Background

GTZ, together with its German partner organisations, started the Tanzanian-German Programme to Support Health (TGPSH) in 2003 to assist Tanzania's Health Sector Reform. It has contributed to the drop of HIV prevalence in the country, improvement of management capacities in the Health financing System, the increased availability of health professionals and the establishement of Public-Private-Partenerships on regional and district levels.

Since 1994 the Government of Tanzania has been striving to bring about in-depth reforms of the health sector, seeking improvement of the quality and accessibility of services throughout the country. The Health Sector Reform was approved by parliament in 1997 and is widely supported by the donor community. From 1998 a Memorandum of Understanding (MoU) has been signed formalising a Sector-wide Approach (SWAp) for Health Development. It forms part of a comprehensive reform process which comprises also the Civil Service Reform and the Local Government Reform.

Support to the Health Sector Reform

In January 2003 the Tanzanian German Programme to Support Health (TGPSH) started its activities. This programme aims at supporting the health sector reform in Tanzania in achieving its goal “to improve the health and well-being of all Tanzanians with a focus on those at most risk and to encourage the health system to be more responsive to the needs of the people”.

Different German organisations as outlined below contribute to TGPSH in the 4 programme regions namely; Mtwara, Lindi, Tanga and Mbeya.

  1.  Deutsche Gesellschaft fuer Technische Zusammenarbeit (GTZ)
    • Capacity development at central, regional and district level
    • Policy and strategy development
    • Priority activities of Regional and Council health Management teams
    • Improvement of Zonal Training Centers / Zonal Health Training Institutes
    • Increased knowledge and competence on reproductive health and AIDS
    • HIV workplace programmes with the public and the private business sector 
  2.  KfW, German Development Bank
    • Rehabilitation programme for district hospitals and some HC in Tanga and Mtwara region
    • Social marketing of condoms and contraceptives
    • Health sector basket fund
  3.  Deutscher Entwicklungsdienst, German Development Service (DED)
    • Hospital Management Advisor at Regional Hospital Tanga, Mtwara and Lindi
    • AIDS Advisor to Lindi and Mtwara regions
    • Medical doctors in Mtwara and Lindi regions
    • Building Engineer for District Health Improvement Programme, Mtwara
    • Engineer for medical equipment for zonal workshop, Mtwara
  4.  Centrum für internationale Migration (CIM), Tanga 
    • Medical doctors at Regional Hospitals of Tanga and Lindi
    • Cooperation with the Christian Social Service Commission (CSSC)
  5. InWEnt - Capacity Building International, Germany
    • Training of trainers
    • Course development
    • Distant learning courses
    • Training overseas

The programme contains 4 components:

  1. Sexual and Reproductive Health and Rights and HIV/AIDS:The positive impact of TGPSH is especially evident in Mbeya region, where the HIV prevalance dropped from 13.5% in 2003/04 (ref. to the Tanzania HIV survey) to 7.9% in 2007/08 (ref. Tazania HIV/AIDS and Malaria Indicator Survey). In line with the Strategic Plan to Accelerate reduction of Maternal, Newborn and Child deaths  in Tanzania (2008-2015) additional approaches include the concept of Community Based Distributors (CBDs) to provide family planning in rural areas, information and educational materials for youth on sexual reproductive health and rights and the implementation of peer education activities in primary and secondary schools.  
  2. Health Financing and Social (Health) Protection: Quality procedures for scoial security and health financing are the keys in TGPSH's efforts to support Tanzania's Poverty Reduction Strategy  as well as the German Action programme to 2015 for poverty reduction in regards to basic social services. TGPSH collaborates with different stakeholders in a multi level approach dealing with implementation of mid-to-long-term health financing strategy and capacity building at the national level. Competence centers have been established at different levels to improve functioning of local prepayment/insurance systems (Community health Funds-CHF), which had a positive influence on the enrolement rate.
  3. Capacity Development and Human Resources:  TGPSH supports capacity development and promotes human resources. its most important contribution is the development of the certified modualr course in District Health Management by InWEnt, which is taught in the Zonal Health training Institutes (ZHTIs) and the Master of Public Health (MPH) course- meeting international standards - at the Muhimbili School of Public Health and Social Sciences. The number of health personnel in Lindi-programme region has doubled from 98 to 219 , in the period 1999 -2007.
  4. Decentralised Subsidiary (Public and Private) Health Services: TGPSH' major contribution has been the establishment and implementation of Service Agreements (SAs), which ensure an efficient working relationship between public and private  health service providers on district and local levels. TGPSH has contributed to the development of a National PPP strategic Plan and the establishment of six SAs, four of which are in its programm regions. 
 
2006 Copyright Tanzanian-German Programme to Support Health.