The journey to better quality healthcare in Tanzania

SafeCare’s quality improvement programs have rapidly scaled up. In Tanzania, SafeCare works with the local Ministry of Health and supports hundreds of facilities in delivering safer, higher quality healthcare to patients.

Delivering quality care has been a recurring theme for the Tanzanian Ministry of Health. For years, improvement interventions were mostly ‘vertical’, or focused on improving access to care for specific diseases such as HIV, Malaria and TB. These top-down interventions led to fragmented healthcare provision. In some cases, two or more intervention teams would work at the same facility, leading to the duplication of services. As observed in similar initiatives, this fragmentation led to low impact and overburdened healthcare workers.

Through a Memorandum of Understanding in 2012, SafeCare supported the Ministry’s facility-wide quality improvement project at public district hospitals. At the same time, through partner organizations, SafeCare also helped improving the quality of care a private, for-profit and at faith based facilities.

Over 350 health facilities in Tanzania have now adopted SafeCare. These facilities, despite their limited resources, incrementally work to comply with internationally approved standards of care. With improvements and standardization leading to investors providing more loans to the sector.

One of the early SafeCare adopters was Tumaini TAG health center. In it's first years of business the facility struggled. Monthly cash flow was too low to pay rent and staff salaries were paid in arrears. The dispensary lacked adequate drug stock, which led to stagnant patient numbers. For facilities like the Tumaini TAG, growing their business and quality of care is challenging. African Banks often hesitate to provide loans to smaller facilities as they perceive the sector as risky and non-transparent. Combined with the shortcomings in quality and little insight into performance, staff were unable to make informed decisions and prioritize.

Tumaini TAG joined PharmAccess’ Medical Credit Fund program in 2011 with it's first business loan. In tandem the facility committed to a quality improvement journey with SafeCare. SafeCare tools and training modules enabled staff to identify gaps and plan a step-by-step quality improvement plan. Over time, they made progress and saw their patient numbers and revenues increase.

Tamaini Matron, nursing supervisor at Tamaini TAG shares:

Most of our patients are surprised about the affordable prices compared to the high-quality services that they receive. Our customers usually recommend our facility to other people, and that is one of the reasons that has contributed to the growth in patient numbers.

Poor quality healthcare is a structural barrier to achieve universal healthcare. Governments in low-income countries have limited capacities to perform inspections and face a shortage of objective standards and data on the providers’ quality. Moreover, providers struggle how to prioritize and to improve. Therefore, SafeCare develops international standards for transparency and bench-marking purposes and supports facilities with stepwise improvement programs. Furthermore, it collects data on quality of care, enabling better decision making.