Deep Dive: Zanzibar government pledges stronger support for nurses and midwives

Zanzibar, a semi-autonomous archipelago within Tanzania, faces persistent challenges in its health sector, particularly in maternal and child health outcomes, which are critical in island contexts with limited resources and geographic isolation from mainland facilities. The pledge by Permanent Secretary Mngereza Mzee Miraji underscores a targeted government effort to bolster frontline healthcare workers amid ongoing needs for better infrastructure and welfare, reflecting broader East African priorities where nurses and midwives are pivotal in combating high maternal mortality rates influenced by cultural practices, poverty, and access barriers. Key actors include the Zanzibar Ministry of Health, led by figures like Miraji and Director Mwanaisha Juma Fakihi, whose commitments align with national health strategies emphasizing professional development through events like the 2025/2026 licensing exams and orientation training. This initiative highlights the strategic interest of the semi-autonomous government in retaining skilled personnel, as nurse shortages are a regional pain point exacerbated by migration to urban centers or abroad, impacting service delivery in rural Zanzibari communities. Cross-border implications extend to Tanzania's union dynamics, where Zanzibar's health investments could influence mainland policies and donor funding from organizations active in the Indian Ocean region. Globally, improved midwifery support here contributes to Sustainable Development Goals on health, affecting aid flows from international partners concerned with African maternal health metrics, while culturally, it navigates Swahili Islamic traditions that shape women's healthcare seeking behaviors. Looking ahead, sustained implementation will determine if these pledges translate into tangible reductions in mortality, potentially serving as a model for other small island developing states grappling with similar workforce and facility constraints, though fiscal dependencies on tourism and cloves exports pose risks to long-term viability.