Health

When the missionaries came to the diocese they brought with them knowledge to teach the gospel, skills to build churches, mission houses, classrooms to teach and train and health facilities (hospitals and dispensaries) to treat and care for the sick and dying.

The importance of building a holistically integral; part of a human persons, mind, body and soul has been part of the church history through decades of witnessing the work of evangelisation in the diocese. We are currently and directly responsible for four (4) dispensaries (Chidya Mtandi, Rondo and Bishop James). Two of these dispensaries (Mtandi and Bishop James) are new initiatives and two are legacies of the time before the 1971 nationalisations, when religious organisations took it upon themselves to establish hospitals and dispensaries, often served by qualified men and women who were called to be of service.

Health service provision is governed by the Diocesan Health Board and its primary role is to “ensure health services are operational and are in line with the national health policy; make sure that health workers abide by their professional ethics and the philosophy of ‘integral development’ that focuses on spiritual and material-wellbeing of people; make sure that health staff are transparent and accountable for church health grants; and ensure that the diocesan health office aligns to the national health plan in collaboration with the Health Authority of the Anglican Church of Tanzania”.

 The government of Tanzania explicitly recognises faith based organizations as significant partners in the provision of health care to its people. The diocese seeks to enhance and utilize the government partnership in the provision of health services by upgrading Mtandi dispensary to the health centre level as most of the requirements have been achieved. Mtandi dispensary can support the government with the vital health care services. Today the diocese continues to serve the people in four (4) dispensaries and the average number of patients served every month and maladies that people face are as stated below:

Chidya Dispensary

Rondo Dispensary

Mtandi Dispensary

Bishop James Dispensary

Overview

In the mid-1990s, the Tanzanian state initiated a public/private partnership (PPP) scheme in the health sector.  As part of this effort, churches were encouraged to revise their historic practices of building health facilities.   

To become eligible for a PPP contract, and so have the government meet costs of the health facility, certain criteria need to be satisfied.  If these are satisfied, the government will pay for medical equipment, certain salaries and drugs. 

Each health service, be it a dispensary, health centre or hospital, operates according to the same model and the government offers varying levels of financial support according to the health service provider satisfying certain criteria.

Health services therefore generate income by providing a variety of services to individuals.  These are summarised as follows:

  • Patient card (TZS3,000 at dispensaries and health centres, TZS5,000 at a district hospital, TZS10,000 for a regional hospital, TZS15,000 for a national hospital): this is effectively a cost of entry and part of the state’s ‘cost-sharing system’.  The patient carries the patient card through from first consultation through to prescription and is updated by the relevant person (doctor, lab technician, pharmacist) along the way;

  • Payment for medicines;

  • Service charges – for example, doctors are paid for their time;

  • Laboratory testing – the patient pays for each test that is undertaken on their behalf; and

  • Admissions – patients pay for use of a bed when they are admitted. 

Patients will pay cash unless they are:

  • Subscribers to one of the health insurance systems;

  • children under 5; or

  • pregnant women.

There are two health insurance systems in Tanzania. 

  • the National Health Insurance Fund.  Cost ranges from TZS190,000 to TZS3,000,000, depending on the number of beneficiaries in the household.  Can be treated anywhere in country.  Varying factors are: number in household and

  • the Community Health Insurance Fund.  This one is particularly at dispensary level, starting from TZS30,000 to TZS50,000.  People can be treated at dispensaries to regional hospital.  anywhere within district.  Maximum family members are 5.

The health service will normally receive payment from the relevant insurance fund within a week of month end.

The main costs for the dispensaries, health centres and hospitals are:          

  • medical equipment;

  • drugs;

  • staff salaries; and

  • repair and maintenance to keep sanitary (e.g. slashing grass during rainy season).

The Health System in Tanzania Today