Creating an eHealth Strategy to Transform Health Care Delivery in Tanzania

Streamlining data collection and sharing through improved informatics and data use within the health sector

Tanzania is devoted to improving health care for its 51 million inhabitants. The majority of Tanzanians live in rural areas with limited access to hospitals, relying on health centers and dispensaries for most of their primary health care needs. Efforts have been made to implement information and communication technology resources to improve data collection, but these initiatives have generally occurred independently from national strategies.

As recognized by Tanzania’s Ministry of Health and Social Welfare (MOHSW), a well-planned eHealth ecosystem can transform health care delivery by enabling information access and supporting health care operations, management, and decision-making. An effective strategy should align with national health priorities and provide the guidance needed to efficiently share information across the entire Tanzanian health care network.

With guidance from the U.S. Centers for Disease Control and Prevention, MOHSW established the National eHealth Strategy to guide development of information and communication technology resources that mesh with its health needs and are easy to implement.

Developing, Planning, and Implementing an eHealth Strategy to Address Tanzania’s Chief Priorities

There are several models for developing an eHealth strategy, but such efforts often overlook the causal link between recognizing health sector priorities and determining how technology can be applied to support those priorities. To ensure that this did not happen in Tanzania, the National eHealth Strategy was guided by the Health Sector Strategic Plan, which identified the country’s health sector priorities.

Among the chief priorities for Tanzania are the high prevalence of HIV, tuberculosis, and malaria. The country also faces a significant shortage of health care professionals. According to MOHSW, Tanzania is only able to meet about 35 percent of its health care staffing needs. Another hurdle is reaching the approximately two-thirds of Tanzanians who live in rural areas, often with poor infrastructure. Many can only access small facilities that offer limited specialty care services.

The National eHealth Strategy addresses these and other priorities by using information and communication technology to enhance planning, managing, and delivering health services. Doing so supports the transformation of the Tanzanian health care system into a safe, high-quality, equitable, efficient, and sustainable system for all citizens. Our experts collaborated with MOHSW throughout the planning, development, and implementation of the National eHealth Strategy—including planning, management, and technical assistance services.

Teaming with MOHSW, we co-led efforts of many stakeholders to draft the National eHealth Strategy document over the course of two years. With funding from the Centers for Disease Control and Prevention (CDC) and the Embassy of the Kingdom of the Netherlands, an RTI and MOHSW team spent another year developing the revised framework, culminating in a one-week workshop with health sector and eHealth experts who collaborated to advance that framework to an implementable strategy.

The strategy was officially launched on September 30, 2013, and helped inaugurate the National eHealth Steering Committee, which continues to meet and review the eHealth work plan.

As Tanzania rolled out a new national Health Management Information System, we provided comprehensive technical assistance, including

• Helping to harmonize indicators
• Developing a national indicator data set
• Revising data collection instruments
• Strengthening supportive supervision
• Working with University of Dar es Salaam and MOHSW to improve capacity in the use of a national health information system.

After rolling out the new national system, MOHSW reported an overall national rate of completeness of 95 percent and on-time rate of 90 percent for the main HMIS forms during the period July through September 2015.

To improve its internal infrastructure, we worked with MOHSW and local vendors to upgrade Ministry networks, systems, and support services. This included establishing a helpdesk for MOHSW to provide effective technical support in information and communication technology to all Ministry personnel.

National eHealth Strategy in Action

Following publication of the strategy in 2013, the eHealth team developed a budget for 2013 to 2018, which included most of the strategic objectives of the health information system and provided MOHSW a framework from which to solicit donor funding. We also created an inventory of eHealth projects in Tanzania.

We are also working with MOHSW, the University of Dar es Salaam Computing Centre, OpenHIE, the Regenstrief Institute, and InSTEDD to introduce the national Tanzania Health Facility Registry. This online tool provides public access to a database of all health facilities in mainland Tanzania, with relevant facility information and GIS map locations.

The National eHealth Steering Committee continues to meet to review the status of implementation efforts and ensure that eHealth projects to ensure they align with the strategy. The Health Facility Registry that launched in September 2015 serves as a foundational element of the implementation, a task force continues to work on data exchange standards and interoperability, and the health sector continues to use the National eHealth Strategy as the blueprint for all eHealth systems.