October 2012

Only 14% of Tanzanians have electricity. What can be done?

Let's think together: Every week the World Bank team in Tanzania wants to stimulate your thinking by sharing data from recent official surveys in Tanzania and ask you a couple of questions. This post is also published in the Tanzanian Newspaper The Citizen every Sunday.

Energy fuels economic development and the evidence is before our eyes every day. Businesses require a steady supply of energy to produce goods and services. Electricity allows school children to study after sunset and hospitals need it to save lives Insufficient or irregular energy supply is associated with significant economic cost for businesses and households. Lack of access to clean energy also creates a myriad of health and environmental hazards, such as indoor pollution from cooking on traditional open-fire stoves and deforestation.

Unfortunately, affordable access to clean energy remains an elusive dream for most Tanzanians, especially those living outside of urban centers and the poor:

The figures don’t lie. Today, about 11 million Tanzanians live in poverty. This is too much. Equally worrisome is that since 2001 the national poverty rate appears to be stuck at approximately a third of the total population despite rapid and stable economic growth.

People need jobs

For a long time, the Tanzanian Government has defended itself: poverty reduction will catch up thanks to the massive public investment made in social and infrastructure sectors over the past decade. More children, including girls, are going to school, and the efforts to reduce infant mortality have registered spectacular achievements. However, it is estimated that those improvements will take one generation to translate into actual productivity gains and higher incomes.

Soon after I turned 40, I started experiencing back problems. I asked my brother for advice (he is a medical doctor) but didn’t quite like what I heard. “Sorry brother, our bodies are just not built for us to live much beyond 40…” he told me. If you take human evolution as a reference, he is right.

For the first 59,900 years of our existence (out of a total of 60,000), people used to live only into their 30s, at best. During the 1000 or so years that followed, there were some modest improvements raising life expectancy to 40 years. Things really changed only in the past 100 years on the backdrop of major medical and sanitation breakthroughs.

Malnutrition has detrimental effects on a child's physical growth (stunting); it can also result in irreversible damage to their brain and mental development, and it increases their risk to illness and death. The biggest impact of malnutrition is seen in the first 1,000 days of life of a child's life - from the time of conception to the time they reach their second birthday.

For women, malnutrition increases risk during pregnancy and the delivery of low birth weight babies. Malnutrition is a serious issue in Tanzania as shown by the following statistics:

Patricio Marquez’s post correctly identifies lack of access to quality medicines as one of the constraints to poor people’s health in Africa. But the solutions he recommends—more public money for “essential drugs benefits”, building resilient institutions, and providing physicians with better scientific information and guidelines about drug prescriptions—are unlikely by themselves to improve poor people’s health outcomes.

More public money. Patricio notes that out-of-pocket expenditures are about 40 percent of total health expenditures and most of this is spent on outpatient drugs. He assumes the reason is that countries have not adopted a program of essential drugs benefits, and the reason for the latter is lack of public resources. But consider the following facts.

Medicines are key inputs for quality medical care and the prevention of disease, and when administered appropriately, as evidence from Sub-Saharan African countries shows, they can contribute significantly to reducing death rates due to conditions such as HIV/AIDS, tuberculosis, and malaria.

But it is also obvious that not everybody in these countries, particularly the poor, enjoys this benefit, since limited access to essential drugs remains a key challenge in most health systems. High out-of-pocket expenditures, typically more than 40% of total health expenditures in some countries (a large portion for outpatient drugs), also place a heavy burden on poor families with chronically ill members who require daily drug intake.

Let's think together: Every week the World Bank team in Tanzania wants to stimulate your thinking by sharing data from recent official surveys in Tanzania and ask you a couple of questions. This post is also published in the Tanzanian newspaper The Citizen every Sunday.

Tanzania has experienced an exceptionally high population growth – from 11 million in 1963 to over 45 million in 2012. Among the factors that have contributed to this increase –one of the fastest in the world– is the falling mortality rate. Life expectancy in Tanzania has increased over the past two decades from 50 to 58 years.

In addition, Tanzanian women have continued to have many children (5.4 per woman in 2010), which is higher than Kenya and Rwanda (4.6) as well as other sub-Saharan countries with the exception of Uganda.
Since 1991, this rate has only declined by 13 percent in Tanzania against 26 and 31 percent in Rwanda and Kenya, respectively. Several other factors have also contributed to the high population growth rate that Tanzania is experiencing:

There is no doubt about the importance of water to human existence. People need clean water to survive and stay healthy. Lack of clean water contributes to the high mortality rates in children around the world. Water is also critical to a country’s development as it is needed not only for agricultural productivity but also for industrial production. Yet access to water remains a major challenge in many countries. Tanzania has been blessed, both on the surface and below ground, with three times more renewable water resources than Kenya and 37 per cent more than Uganda.

Despite the vast amounts of fresh water available, many Tanzanians are still faced with water shortages due to insufficient capacity to access and store it both in rural and urban areas. Few households have access to clean drinking water from a piped source. Only a small fraction of rural households can access water to irrigate their farms. The following statistics illustrate the magnitude of the problem:

This blog post was co-authored with Dino Merotto, Tihomir Stucka, and Tau Huang.

The benefits of debt relief have persisted, although some countries may now be borrowing too quickly.

Remember Jubilee 2000 and the HIPC Initiative? Remember the “Drop the Debt” and “One” movements in 2005? Live 8? Bono on the White House Lawn? Those white “make poverty history” wristbands?

Seven years on, debt is now making headlines in the rich countries. In Europe and the US the news is of sovereign debt downgrades amid speculation about capacity to rollover debts, and countries’ long-term fiscal capacity to repay.

As a fan of numerology, let me focus on a special number that captures a global trend: call it the lucky number seven. Since the end of last year, we are seven billion people in the world. We produce a total GDP of US$70 trillion (which means that globally per-capita income is US$10,000 on average) and the average life expectancy worldwide is--you guessed it--70 years.

Let’s extend the seven thread: if the world economy grew at seven percent per year, it would double within a decade (because ten years of seven percent growth don’t amount to 70, but 99 percent, due to the compounding effect). Now with population growth at one percent (thankfully not seven), average per capita incomes would increase from US$10,000 to about 18,000. That is quite a jump, and a level of prosperity that few of our parents and grand-parents would never have imagined.

Sadly though, averages will continue to mask wide disparities, both between countries and within societies.

Let's think together:Every week the World Bank team in Tanzania wants to stimulate an evidence-based debate by sharing data from recent official surveys and ask you a few questions. These posts are also published in the Tanzanian newspaper The Citizen every Sunday.

Tanzanian families have been doing things differently of late. More of them have been sending their daughters to primary school and more women have become heads of families with increasing financial responsibilities. Increasingly too, more women are involved in the political arena today. These trends can also be found in most countries in the world but they are especially visible in Tanzania as reflected by the following statistics.

October 2012

Only 14% of Tanzanians have electricity. What can be done?

For shared prosperity Tanzania needs a universal strategy

Living a long and healthy life – Africa and Kenya are only starting to catch up

Invest in nutrition to invest in the future?

Improving access to drugs: Fitting the solution to the problem

How can we improve access and get more value from drug expenditures in Africa?

Can Tanzania afford 100 million citizens in 2035?

Tanzania: Water is life, but access remains a problem

African Debt since Debt Relief: How Clean is the Slate?

“Seven” is the world’s defining number: what does it mean for Kenya?

Is this a woman's world? Gender equality in Tanzania

October 2012

You are here

RESOURCES FOR