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Dr. Samuel Ogillo
Association of Private Health Facilities in Tanzania - APHFTA
GIC Forum on Health and Social Protection, Bonn, Germany
August 27th, 2013
How to engage with the Private Sector: Experiences from Establishing a Public-Private
Dialogue in Health in Tanzania
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Overview Private Sector Engagement in Tanzania
PPD-Tanzania21/04/23
The private sector is a significant actor in the Tanzanian health care system
40% of primary health care services by the Private Health Sector
Strong presence of faith-based organizations (FBO) in marginalized rural areas
Formal private health sector- with Relevant Registration and Regulatory Bodies
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Stakeholder Landscape Tanzania Health Sector
PPD-Tanzania21/04/23
Source: PSA Report, USAID, IFC, WB 2013
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Overview Private Sector Engagement in Tanzania
PPD-Tanzania21/04/23
Till 2005 - Diverse, fragmented private sector: for-profit, non-for-profit, faith-based
Mistrust and misperceptions between the sectors was at highest between 1977 to 1991 due to unconducive healthcare policies and absence of dialogue platform
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Engaging the Private Health Sector in Dialogue- Tanzania: 2005
PPD-Tanzania21/04/23
2005: An informal group of key health leaders spearheading the policy dialogue and seeking new approaches for public-private engagement
TECHNICAL REVIEW 2005 Theme: Public Private Partnership for Equitable Provision of Quality Health Service. This was an eye opener to the health sector on Public Private Dialogue
The Joint Annual Health Sector Review 2005: PPP became an important agenda
AGREED: The Ministry of Health and Social Welfare in Tanzania to fully engage with the private health sector in dialogue towards improving healthcare delivery at all levels of care
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How to Engage? Taking Advantage of Opportunities
PPD-Tanzania21/04/23
- The policy and regulatory environment had to be conducive and welcoming to change if dialogue had to take place
- The Review of Health Care Policy in 2007 and the Health Sector Strategic Plan III of 2009 was an opportunity to make Public Private Partnership a cross cutting issue
- The private health sector actively participated in the policy formulation and strategy development process
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Taking Steps Towards Engagements
PPD-Tanzania21/04/23
Health Sector Policy 2007: PPP in health as cross cutting agenda- mentioned through out the policy document
The Policy guided the development of the Health Sector Strategic Plan III 2009-15, where PPP would also be a cross cutting agenda - Strategy (6) dedicated to PPP
Appointment of a Public Private Partnership Steering Committee by Permanent Secretary, Ministry of Health and Social Welfare: Constituted Public and Private Health Sector Representatives
Led to formation of PPP Technical Working Group (2009)
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Taking Steps Towards Engagements-2
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2010-2011: PPP Policy and PPP Act
Government of Tanzania developed a PPP Policy in 2010
PPP Act passed by parliament in 2011
2013 - PPP Act under review to better accommodate smaller PPPs, including PPP health initiatives
Service Agreements for healthcare delivery have been signed between Government and Private Sector
An enabling and conducive environment for dialogue and partnership has thus been created
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Public-Private Forum for Health in Tanzania
Forum Board
Resource Centre
Secretariat
Building a Platform: The Public-Private Health Forum
PPD-Tanzania21/04/23
an inclusive, participatory mechanism in which a diverse range of stakeholder groups come together regularly for exchange
Joint Agreement on vision, mission, guiding principles and how to work together efficiently – clear roles, responsibilities, operating policies and governing structures
Shared Leadership through Forums Board chairs, which is responsible for the strategic direction, policy dialogue with key government officials, and technical leadership
Supportive structure through a secretariat, resource centre and TFs
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The Public-Private Health Forum in Tanzania - Composition
PPD-Tanzania21/04/23
Public-Private Health Forum in Tanzania Board
Government of Tanzania (8)
Health Professionals
(2)
Related to Health
(4)
Private Health Services
(6)
Private Sector in Health (12)
APHFTA PRINMAT TAPI/TPM CSSC BAKAWATA Foundation
Alternative Medicine
still to be nominated
MOHSW (2)
MOF PPP Commission
(1)
PMO-RALG (2)
PMO/TIC PPP Unit
Coordinator (1)
TPHA MAT 3rd slot under
consideration
Non-health businesses (1) ATE
API (1)
PMTI (1)
Civil Society (1)
Other Ministry (by invitation)
(1)
NHIF (1)
Development Partner
(1)
Source: Draft TOR , GIZ 2013
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Other Platforms for Engagement in Tanzania Health PPDs
PPD-Tanzania21/04/23
NPPP Steering Committee PPP Technical Working Group Reforms of District & Regional Hospitals Maternal, Newborn & Child Partnership NHIF & NSSF Private Hospital Registration Board Joint Annual Health Sector Reviews Human Resource for Health Working Group Health Financing Committee OTHERS ++
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Successes Challenges
PPD-Tanzania21/04/23
- Space for all health sector groups established to discuss health system issues
- Linkages between various stakeholders strengthened
- Capacities at public institutions built up
- Private sector engagement advocated
- Organizing the divers private health sector
- Political willingness
- Level of influence and significance of the forum on decision making processes
- Accountability and transparency
- Limited capacities
- Develop coherent financing policy/strategy
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What Was the Force Behind the PPD?
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Realization of the need to dialogue - identification of problem and drivers for change
Strong commitment and leadership:- crucial from both public and private key health leaders
Realization of the need for change in mindset:- Development of a positive attitude towards each other
Integrity: Transparency and openness pre-requisite Management of a divers group of stakeholders
secretariat needs to be well equipped (human capacities and financial resources)
Political will
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Way forward
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- Formalize dialogue structures at national – regional – local level
- Strategic priorities for increased private sector engagement development of a roadmap and working plan
- Identify strategic investments and business models Develop PPP Pipeline and potential projects
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Food for Thought
PPD-Tanzania21/04/23
Consider approaches used by developed countries to help improve healthcare services in developing countries: Is there a need for change in our approach?
How can developing countries engage in healthcare business partnerships with the developed countries, and in turn bring a positive change in healthcare through these partnerships instead of a donor-recipient relationship
What is the private health sector’s role in the attainment of UHC?
How can PPP, e.g. Service Agreements, enhance the attainment of UHC?
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Thank you for your attention
The Association of Private Health Facilities in Tanzania - APHFTADr. Samuel Ogillo, [email protected]
Dar es Salaam, Tanzaniawww.aphfta.org
Tanzanian German Programme to Support Health -TGPSHDr. Inge Baumgarten, [email protected]
Dar es Salaam, Tanzaniawww.giz.de / www.tgpsh.or.tz
PPD-Tanzania21/04/23
