The Interview was done purposely as a way of getting key issues that the Chairman wants to share with APHFTA members and the public at large.
I qualified from Makarere University College, Kampala in March 1966 and joined Muhimbili in April the same year for my Internship. In 1967 I was posted to Tanga as Registrar. You can therefore say I started practicing medicine in April 1966 while at Muhimbi; that is 47 years as of today.
In my opinion, the future for a Tanzanian Doctor in private medical practice is bright. However, the environment of practicing has changed drastically. In the past a single doctor practice was a viable proposition. Today, because of population explosion, greater demand for a more sophisticated and changing health care system, greater awareness of the population in demanding a more targeted specialised care, group private medical practice of several doctors with different specializations working together as a team, would be a more viable proposition. Growth and expansion would be easier and desirable. Single doctor practice is not to be encouraged any more as its survival is precarious.
ii. Briefly share your short term and long term dreams for APHFTA (Next 5 years and next 10 years)
APHFTA has come a very long way from a very small beginning at its inception in 1994 with hardly 30 members, no secretariat, no sustainable income, with membership confined mainly of Dar es Salaam private practitioners, to what it is today. However, due respect must be given to our founder members for sustaining the Association for many years under a very harsh and unfriendly environment. These few devoted individuals kept alive the unity of the private health sector; conducting Annual Scientific Conferences every year and AGMs without fail, year in and year out, under very difficult financial situation. APHFTA has to pay homage to these valiant individuals who were pioneers of the private health sector. Today APHFTA and the private health sector as a whole have become stronger and important stakeholders in the health system of Tanzania than ever before.
By 2002 when the present leadership took over the Association, known then as “The Association of Private Hospitals in Tanzania – APHTA” had a membership of only 84. A decision was then made by us to change the way the association was being run, to make it more dynamic and expand not only its membership across the country, but also to lay down ideas of how to provide advocacy, networking system, continuous professional and non-professional training, strengthen their capacities and provide a more interactive forum for exchange of ideas and provide a launching pad for growth.
A 3 year Strategic Development Study was launched which was geared towards establishment of a National Secretariat, lay down a plan for the establishment of Revolving Development Fund, to provide low interest loans to members, membership enrolment drive was planned and implemented in order to serve our members better. This led to the establishment of Zonal Secretariats. With the Help of Development Corporation of Ireland (DCI) these ideas and vision were realized and from then on, history was finally made. From there a second 5-year Strategic Development Plan was promulgated and implemented fully. We are currently in our third 5-year Strategic Development Plan which was launched in October, 2011 by the Junior Minister of Health & Social Welfare, Dr. Nkya.
Today the association, now known as “The Association of Private Health Facilities in Tanzania – APHFTA” is a giant and an umbrella organisation for the whole of the private health sector in Tanzania and is being manned currently by almost 40 permanent staff members, has a strong National Secretariat in Dar es Salaam, and 4 very active Zonal Secretariats, in Lake Zone, Northern Zone, Southern Highlands Zone and Coastal Zone. Hopefully two more zones will be added in future, Central and Southern.
APHFTA, under a strong leadership of Dr. Sam Ogillo as CEO, assisted by the pioneer staff, Mr. Jared Ndiege a very senior member of our staff as the Chief Accountant, who was our key player in the establishment of the National Secretariat in 2004, together with a team of young but very dedicated and competent staff, has made tremendous strides in expanding membership to over 500, launching numerous programmes for our members, ranging from HIV/AIDS to NCD, Quality improvement training, business training, networking, reproductive child health, advocacy and many other activities. APHFTA with the support of Medical Credit Fund, a Dutch NGO, is involved in the provision of credit funds to member facilities across the country. This was our initial plan under the Revolving Development Fund initiated earlier on in our first 3-year Strategic Development Plan. It has now been realized and implemented for almost two years.
APHFTA is now a sought out partner by numerous institutions, local and international, to participate in coordinated health programmes. These include PATH, PSI, MCF, PharmAccess, GIZ, USAID, Bienmoyo and others. The private health sector now stands tall and proud as an important health care stakeholder; recognised and appreciated by the Government through the Ministry of Health & Social Welfare as well as the Development Partners.
The future for APHFTA is even greater than can be imagined by any one of us. However, this glorious future depends entirely on the dedication of its staff and commitment of its members. These two groups can propel APHFTA to greater heights or bury it in a forgotten graveyard. It is my hope and dream that the two will work together diligently and lead APHFTA to become a national and international organisation of renown.
APHFTA should strive to provide more services and support to its members. It should always be there for them. Networking and referral systems within the private health sector should be established and strengthened. Support within the system between facilities should be encouraged and supported. Group private health care facilities should be established in the rural setting, with APHFTA support by providing startup financing, guidance on management and working capital.
Pooled procurement of pharmaceuticals and medical equipment is a proposition that can be worked out in partnership with our members from the Pharmaceutical sector. Here too APHFTA will be able to raise additional funds for its sustainability.
Financial sustainability of APHFTA is a major constraint facing its survival. Unless APHFTA develops modalities to create larger finances by itself, it will fail to grow, expand or provide greater services to its growing membership population. Research, joint commercial enterprises such as in training, establishment of conference facilities at our Kibaha Centre and other centres across the country can be the way forward. Dependence on Donors alone is dangerous and hardly a sustainable alternative. Members’ views should be sought to build on these ideas.
iii. What has been the greatest achievement of the Private Health sector in Tanzania since its establishment in 1994?
The establishment of an independent National Secretariat has been the greatest achievement to the growth and survival of the association. It was the key that opened all doors for what it is today. Dedication of the staff as well as the devotion and commitment of the members of the Board of Directors has been exemplary. The volunteering attitude of the Board members, who serve whole-heartedly with no payment of any sort, has been a great boon for the association. The Board also encouraged the Secretariat to work without interference which encouraged innovation and commitment of the Secretariat staff. Without this attitude of the Board, APHFTA would not be here today.
The second greatest achievement is that APHFTA is now an umbrella organisation for the whole of the private health sector in Tanzania. It is one of the most important and reliable stakeholder in the health sector, recognised and depended upon by the Ministry of Health & Social Welfare as well as the Development Partners and by the community we serve.
iv. How has APHFTA changed the Private Health Sector landscape in Tanzania?
Private Health Sector today is a strong, dedicated and united front. The range of services provided by the sector matches that of the Faith-based and even the Public institutions. Amongst our members are those providing medical training, doctors, nurses and paramedics, to consultancy hospitals, diagnostic centres, down to health centers, small dispensaries in rural areas and Accredited Drug Dispensing units (ADDO). This was not so early on at its inception in 1994. Then there were only handful private dispensaries. This breath taking growth has been facilitated by the hard work of the Members of the Board in being very active in advocacy and fighting for the rights of the private health sector in all health forums across the country. It was hard and dedicated work. The Board members were determined to break barriers of suspicion and false impressions of the private health sector that had been embedded in the minds of the authority and donors. Their attitude was fight to the finish. This struggle to propagate the ideals of human private enterprise has born the fruits of today for the private health sector to grow and bloom. It is therefore important for the whole of the private health sector not only to understand this early struggle, but to sustain it. Together, the whole private sector providers, must dedicate themselves to provide quality health care to the community, care that is equitable, fair, cost effective and honest. The need for members to support each others’ growth and integrity will establish an honourable private health sector in Tanzania. That is my dream and my vision. So help me God.