governance and accountability, and for waiver schemes meant for the most vulnerable and disadvantaged groups. Childhood mortality and Right to Survival - There are indications that child mortality rates – which had remained stubbornly high throughout the 1990s, are now being reduced as improvements in areas such as malaria prevention, treatment and immunization begin to take effect. Preliminary results from the Tanzania Demographic and Health Survey (2004). indicate that the Infant Mortality Rate (IMR) has fallen by almost a third in the last five years (68 deaths per 1,000 live births, down from 99 per 1,000 in 1999)32. The under-five mortality rate (U5MR) has also dropped by nearly a quarter over the same period (from 147 per 1,000 live births to 112). Despite this, around 250,000 children die each year from preventable illnesses with 80 per cent of deaths occurring at home. Approximately half of all infant deaths occur in the week after birth, and neo-natal deaths account for 29 per cent of the U5MR. The leading causes of under-five mortality are, in decreasing order of importance, malaria, anaemia, pneumonia, prenatal conditions, diarrhea and HIV/AIDS. Malnutrition is an underlying cause of most deaths. Data from three Demographic Health surveys suggest an increase in Zanzibar infant and child mortality rates from 1996 to 1999, and a decrease thereafter. Indirect mortality estimates from the 1988 and 2002 centres data indicate a reduction of Zanzibar’s infant mortality, from 120 to 89 infant deaths per 1,000 live births under – five mortality dropped from 202 to 141 deaths per 1,000 live births during the same time period. The following table shows infant and child mortality rates in the five regions of Zanzibar:- 32 Tanzania Demographic and Health Survey (TDHS). All data from this section is from the TDHS unless otherwise indicated. 33

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