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Dr. Samuel Ogillo Association of Private Health Facilities in Tanzania - APHFTA

How to engage with the Private Sector: Experiences from Establishing a Public-Private Dialogue in Health in Tanzania. Dr. Samuel Ogillo Association of Private Health Facilities in Tanzania - APHFTA GIC Forum on Health and Social Protection, Bonn, Germany August 27 th , 2013.

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Dr. Samuel Ogillo Association of Private Health Facilities in Tanzania - APHFTA

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  1. How to engage with the Private Sector: Experiences from Establishing a Public-Private Dialogue in Health in Tanzania Dr. Samuel Ogillo Association of Private HealthFacilities in Tanzania - APHFTA GIC Forum on Health and Social Protection, Bonn, Germany August 27th, 2013

  2. Overview Private Sector Engagement in Tanzania 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 PPD-Tanzania

  3. Stakeholder Landscape Tanzania Health Sector Source: PSA Report, USAID, IFC, WB 2013 PPD-Tanzania

  4. Overview Private Sector Engagement in Tanzania 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 PPD-Tanzania

  5. Engaging the Private Health Sector in Dialogue- Tanzania: 2005 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 PPD-Tanzania

  6. How to Engage? Taking Advantage of Opportunities 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 PPD-Tanzania

  7. Taking Steps Towards Engagements 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) PPD-Tanzania

  8. Taking Steps Towards Engagements-2 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 PPD-Tanzania

  9. Building a Platform: The Public-Private Health Forum 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 PPD-Tanzania

  10. The Public-Private Health Forum in Tanzania - Composition Source: Draft TOR , GIZ 2013 PPD-Tanzania

  11. Other Platforms for Engagement in Tanzania Health PPDs 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 ++ PPD-Tanzania

  12. Successes Challenges 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 PPD-Tanzania

  13. What Was the Force Behind the PPD? 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 PPD-Tanzania

  14. Way forward 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 PPD-Tanzania

  15. Food for Thought 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? PPD-Tanzania

  16. Thank you for your attentionThe Association of Private Health Facilities in Tanzania - APHFTADr. Samuel Ogillo, ogillo@aphfta.orgDar es Salaam, Tanzaniawww.aphfta.orgTanzanian German Programme to Support Health -TGPSHDr. Inge Baumgarten, tgpsh@giz.deDar es Salaam, Tanzaniawww.giz.de / www.tgpsh.or.tz PPD-Tanzania

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