EXECUTIVE SUMMARY OF MANAGED HEALTH CARE PROJECT

The Evangelical Lutheran Church in Tanzania (ELCT) is one of the biggest churches in Tanzania with more than 3.5 million members.  Besides proclaiming the Word of God, the church is very much committed to other comprehensive social services including education, health, and other development related programmes. The ELCT is running 20 Hospitals and over 160 dispensaries and Health Centres catering health care for about 15% of the population of Tanzania which now stands at 34.5 millions (2002).

In 1997 the church launched innovative approach to Health Care provision by embarking on a programme of Managed Health Care. This is type of care pre-determined to suit the needs of the consumers and with concurrent advocacy on Community Health Fund. This approach to health Care is meant to provide excellent quality care to communities in service areas of ELCT Health Unit by using CHF to enable communities access services and at the same time sustain Health Units financially.

Managed Health Care Programme has 29 objectives classified in seven major categories which include: Emphasis on General Management of Health Units, Financial Management, Strengthening Primary Health Care, Reinforcing ELCT Health Policy, Staff Training, Research, Soliciting Doctors’ remuneration and Facilitative Supervision (Medical Audit).

This programme was evaluated in March 2002 after about a period of five years. The purpose of evaluation was to determine the achievements in relation to set goal and objectives, and to identify Programme constraints, threats and opportunities. Other purposes were to give recommendations for further changes in the Programme leading to more positive impact or suggest alternative for MHCP.  

The Evaluation report indicated that the programme had made positive impact to both health of the people served and management of health units and many other aspects of the programme. Following these findings, it was recommended that the programme is worthy further support and funding to produce more impact. However, one component of Primary Health Care indicated to have received limited emphasis and hence the need to strengthen this component in Phase II of the programme.

During planning for phase II of MHCP, eleven elements including PHC were identified as priorities for improved implementation of MHCP phase II and evaluation team put down some recommendations for better impact. These include: assisting diocese to prepare CBHC plans, improving supervision, adopting Health Education materials from successful dioceses, collaboration with Iringa PHC institution and adopting psycho-social methods for Health Education such as LePSA, and PRA. Others include strengthening the National Package of Essential Health Interventions, training Dispensaries and Health Centres on MHCP.

In phase II of MHCP, more emphasis will be on Primary Health Care - which is essential curative, promotive and prevention care aiming at strategies that keep people health through information, practice of healthy behaviours and participation of families in maintaining their health. The project will be implemented form July 2003 to June 2008. In this phase II of MHCP the PHC component will address measures for reduction of HIV prevalence, care and social support to people infected and affected with AIDS, reduction of morbidity and mortality due to malaria, improving Reproductive and Child Health services. Other elements will be improving sanitation, water supply, and prevention of hypertension, mental illnesses and eye problems in some dioceses of ELCT. Community participation and capacity building to diocesan PHC/AIDS Programme Coordinators will be essential part of the programme. The role of ELCT-PHC Coordinator will be help strengthen management capacity of diocesan programmes through training, advocacy and facilitative supervision.

Managed Health Care Programme Team at Headquarters will support the diocesan coordinators who will be the main implementers of the programme through supervision, training and soliciting funds. The DMCCD contribution will be participating in evaluation of programme impact and fund raising and endorsing any changes found necessary in Programme period. The cost of the PHC interventions, training, materials salary and equipment will be 385,075,200/- Tanzania million Shillings that will be reimbursed to the programme in instalments.

You can also read the full project document.