HEALTH SYSTEM THINKING
Swiss TPH/HPSS Project interventions, a lifeline to the achievement of UHC in Tanzania
By Henry Mazunda
Jul 20, 2022
Swiss TPH has been implementing a flagship Swiss-Tanzania Cooperation Project, the Health Promotion and System Strengthening (HPSS) in Tanzania since 2011.
The project which entails development of innovative solutions and supports their integration into national systems and policies in order to improve access to, utilization and quality of health services in the country, has been contributing greatly to the government’s efforts towards the achievement of Universal Health Coverage (UHC).
Part of the project’s resources has been channeled towards research efforts in the areas of health financing, medicine supply and management, health technology and community health promotion.
Speaking recently at the National Institute for Medical Research (NIMR) Annual Joint Scientific Conference (AJSC), themed “A Multi sectoral Approach for Health: An Agenda for Health Systems Strengthening Towards Achieving Universal Health Coverage,” Swiss TPH/HPSS Project Director, Manfred Stoermer presented the project’s important contributions made to the Tanzania’s health sector.
“At this conference, we have made presentations on how we are supporting the government to achieve Universal Health Coverage through different innovative system strengthening initiatives such as improving the Community Health Fund into a viable health insurance scheme; developing a supplementary medicine supply system which ensures seamless supply of medicines even when the Medicine Stores Department runs out of stock; strengthening health technology systems as well as supporting the community health promotion programs”, he said.
In his opening remarks at the AJSC, Vice President of the United Republic of Tanzania, Dr Philip Mpango, said the UHC theme was relevant and timely for Tanzania as the global health community reiterates that in order to achieve universal health coverage, there is need to strengthen the countries’ health systems while also improving coordination of efforts and initiatives.
“Health is a cross cutting issue, which means, in order to be successful in this sector, the government, private sector and all other stakeholders must work together. In fact, I do not need to belabour the importance of multisectoral approach for the attainment of Universal Health Coverage at this meeting of esteemed scientists”, Dr Mpango said.
The AJSC brought together researchers, academicians, health practitioners, graduate and postgraduate students, policy and decision makers, the media and representatives of special groups to discuss and recommend solutions to major health challenges. Topics that were discussed included prevalent, emerging and re-emerging infectious diseases, neglected tropical diseases, traditional medicine, antimicrobial resistance, environmental health and climate change, non-communicable diseases, nutrition, reproductive, maternal, child and adolescent health.
Based on its operational research findings, Swiss TPH/HPSS Project was invited to make eight (8) presentations highlighting the project’s health systems strengthening contributions towards achieving universal health coverage with a focus on health insurance and health commodity supply and use.
Additionally, HPSS presented research findings pertaining to its initiatives at the symposium on the sidelines of AJSC under the banner: “The improved Community Health Fund (CHF) – Transforming a modest prepayment scheme to a viable health insurance for the Tanzanian population”.
The CHF is a government run pre-payment fund that was introduced in 2001 where each local government authority (LGA) was mandated to establish a community health fund. However, an evaluation pertaining to the operation of this fund showed that its implementation was marred by numerous challenges.
One of the priorities of the government is to ensure that all citizens have access to quality healthcare through health insurance systems, especially those in the informal sector in order to achieve the goal of universal health coverage.
It is therefore against this background that the Government embarked on reforms in the CHF governance, enrolment of members and benefit package. The SwissTPH/HPSS project has collaborated with the President’s Office – Regional Administration and Local Government (PORALG) and the Ministry of Health to improve the CHF insurance scheme and to ensure efficiency and effectiveness in the coordination and delivery of healthcare to eventually meet national goals. CHF Iliyoboreshwa is the reformed and improved model of the CHF and currently has over three million active members.. It is operated by the government as a non-profit scheme aimed at protecting citizens against high healthcare costs and has been implemented across all regions of mainland Tanzania.
In a related development, Swiss TPH/HPSS project has conducted a study on rational medicine use and factors affecting pharmaceutical practice in Tanzania which among other things revealed that public primary health facilities face critical shortage of qualified staff, resulting in inefficient use of resources.
The study findings were presented at the 10th African Pharmaceutical Symposium (AfPS) on “Pharmaceutical evolution in the era of technological advancement, the present and the future”, held from 16 to 21 July, 2022 in Dar es Salaam. The presentation pointed to the importance of technological tools for research activities, such as data applications to enhance reliability of data collection and analysis.
Technical Advisor on Medicine Supply and Management at Swiss TPH/HPSS project, Fiona Chilunda, said one of the areas in Tanzania that are highly affected by inadequate human resources for health is the pharmaceutical subsector, specifically at the primary health care service level.
“The capacity to deliver quality pharmaceutical or health care services depends on having a sufficient, competent, and flexible pharmaceutical workforce that is able to deliver the pharmaceutical and medicine related services needed”, she said. The study observed that the shortage of pharmaceutical personnel is also due to uneven distribution of available staff and slowness in government uptake of existing pharmacy graduates to provide services at primary health care facilities. This is compounded by poor recognition, unattractive payment package and lack of sufficient support to lower cadres, leading to low motivation and unwillingness to be engaged in public health facilities.
The Swiss TPH/HPSS project thus continues to be an important partner to the Tanzania Government for innovations and evidence-based information that inform government policies, plans and programmes in the health sector.