Health services delivery by the churches in Tanzania dates back to the pre-colonial era more than 100 years ago. Service levels as well as quality of the services were at a level that was proportionate to the needs and available resources. To a large extent, the resources were foreign, brought in with the coming of Church Missionaries. 

In post colonial Tanzania, the government assumed an increasingly role and commitment to reach the entire population with health services. The Church continued to provide services alongside the government based on national guidelines to compliment national initiatives in improving health and wellbeing of the entire population.

Up to early 1990s, the delivery of health services in the ELCT health institutions had been very challenging example inadequate financing of the services, poor health infrastructure, inadequate and poorly trained personnel, inadequate staff motivation and, therefore, high staff turnover in the institutions. Consequently, quality of services and, therefore, sustainability of the institutions was compromised.

As a response to this context and, as a means to improving the management situation of the health institutions, the Managed Health Care Program-MHCP was developed by ELCT and endorsed by the ELCT leadership in 1994 the program which ended in 2014. This was a strategy to provide health services that are affordable, accessible, equitable and of good quality with a focus on sustainability. It is also a reform strategy in itself to enable the ELCT cope with the challenges of the National Health Sector Reforms.

MHCP which was coordinated at the head office of the ELCT and implemented in dioceses, ELCT hospitals and surrounding communities resulted to several projects and programs that have been sustained in ELCT health work.