A one-day symposium was held in Dar es Salaam on 28th February 2020 to learn from the results of evaluations of quality improvement programmes, and to discuss the way forward for institutionalizing quality in Tanzania’s private sector.

The symposium was hosted by the Christian Social Services Commission (CSSC), Association of Private Health Facilities in Tanzania (APHFTA), the PharmAccess Foundation, and the Ifakara Health Institute (IHI), with the Guest of Honor being Chief Medical Officer Prof. Muhammad Bakari Kambi of the Ministry of Health Community Development, Gender, Elderly and Children.

Why private sector? The private sector is an important and growing provider of healthcare in Tanzania, and has the potential to play a key role in the move to Universal Health Coverage (UHC).  UHC requires both improving access to care, and quality of care, but improving quality can be very challenging.

Findings were presented from an impact evaluation of the SafeCare Model developed by PharmAccess with the aim of improving quality of care, which was implemented by APHFTA and CSSC in health facilities in Tanzania. The impact evaluation was conducted by IHI, PharmAccess and London School of Hygiene and Tropical Medicine.

The evaluation results highlighted that baseline quality was low in all facility types, as measured through compliance with infection prevention and control (IPC), and through treatment of standardized patients. SafeCare was effective at improving structural quality a little, but did not improve clinical quality. Future programmes should consider stronger incentives for quality improvement, greater focus on improving care processes, targeting fewer high-volume facilities, and exploring digital strategies to increase intervention intensity.

The meeting ended with the signing of a “Quality Improvement Declaration” by APHFTA, CSSC and PharmAccess, committing to strengthening quality in Tanzania’s health system in terms of safe, effective and patient-centred care.

The SafeCare evaluation was funded by Health Systems Research Initiative, jointly supported by the UK Medical Research Council, Economic and Social Research Council, Department for International Development, the Global Challenges Research Fund, and the Wellcome Trust.

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