Tanzania health system

Structure

  • 7,480 health facilities (~83% public/ Faith Based Organisation (FBO))
  • 85% of the population get their health services from primary health care facilities
  • 60% population uses public health system for the provision of malaria services

Four main levels:

  • District
  • Regional
  • Zonal
  • National

Training

  • 450 health workers will be trained on Emergency Triage Assessment and Treatment (ETAT) from 30 districts, including for severe malaria
    • To date, NMCP has conducted training of 294 health workers on ETAT from 21 districts.

Challenges

Resources allocation:

  • Aim for quality health services: a dispensary in every village, a Health Centre in every ward and a District Hospital in every District
    • Minimum number of health workers required: 145,454, actual number: 63,447 (shortage: 56.38%)
    • Rapidly aging workforce will exacerbate the crisis

Data use and culture:

  • Data quality, analysis and use of information for planning and decision making 

Limited access to medicine and health commodities:

  • Primary health care facilities face challenges in delivering services due to sub-optimal infrastructure, shortage of skilled staff and a lack of supplies of essential medicines
  • 2014:
    • 24.36% of health facilities in the country found to have entire package (10/10) of tracer medicines
    • 20%-30% of hospitals were out of stock of four common items
    • 40%-50% of hospitals were out of stock of a further six item 

 

Health financing:

  • Dependence on external partners (49%)

    • Significant proportion of donor funding goes to vertical programmes benefitting only a small segment of the population

    • Share of domestic tax sources (21%) is very low

    • Level of dependence on out-of-pocket payment (25%)

      • Source of inequity in access to health care and high degree of financial risk for family or individual emergency health expenditures