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.
  • In 2019, an additional 2,251 healthcare workers received training on malaria case management and malaria rapid diagnostic test (mRDT) quality control, 40 laboratory technicians received training on microscopy in the Lake and Western Zones, and 600 healthcare workers in the Southern Zone received training on malaria case management and mRDT QC. [2]
  • Also in 2019, Council Health Management Teams (CHMTs) conducted supervision visits and training to improve the quality of Malaria in pregnancy (MIP) services using the National Malaria Control Program’s (NMCP’s) quality improvement package in 1,462 (80%) health facilities in all seven regions of Lake and 66 Western Zones, and 1,044 (87%) in the four regions of the Southern Zone. [2]

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