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

Structure 

In Tanzania, malaria diagnostic and treatment services are offered by 6,990 public, 359 faith-based organisations, and 872 private health facilities, while an additional 8,000 pharmaceutical outlets offer malaria treatment options. Preventive therapies for pregnant women are delivered in over 7,000 reproductive, child health clinics.[1] The estimate for reliance on the private sector in mainland Tanzania is that approximately 40% of patients with fever seek treatment at private health facilities. 

The health system has four main levels: 

  • District 
  • Regional 
  • Zonal 
  • National 

Training

Training 

By 2020, the (NMCP has conducted training of 294 health workers on Emergency Triage Assessment and Treatment (ETAT) from 21 districts. Training was planned for a further 450 health workers from 30 districts on ETAT, including for severe malaria. In 2019, an additional 2,251 healthcare workers received training on malaria case management and 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 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 ageing 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 suboptimal infrastructure, shortage of skilled staff and a lack of supplies of essential medicines 

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