% 23% 60% Births attended by skilled attendants (2006-10) 49% 6% 44% 42% HIV+ pregnant women/exposed infants receive ARVs for PMTCT 59% No data 43% No data Source: World Bank and UNICEF country statistics Table 8: Access to nutrition interventions for pregnant women and young children in East Africa Tanzania Ethiopia Kenya Uganda Children below 5 with moderate/severe stunting (2006-10) 42% 51% 35% 38% Vitamin A supplementation coverage (6-59 months) (2010) 99% 84% 62% No data Infants with low birth weight (2006-10) 10% 20% 8% 14% Infants exclusively breastfed until 6 months of age (2006-10) 50% 49% 32% 60% Population that consumes iodized salt (2006-10) 59% 20% 98% 96% Prevalence of anemia in pregnant women (2010) 58% 62.7% 55.1% 41.2% Source: UNICEF MICS Country Statistics; WHO Global Database on Anemia SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 17 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 As Figures 8 and 9 show, there are significant disparities women. More than one-fifth of children from the in access to essential ECD services by both wealth and poorest families are underweight, compared to less by urban-rural location. Children from wealthy families than one-tenth of children from the wealthiest families. are more than 13 times as likely to be registered as The urban-rural disparities are not as stark as those those from the poorest families, and pregnant women between families with different levels of wealth, but are from wealthy families are three times as likely to deliver still apparent. a baby with a skilled attendant present as pregnant Figure 7: Regional variation in preprimary school enrollment 100 90 90 80 70 73 Enrollment Rate (%) 70 58 58 60 49 51 50 38 40 42 43 45 46 44 40 31 31 32 35 30 25 26 28 19 20 10 0 Tabora Ruvuma Iringa Tanga Rukwa Kilimanjaro Dodoma Mtwara Mara Manyara Arusha Kagera Mwanza Lindi Mbeya Kigoma Shinyanga Pwani Singida Dar es Salaam National Average Morogoro Figure 8: Disparities in ECD by wealth Figure 9: Disparities in ECD comparing urban and rural populations SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 18 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 Children in urban areas are four times more likely to be  Equity – Given the significant disparities which exist in registered than their rural counterparts and pregnant access to ECD services based on family income level, the women in urban areas are twice as likely to give birth with GoT should consider targeting mechanisms to reach the a skilled attendant as women in rural areas. The use of poorest families with young children. One option to improved sanitation facilities is low across the country: consider is a Conditional Cash Transfer (CCT) to promote just one-third of the urban population and one-fifth of the access to ECD services (either enrollment in preprimary rural population have access to improved sanitation. school or health services). Though Tanzania is considered one of the most stable and Policy Goal 3: Monitoring and Assuring peaceful countries in the region, it is home to a large Quality refugee population due to conflicts in neighboring countries such as Rwanda and Burundi. Refugee populations often  Policy Levers: Data Availability • require specialized interventions and targeting mechanisms. Quality Standards • Compliance with Investments in ECD can be highly effective ways to reach Standards marginalized populations and ensure integration into Monitoring and Assuring Quality refers to the existence of society from an early age. information systems to monitor access to ECD services and outcomes across children, standards for ECD services and Given the potential benefits, the needs of young systems to monitor and enforce compliance with those refugees in Tanzania should be taken into account in standards. Ensuring the quality of ECD interventions is vital policy planning. because evidence has shown that unless programs are of high quality, the impact on children can be negligible, or Policy Options to Implement ECD Widely in even detrimental. Tanzania  Scope of Programs – Parent and caregiver education Policy Lever 3.1: is an area that is currently underdeveloped within the Data Availability scope of ECD interventions in Tanzania. Given the critical role that parents and caregivers play in Accurate, comprehensive and timely data collection can promoting the healthy development of children, the promote more effective policy-making. Well-developed GoT should consider purposeful incorporation of information systems can improve decision-making. In parenting and caregiver education into existing particular, data can inform policy choices regarding the outreach mechanisms to promote early stimulation volume and allocation of public financing, staff recruitment and holistic care for young children. A public and training, program quality, adherence to standards and information campaign could also be considered. efforts to target children most in need.  Coverage – The current informal status of community health workers limits the level of Both administrative and survey data are collected in coverage which can be achieved; the GoT could Tanzania, though the collection of administrative data, consider formalizing the role of community particularly in regards to finance levels, could be health workers (this would, of course, have improved. Tanzania participated in UNICEF’s Multiple financial implications). Though basic healthcare for Indicator Cluster Survey (MICS) in YEAR and YEAR. The pregnant women and young children is officially MICS data provide a rich source of information on a number free in Tanzania, shortages at the service delivery of indicators related to young children’s healthy level often result in fees being levied development. Table 9 presents a series of – consideration should be given to the impact key indicators that a country can collect to track of these additional costs on families. the provision of services to promote young SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 19 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 Table 9: Availability of data to monitor ECD in Tanzania Administrative Data Indicator Tracked Special needs children enrolled in ECCE (number of)  Children attending well-child visits (number of) X Children benefitting from public nutrition interventions (number of)  Women receiving prenatal nutrition interventions (number of)  Children enrolled in ECCE by sub-national region (number of)  Average per student-to-teacher ratio in public ECCE  Is ECCE spending in education sector differentiated within education budget? X Is ECD spending in health sector differentiated within health budget? X Survey Data Indicator Tracked Population consuming iodized salt (%)  Vitamin A Supplementation rate for children 6 -59 months (%)  Anemia prevalence amongst pregnant women (%)  Children below the age of 5 registered at birth (%)  Children immunized against DPT3 at age 12 months (%)  Pregnant women who attend four antenatal visits (%)  Children enrolled in ECCE by socioeconomic status (%) X children’s development. These indicators are divided into cognitive, linguistic and socio-emotional development are both administrative data (census data, not tracked. Without some monitoring of children’s reflecting total uptake) and survey data (based outcomes in these interrelated domains, it is difficult to on sampling of a specific population). Both administrative holistically assess children’s development and the degree and survey data are useful and necessary to track access to to which existing interventions are successful. services and outcomes. There is no system to comprehensively track children’s Tanzania’s Education Monitoring and Information System development across the four interrelated domains of (EMIS) tracks access to ECCE for specific sub-groups of child development and mechanisms to intervene when young children. Tanzania’s EMIS differentiates ECCE necessary are not well developed. enrollment by urban-rural location, sub-national division, gender and for students with special needs. This information is publicly available annually in the BEST Policy Lever 3.2: publication. The EMIS system does not currently track enrollment by mother-tongue or by socio-economic Quality Standards status. The EMIS system currently tracks enrollment in preprimary school and early learning for children age 5 Ensuring quality ECD service provision is essential. A focus and 6. This system limitation neglects the need to monitor on access – without a commensurate focus on ensuring enrollment trends and levels of service quality for younger quality – jeopardizes the very benefits that policymakers children and an expansion in the range of ages tracked hope children will gain through ECD interventions. The should be considered. quality of ECD programs is directly related to better cognitive and social development in children.8 Child development outcomes are not adequately tracked in Tanzania and there is no system in Standards for ECCE have recently been drafted in place to comprehensively monitor the development of Tanzania. Standards for ECCE were established in 2011 by individual children. Through the health information 8 monitoring systems, some data on children’s physical Quality references: Taylor & Bennett, 2008; Bryce et al, 2003; Naudeau et al, 2011V; Victoria et al, 2003. outcomes are collected and monitored. Children’s SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 20 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 the Inter-Ministerial ECD Steering Committee, with support construction standards, which include requirements for from UNICEF. These include operational guidelines, structural soundness and connection to electricity. minimum standards for ECD service providers and draft According to policy, primary schools in Tanzania (and curricula. Because the standards are recent, no information accordingly, preprimary schools) are not required to is available on adherence to standards, but anecdotal have access to a potable water source, but they are evidence suggests adherence is minimal. required to have functional hygienic facilities. There are clearly established requirements for ECCE There are established registration and accreditation professionals teaching in public preschools; the procedures for both state and non-state ECCE facilities. requirements may, however, be overly rigid and limit All ECCE facilities are required by law to be registered and opportunities to scale access to ECCE more broadly. undergo standard inspections as part of the registration Preprimary teachers serving in State preprimary classes process. In practice, some non-State ECCE facilities – are required to have completed secondary school and two particularly those serving children below the age of 5 – are years of full-time pre-service training – this tertiary not registered and do not undergo any inspection. education conveys upon them a certificate for participation in a specialized course of studies Policy Lever 3.3: (corresponding to the international standards of ISCED 4A, Compliance with Standards 5B and 5A). ECCE teachers are not required to have completed a supervised internship or teaching practicum Establishing standards is essential to providing quality prior to certification or employment. For teachers in non- ECD services and to promoting the healthy State ECCE facilities, the standards are less stringent. In development of children. Once standards have been practice, most teachers have completed secondary school established, it is critical that mechanisms are put in and “certificate� courses which vary in length from several place to ensure compliance with standards. weeks to several months and are offered by private teacher training centers (through the Aga Khan University, Preprimary teachers meet established pre-service for example). training requirements in most preprimary schools. There are a total of 10,830 teachers, working in State ECCE teachers serving children below the age of 5 are and non-State preprimary schools in Tanzania. The required to have completed lower-secondary school. official requirement for teachers to work in a primary There is no mandatory in-service training for ECCE school is a Grade A Teaching Certificate (which caregivers for children below the age of 24 months. For signifies the completion of a two-year pre-service caregivers and teachers of children above the age of 24 teaching course); this same requirement is applied to months, an annual training of 40 hours is required, preprimary teachers in State schools. While 85 which covers the topics of health, cognitive percent of all teachers do meet this requirement, just development, social development and emotional 28 percent have a specialized pre-service ECD development. The training is provided by the certificate. Anecdotal feedback from primary and Government and takes place at Teacher Resource preprimary teachers, as well as school and EMIS Centres. records, indicate that the training institutions There are established service delivery standards for ECCE currently approved to provide pre-service ECD in Tanzania; specific infrastructure standards for ECCE are certificates now have adequate capacity to meet not developed, but State preprimary schools must comply demand. with established infrastructure standards for primary schools. There are no detailed infrastructure standards Preprimary schools do not comply with established for preprimary schools in Tanzania, apart from service delivery and infrastructure standards. Average minimum standards related to floors, roofing and child-to-teacher ratios in preprimary schools have windows. For State preschools, in practice, standards increased dramatically in recent years. As Figure 9 exist because the policy introducing preprimary shows, this trend has been consistent in both State and schooling requires that they be located in existing non-State schools. For State schools, the average primary schools; hence public preprimary schools are student to teacher ratio has increased from 45:1 in required to adhere to the detailed primary school 2007, to 100:1 in 2011. For non-State schools, the SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 21 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 Figure 10: Student to teacher ratios in preprimary Figure 11: Student to qualified teacher ratios in classrooms preprimary classroom average has increased from 14:1 in 2007 to 81:1 in Policy Options to Monitor and Assure ECD 2011. Since 2010, the number of students per qualified Quality in Tanzania teacher has been tracked (as opposed to all teachers,  Data Availability – Relatively reliable administrative regardless of qualifications, as shown in Figure 9). and survey data are available in Tanzania to monitor children’s access to essential ECD services. The age As Figure 10 shows, in just one year, the number of range of available early learning and preprimary students per qualified teacher increased from 74 to school data (covering children age 5 and 6) is, 115 and 37 to 108 in State and non-State schools, however, a serious limitation. The monitoring of respectively. These data are for preprimary schools children’s development and outcomes across the serving children age 5 and 6; data for ECCE centers interrelated domains of ECD is not well-developed. serving children below the age of 5 are not available. The GoT could consider conducting a survey to Both State and non-State preprimary schools collect information on children’s development to are required to comply with established service get a baseline from which to consider a scalable delivery and infrastructure standards; in practice, approach to tracking child development outcomes, however, compliance is not well-monitored or including the development of individual children. enforced. Compliance with infrastructure standards is Improved tracking of ECD expenditures within and enforced during the school registration process. across sectors – at the local, sub-national and According to policy, preprimary schools should be national level should be considered to allow for the inspected quarterly. The recent policy guidelines for assessment of the cost-effectiveness of construction standards that apply to preprimary schools interventions and improved policy planning and were established in 2011; as such, no data monitoring allocation of resources. compliance are available yet. Non-State schools are  Standards – The current policy requiring two years inspected during the registration process, at which time of full-time pre-service training for preprimary the qualifications of teachers are verified, but teachers teachers may not be the most effective approach as are not required to have completed a two-year full-time the GoT works to scale access to preprimary school. teaching course (as is the case for teachers in State The institutions currently preparing preprimary preprimary schools). State schools are required to teachers do not have the capacity to train enough adhere to established personnel recruitment standards. teachers to meet the growing demand and the two- Schools that fail compliance tests are not granted year full-time requirement is expensive and time- annual operating licenses. intensive. The GoT may want to consider a more SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 22 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 flexible approach to training, with a focus on high- ground. In Tanzania, for example, despite a policy quality but shorter duration training programs and mandating the registration of children at birth, just 22% of those programs that allow teachers to work all children are registered. Similarly, despite a policy towards certification while teaching (which has the mandating the iodization of salt, just 59% of households are added advantage of giving teacher practical consuming iodized salt. These discrepancies between experience to apply in their studies). policy intent and outcome indicate a need to examine the  Compliance with Standards – Now that new policies and their implementation. Conversely, the policy standards have been developed, it will be important and implementation of vaccines has yielded a successful to monitor and enforce compliance. Currently, 91% coverage rate. child to teacher ratios are extremely high in preprimary classrooms in Tanzania - new Table 11 summarizes key policy provisions in East Africa, classrooms and new teachers are urgently needed along with related outcomes. Despite mandatory salt to meet demand without sacrificing quality. The iodization policies in all four countries, household GoT could also consider policy options to encourage consumption of iodized salt varies from a low of 20% in non-State providers to increase service provision or Ethiopia to a high of 96% in Uganda. Birth registration formally register existing facilities. seems to be a challenge throughout the region; all four countries have mandatory registration policies – these policies, however are currently yielding registration rates of Comparing Official Policies with Outcomes less than a quarter of the population in each country. The The existence of laws and policies alone do not always approaches to breastfeeding promotion and preprimary guarantee a correlation with desired outcomes. In many school vary from country to country, yielding mixed countries, a disconnect exists between policy intent and outcomes. the reality of implementation and service delivery on the Table 10: Comparing policy intent with ECD outcomes in Tanzania Policy Outcomes Tanzanian policy complies with the International Rate of exclusive breastfeeding until six months: Code of Marketing of Breastmilk Substitutes 50% Tanzania has a national policy to mandate the Household consumption of iodized salt: iodization of salt 59% Preprimary school is officially free in Tanzania, but it Preprimary school enrollment (age 5-6): is not compulsory 33% Young children are required to receive a complete Children with DPT (12-23 months): course of childhood immunizations 91% Registration of children at birth is mandatory through Completeness of birth registration: the Registration Insolvency Trusteeship Agency 22% SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 23 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 Table 11: Comparing policy intent with ECD outcomes in East Africa Comparing Policies with Outcomes in East Africa Tanzania Ethiopia Kenya Uganda Salt Iodization Mandatory since Mandatory since Salt Iodization Policy 2006 2011 Mandatory Mandatory Population Consuming Iodized Salt 59% 20% 90+% 96% Appropriate Infant Feeding and Breastfeeding Promotion Compliance, Code of Marketing of Breast Some provisions Law Law Milk Substitutes law Exclusive Breastfeeding until 6 Months 50% 49% 32% 60% Preprimary Education Not compulsory; Not compulsory; Not Compulsory; State-provided Government Government does finance Preprimary School Policy free for two does not finance some recurrent Not compulsory; all years officially recurrent costs provision is non-State but user fees are and user fees are costs but user fees are common common common Preprimary School Enrollment Rate 33% 5% 42% 6.6% Birth Registration Birth Registration Policy Mandatory Mandatory Mandatory within 3 months of birth Birth Registration Rate 22% 7% 21% Preliminary Benchmarking of ECD in Table 13 presents the status of ECD Tanzania with International Comparisons policy development in Tanzania alongside a selection of Table 12 presents the classification of ECD policy in neighboring and OECD countries. Sweden is home Tanzania within each of the nine policy levers and three to one of the world’s most comprehensive policy goals. For each of the three policy goals, and developed ECD policies and achieves a Tanzania’s level of development is classified as benchmarking of “Advanced� in all nine policy levers. “Emerging.� While recent efforts to develop the IECDP, improve coordination and develop minimum standards for ECCE are all notable steps, significant areas for improvement remain. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 24 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 Table 12: Classifying the level of ECD policy development in Tanzania Table 13: Comparing ECD policy in Tanzania internationally Level of Development ECD Policy Goal Policy Lever Tanzania Kenya Chile Ethiopia Sweden Turkey Legal Framework ���� ���� ���� ���� ���� ���� Establishing an Enabling Coordination ���� ���� ���� ���� ���� ���� Environment Financing ���� N/A  ���� ���� ���� Coverage ���� ���� ���� ���� ���� ���� Implementing Equity ���� N/A ���� N/A ���� ���� Widely Area of Focus ���� ����  ���� ���� ���� Data Availability ���� ���� ���� ���� ���� ���� Monitoring and Quality Standards ���� ���� ���� ���� ���� ���� Assuring Quality Compliance with ���� ���� ���� ���� ���� ���� Standards SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 25 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 Table 14: Summary of policy options to improve ECD in Tanzania Policy Policy Options and Recommendations Dimension • Approve the draft IECDP as a matter of priority • Develop and approve a costed implementation plan for the IECDP once approved Establishing an • Insert line items for ECD into the budgets of the five key ministries: MoEVT, MoH, MoSP, Enabling PMO-RALG, MCDGW and/or improve mechanisms to track ECD expenditures Environment • Consider capitation grants to schools for preprimary expenditures • Consider impact of additional costs for services on families and potential solutions (such as conditional cash transfers) • Target programs to reach the poorest, most marginalized young children • Formalize community health workers and ensure that messages around early stimulation Implementing are incorporated to reach children age 0 to 3 Widely • Increase access to skilled attendants at birth • Reach parents more education and messages on ECD and early care and stimulation • Ensure that compliance with standards is enforced according to new quality standards • Increase availability of training opportunities for ECD service providers to address skills shortages Monitoring and • Consider reforms to preprimary teachers preparation policy to scale up training of Assuring Quality preprimary teachers in a cost-effective and high-quality manner so that high child-to- teacher ratios can be addressed • Consider mechanisms to support for private providers to enter the market to provide affordable and high-quality ECCE Conclusion preprimary school presents the GoT with a particular The SABER-ECD initiative is designed to enable ECD challenge given that the national average child-to- policy makers and development partners to identify teacher ratio is already 100:1, with just 33 percent of opportunities to develop effective ECD systems. The children age 5 and 6 enrolled. Adequate finance and SABER-ECD classification system does not rank quality assurance frameworks will be necessary to countries according to any overall scoring; rather, it is ensure that quality does not decrease as access intended to share information on how different ECD increases - if not, the very benefits that children and systems address the same policy challenges. This families seek from early learning opportunities will be Country Report presents a framework to compare jeopardized. The recent development of standards for Tanzania’s ECD system with other countries in the preschool service delivery is a positive step towards region and internationally. monitoring and ensuring quality, but current enforcement mechanisms are not sufficient to ensure The approval of the draft IECDP is a critical step to build compliance. upon recent momentum for ECD following the Inaugural Biennial National Forum on ECD (held in Arusha in Within each Policy Goal, opportunities exist to strengthen February 2012). Once approved, the challenge will be ECD policy and service delivery to ensure that all young to develop a costed implementation plan to scale children have a strong start in life and are afforded the coverage and ensure quality. The scale-up of access to opportunity to reach their full potential. Table 14 summarizes these policy options and recommendations. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 26 TANZANIA | EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT | 2012 www.worldbank.org/education/saber The Systems Approach for Better Education Results (SABER) initiative produces comparative data and knowledge on education policies and institutions, with the aim of helping countries systematically strengthen their education systems. SABER evaluates the quality of education policies against evidence-based global standards, using new diagnostic tools and detailed policy data. The SABER country reports give all parties with a stake in educational results—from administrators, teachers, and parents to policymakers and business people—an accessible, objective snapshot showing how well the policies of their country's education system are oriented toward ensuring that all children and youth learn. This report focuses specifically on policies in the area of Early Childhood Development. This work is a product of the staff of The World Bank with external contributions. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries. THE WORLD BANK SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 27