A healthcare provider engages a client during an integrated outreach in Mbeya, Tanzania.
Each year, the Government of Mbeya District Council (DC) in Tanzania allocates funds for family planning services, recognizing their vital role in improving reproductive health outcomes. However, like many councils, Mbeya DC faces persistent challenges with limited budgets, inefficient tracking of expenditures, and underutilization of allocated funds. Gaps in documentation make it even harder to justify increased allocations, compounding resource constraints.
As Tanu Kameka, the District Executive Director of Mbeya DC, explained:
The budget is small, and even the limited funds are not fully used. Frequent transitions of healthcare providers make it harder to implement and monitor plans including community skepticism about family planning affects service uptake.”
When The Challenge Initiative (TCI) began working with Mbeya DC, these financial management challenges were significant barriers to effective budgeting and spending on family planning. Health finance staff lacked training in financial reporting systems, which delayed resource allocation and disrupted service delivery. Without swift intervention, these inefficiencies threatened the sustainability of TCI-supported facilities.
Strengthening Financial Management for Family Planning
To address these challenges, TCI partnered with the Mbeya health management team to improve financial planning, budget allocation, and expenditure tracking. Through targeted coaching and collaboration with geography teams, TCI helped strengthen adherence to public financial management procedures and promote transparency. The approach focused on:
- Building the capacity of city health finance teams to accurately document and track expenditures.
- Encouraging councils to commit to an annual increase of at least 10% in family planning funding.
- Improving fund utilization to ensure resources directly support service delivery.
Key Financial Management Systems
Two key financial management systems played a pivotal role in this transformation:
- Planning and Reporting System (PlanRep): PlanRep supports health facilities in developing accurate financial plans and ensures resources are allocated efficiently.
- Facility Financial Accounting and Reporting System (FFARS): FFARS tracks budget disbursements and real-time expenditures while generating reports at facility, council, regional, and ministry levels.
TCI trained city health finance officers and budget teams to use these systems effectively, significantly enhancing financial accountability.
Notable Achievements
Because of TCI’s support, Mbeya DC has made remarkable strides in strengthening its financial management systems for family planning:
- Increased Financial Commitments: Local governments have consistently increased their family planning budgets by more than 10% annually. From TZS 70 million in 2022–2023 to TZS 90.5 million in 2024–2025, this sustained growth reflects a deepening prioritization of family planning services.
- Improved Fund Utilization: Before TCI’s intervention, a large portion of the allocated funds went unused due to poor documentation. With enhanced financial management, councils now fully utilize their budgets. In 2023–2024, Mbeya DC achieved an extraordinary 197% expenditure rate, more than doubling the allocated commitment and marking a 243% increase from the previous year.
- Stronger Alignment Between Commitments and Expenditures: The projected 72% spending rate for 2024–2025 reflects more strategic planning, better resource mobilization, and efficient fund utilization.
- Strengthened Financial Management Systems: Integration of PlanRep and FFARS improved transparency and made budgeting and expenditure tracking more structured and effective.
- Institutionalized Data-Driven Decision-Making: Councils now use financial data and performance scorecards in quarterly reviews to evaluate progress and advocate for increased funding during the Comprehensive Council Health Planning process.
- Greater Local Government Ownership: Through coaching and financial clinics, city health finance officers have taken stronger ownership of documenting and tracking expenditures – leading to a more sustainable, locally driven approach.
- Sustained and Future Commitments: Family planning funding is now fully integrated into current and future work plans, ensuring high-impact interventions remain a budgetary priority.
Overcoming Challenges and Ensuring Sustainability
County Health Management Team, an Igawilo Health Care Facility member, and the TCI team during a “Strengthening Family Planning Financing” clinic in Tanzania.
Transforming financial management in Mbeya DC came with its own set of challenges. Early on, councils lacked proper documentation and had difficulty retrieving accurate financial data due to the absence of designated focal persons for tracking expenditures.
To address these gaps, TCI’s finance and grants teams provided hands-on coaching and helped establish structured processes. While major progress has been made, sustaining these improvements requires ongoing engagement, including regular financial review meetings, performance monitoring, and strong leadership.
As Iman Kagesya, District Health Secretary for Mbeya DC, shared:
The financial reviews and clinics program have demonstrated that FFARS is a powerful tool for tracking expenses within the government system. It provides clear visibility into spending at each health center and the remaining balances in each unit, allowing us to make informed decisions and better manage our financial resources.”
By embedding sound financial management practices into local systems, TCI is fostering lasting, system-wide change in Tanzania. Mbeya DC’s experience shows how targeted coaching, local ownership, and the use of real-time data can transform how family planning programs are funded and managed –ensuring they remain accessible, efficient, and sustainable.
