During the colonial era, the private providers of health services included the non-government organisations – mainly religious organisations and the voluntary Agencies. These religious organisations were and are still categorised as “private not for profit” providers of health services. The other category of private providers of health services are those who provide health services for profit “Private for Profit.This category of providers of health services have been in existence since the colonial period.

This arrangement in providing health services continued after Tanzania had become independence. After the Arusha declaration in 1967, there were reforms in the health sector. It was no longer accepted to trade/make profit using human health. The government was conviced that with the help from the “private not for profit” it could provide the required health services to all its people. In 1977, the private for profit were effectively banned from practising. However, there was a provision that they could continue providing health services if they were operating under the umbrella of religious organisations belonging to the private not for profit category. Many of the “private for profit” providers of health services opted for this only alternative. Their hospitals and first line health facilities were then registered under the auspices of religious organisation, mainly Christian and Islam.

The ban on “private for profit” health services continued up to 1991 when the government reviewed the ban. With time, it had became clear that the government’s ability to provide quality health services was being eroded by the unfavourable economic conditions. The review of the government allowed doctors and dental surgeons to start private for profit practice. Individuals who were not doctors were/are not allowed to start private practice on their own. In 1996 the Ministry of Health produced Guideline Standard for Health Facility. This was taken as a measure to ensure that private for profit and not profit provide quality services. Before a private health facility is registered, it has to fulfil the requirements of the Guideline Standards for Health Facility.

At the Ministry of Health Headquarters, there is a section in the Directorate of Hospital Services which deals with affairs of private hospitals, health centers, and dispensaries and clinics. Clinics include those which provide dental services.

The section is charged with the following tasks of:-

• Registration and supervision of private hospitals, Health Centres, Dispensaries and Clinics.
• Coordinating the activities of hospitals belonging to NGOs, voluntary Agencies, including those having the status of District designated hospital (DDH).
• Compiling annual reports of the NGO and VA hospitals
• Preparing budgets grant in Aid for the above mentioned hospitals
• Attending Board meetings of DDHs.
• Preparing and attending the annaul DDH, Tanzania Christian Medical Association (TCMA) and the Grant in Aid Advisory Committee meetings.
• Making follow up on issues concerning staff in DDHs.
• Recommending grants for the above mentioned hospitals
• Collaborating with other sections/departments within and outside the Ministry of Health, including reviewing policy guidelines and their implementation.
• Other tasks as may be directed by Directorate and the top leadership of the Ministry of Health Coordinating the Public/Private Partnership Strategy (No.7) in the implementation of the health sector reforms.
• Coordinating implementing the decisions of the Private Hospital Advisory and the Grant in Aid Advisory Boards.

Private Health Centres

There are a total of 126 registered health centers. 70 health centers belong to the Voluntary Agencies 50 health centers private for profit the remaining 6 belong to parastatal organization.

Private Dispensaries

There are 1340 registered private dispensaries. 561 dispensaries are private for profit while the remaining 250 dispensaries belong to Parastatal organizations. There are 30 registered dental clinics and 28 registered medical clinics.

Location of Private Health Facilities
Location of Private Hospitals, Health Centres and dispensaries of the 121 private hospitals 56% of these hospitals are located in the rural areas. These hospitals are almost all private not for profit. The remaining 53 are in Urban.

Of the 126 registered Health Centres 65 (52%) are in the rural areas. The remaining 61 (48%) are in the urban areas.

Regarding the location of dispensaries the available records shows that about 134 (10%) dispensaries are located in the rural areas. The rest are in the Urban areas. As for the dental and Medical Clinics all of them are located in the Urban areas.

The other private health facilities are pharmacies. Some of which belong to voluntary Agencies. The major parts are privately owned by individuals or private organizations.

• Pharmaceutical Services
• Diagnostic Services
• Traditional Medicine
• Mental Health

HEALTH FACILITIES (2000):

Source:   Ministry of Health Statistical Abstract          

The distribution of Health Facilities has a heavy rural emphasis because more than 70% of the population live in rural areas. Plans for the establishment of health facilities have in the past taken into consideration the facility/population ratio, but with time this has in some areas been seriously overtaken by the high population growth-rate.