Send to

Choose Destination
J Glob Health. 2018 Dec;8(2):021201. doi: 10.7189/jogh.08.021201.

Explaining progress towards Millennium Development Goal 4 for child survival in Tanzania.

Author information

Institute for International Programs, Johns Hopkins University. Dar es Salaam, United Republic of Tanzania.
National Bureau of Statistics. Dar es Salaam, United Republic of Tanzania.
Muhimbili University of Health and Allied Sciences. Dar es Salaam, United Republic of Tanzania.
Tanzania Food and Nutrition Centre. Dar es Salaam, United Republic of Tanzania.
Tanzania Commission for Science and Technology. United Republic of Dar es Salaam, Tanzania.
Department of International Health. Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.



During the Millennium Development Goal (MDG) era (1990-2015) the government in Mainland Tanzania and partners launched numerous initiatives to advance child survival including the comprehensive One Plan for Maternal Newborn and Child Health in 2008-2015 and a "sharpened" One Plan strategy in early 2014. Moving into the Sustainable Development Goal era, the government needs to learn from successes and challenges of striving towards MDG 4.


We expand previous work by presenting data for the full MDG period and sub-national results. We used data from six nationally-representative household surveys conducted between 1999 and 2015 to examine trends in coverage of 22 lifesaving maternal, newborn, child health and nutrition (MNCH&N) interventions, nutritional status (stunting; wasting) and breastfeeding practice across Mainland Tanzania and sub-nationally in seven standardized geographic zones. We used the Lives Saved Tool (LiST) to model the relative contribution of included interventions which saved under 5 lives during the period from 2000-2015 compared to 1999 on a national level and within the seven zones.


Child survival and nutritional status improved across Mainland Tanzania and in each of the seven zones across the 15-year period. MNCH&N intervention coverage varied widely and across zones with several key interventions declining across Mainland Tanzania or in specific geographical zones during all or part the period. According to our national LiST model, scale-up of 22 MNCH&N interventions - together with improvements in breastfeeding practice, stunting and wasting - saved 838‚ÄČ460 child lives nationally between 2000 and 2015.


Mainland Tanzania has made significant progress in child survival and nutritional outcomes but progress cannot be completely explained by changes in intervention coverage alone. Further examination of the implementation and contextual factors shaping these trends is important to accelerate progress in the SDG era.

[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

Competing interests: The authors have completed the Unified Competing Interest form at (available on request from the corresponding author) and declare no conflict of interest.

Supplemental Content

Full text links

Icon for PubMed Central
Loading ...
Support Center