Lessons learnt abroad on healthcare

‘Public Private Partnerships can change the face of healthcare in Africa’ – this was a bold and apt statement made by Dr Amit Thakker, Chairman of Kenya Healthcare Federation during the Tanzania Health Summit in 2016.
The public private partnership system he proposed echoes the principal of an integrated health system that is at the heart of Ontario’s Local Health Integration Network (LHIN) in Canada.
While Tanzania and Ontario have grossly different health systems, both rely on health service provided by privately owned entities.

The lessons
There’s a lot that Tanzania can learn from their Canadian counterparts. The Local Health Integrated Network (LHIN) plan, integrate and fund local health care, improving access and patient experience. This is done by bringing together a variety of stakeholders to achieve the common goal of improving access to healthcare for all.

• In Ontario, each region has a LHIN which is further divided into smaller sub-regions having their own respective sub-LHINs. This enables each sub-region to focus more on their target population and the diseases affecting them.
 For example; some sub-regions of the province have older people, hence the incidence of ischemic heart disease would be more. The LHIN system allows different regions to implement the vision of the ministry of health at a local level.
This new system reduced unnecessary bureaucracy and in turn helped many sub-regions save up to 8 per cent of their allocated budget. This is an important lesson for Tanzania.

• The establishment of the LHIN system also created a better sense of responsibility in terms of using the allocated health budget. Numerous sub-regions used their budget well and self-funded a lot of the health initiatives without creating an extra deficit for the federal government.

• Another benefit of the LHIN system is community engagement. It involves the public and takes feedback from the community regarding primary care, mental health and much more. They then use this feedback to improve the health services in the area.

• The LHIN system facilitates coordinated care where health facilities communicate with each other in case a patient gets services from different health centers.
This creates a harmonious relationship between healthcare workers and leaders of different health institutions unlike in Tanzania, where competition and profit are in most cases considered a priority.

Today, a year after Dr Thakker’s speech, Tanzania is still lacking a robust Public Private Partnership (PPP).
Private facilities near each other continue to invest in the same resources competing for the same demographic. Often, patients would have to repeat medical tests when shifting from one facility to another as patient records are not always shared between healthcare providers causing delays due to repetitive history taking.
The lack of understanding between private and public entities is one main problem in Tanzania. The current status quo of ‘public vs private’, a competition that exists in the minds of various health stakeholders hinders the effectiveness of better healthcare for the Tanzanians.
This is reflected by a statement from the CEO of Sanitas Hospital, Mr Murthy Venkateswaran, “The public sector does not trust the private sector and until this is overcome, an integrated health system in Tanzania will only be a dream.”

The author is a Tanzanian health professional pursuing post-graduate studies in Public Health at Western University, Canada.