Health System Strengthening
The Health Promotion and System Strengthening project strives to improve quality and utilization of health services in Tanzania. We are cultivating an effective, well-governed, accessible health care system to scale at national level. The goal of the project is to improve the health status and well-being of Tanzanians, focusing on those most at risk, and to support health systems in becoming more responsive to health needs for all population groups.
Our objective is to improve quality, access to, and utilization of health resources and services, and to see these services delivered by an effective and well-governed health system.
Our approach combines health promotion and integrated system strengthening at zonal levels. To strengthen the health system, we are redesigning health financing approaches and providing support for management of finances, medicines, equipment and infrastructure.
We are attentive to issues that cut across the boundaries of these realms, too: gender, HIV/AIDS, social inclusion and good governance are core values in this project and are mainstreamed in all our activities.
Encompassing is our commitment to operational research to optimize strategies for sustainable, effective health systems and to provide evidence to support policy dialogue and implementation.
History of the HPSS project
HPSS phase 1 identified major problems facing the health system in Dodoma Region on both the supply and demand side, and developed innovative solutions for health system strengthening and participative approaches for solving them.
HPSS phase 2 fully elaborating these solutions, implementing them in three pilot regions (Dodoma, Morogoro and Shinyanga), with testing and adjusting in a process of empirical analysis and by engaging in stakeholder alignment and government policy support. National roll-out of innovations started with anchoring in national policies and training institutions.
HPSS phase 3 is conceived as an exit phase to ensure the sustainability of the outcomes. It integrates lessons learnt from implementation with recommendations from the Tanzanian government (MoHCDGEC, PORALG, and MOFP), suggestions of implementation partners and national institutions (NHIF, MSD) and builds on the findings and recommendations of the mid-term review.
Phase 3 of the HPSS project
The health system of Tanzania is strengthened in respect to iCHF health insurance, Jazia PVS medicines management, health technology management, and community participatory health promotion.
A Technical Assistance Facility (TAF) for the GoT coordinated through the Health Systems Strengthening Resource Centre located at PORALG. The TAF
1) supports the scale up of HPSS innovations,
2) supports the development and dissemination of standard operating procedures and policy guidelines for effective deployment of HPSS innovations, and
3) uses innovative capacity building approaches to ensure compliance with guidelines;
Specialized assistance for digitalisation to the GoT (MoHCDGEC, PORALG, and MoFP) to ensure system compatibility and effective integration of HPSS interventions such as the health insurance management information system (CHF-IMIS), including the cashless payment function integrated in the Government Electronic Payment Gateway (GePG) and others, as well as IT systems relating to Jazia PVS, equipment management system and health promotion;
The creation of nationally-led think-tank structures, e.g. a Research Advisory Committee for evidence generation to identify and prioritize knowledge gaps relevant to the nationwide deployment of iCHF, Jazia PVS, and HTM and HP, to be addressed in partnership with suitable consultants and academic institutions.
The Technical Assistance Facility (TAF) effectively supports national implementation of iCHF, Jazia PVS, openMEDIS and community participatory HP.
The GoT effectively develops and implements digitalization solutions regarding CHF-IMIS, Jazia PVS, openMEDIS and health promotion, aligned with the national IT landscape.
Data and findings generated by HPSS are effectively used to develop evidence based capitalisation products for informing policy decisions of GoT.
Cross cutting issues included in work plans are gender equity, accountability and the promotion of innovation.
The HPSS project concentrates on supporting the GoT with the nationwide scale-up of HPSS innovations through the provision of specialised technical assistance. It has moved from the project mode of working in 3 pilot regions to supporting the GoT at national level. Its objectives are to refine the products of the project, to optimize their implementation strategy, support their inclusion in the policy dialogue in Tanzania and anchor them at central government level. HPSS provides TA to optimize implementation of the innovations, to ensure full system compatibility and compliance with government digital systems, and to support the further advancement of policy options through evidence generated.
HPSS supports MoHCDGEC and PORALG through a close integration at the level of work plans. The project utilizes the “Health Systems Strengthening Support Centre” anchored at PORALG as a coordinating mechanism to provide TA to both MoHCDGEC and PORALG for policy and implementation support of the project component contents.
MoHCDGEC and PORALG provide strategic direction to HPSS for elaborating annual and quarterly work plans, which are jointly discussed and agreed. HPSS provides a budget for supporting their implementation. In order to achieve sustainable solutions, the financial contributions of HPSS is complementary to the governmental resources invested.
The HPSS project management unit (PMU) in Dodoma provides human resources, financial management and procurement services. The PMU reports to the HPSS Project Director at the Swiss TPH.
The TAF provides operational and technical expertise in implementing iCHF, Jazia Prime Vendor, openMEDIS, and community participatory health promotion. The TAF expertise represents all levels of operations (community, district, region, zones, nation, IMIS). It is managed by the Project Manager reporting operationally to the Director Health Services (PORALG) and to the HPSS Project Director. Technical experts on various project components based in Basel and Dodoma support the programme implementation. In addition, the project has deployed eight zonal rapid response teams with a focus on monitoring of HPSS innovations.
Central facilitation and Zonal satellites
The project provides technical support to the government centrally through the national senior Technical Team.
For backstopping the implementation activities in the regions, the project operates with decentralized satellite teams. The technical support teams are posted in eight operational zones, covering 3 to 4 regions per zone.