Project background
Zanzibar has provided free healthcare services since gaining independence in 1964. Scarce funding, insufficient quality control, and limited standard practices led to significant differences in the quality of care between various healthcare facilities. After introducing mandatory health insurance in 2023 to ensure equitable access, the government began partnering with PharmAccess to improve the quality of public healthcare by adopting SafeCare principles. In October 2024, Swiss Re Foundation joined to support the initiative.
Project outline and goal
The aim of this collaboration is to systematically improve the quality of healthcare services in Zanzibar. SafeCare identifies quality gaps based on ISQua EEA internationally accredited standards of care. These standards analyze clinics and hospitals holistically, considering all aspects of a healthcare facility and the processes necessary to run smoothly, efficiently, and effectively. It includes aspects of care provision from clinical services (e.g., infection prevention), management (e.g., human resource management) and support services (e.g., waste management).
SafeCare is designed for resource-restricted settings. The methodology includes a stepwise approach that allows healthcare facilities to work at their own pace and to gradually improve systems and services with support from digital tools and resources. Each step enables facilities to track and take ownership of their own improvement. SafeCare is applicable to all types of healthcare facilities, from small clinics and dispensaries to large hospitals.
Ecosystems players involved
The effort to raise the standard of healthcare in Zanzibar is implemented through a close partnership between government, non-profit, and private sector. The Zanzibar Ministry of Health leads the initiative at the system level, ensuring alignment with national health priorities and policies. PharmAccess provides technical assistance and supports implementation by applying the SafeCare methodology, deploying digital tools that enable data-driven quality improvement and organizing capacity-building activities. The Swiss Re Foundation provides financial support. Public and private healthcare facilities participate directly by adopting SafeCare quality improvement methodology andf using digital systems to monitor, improve, and institutionalize the quality of care they provide.
Anticipated outcomes and impact
The collaboration aims to institutionalize a SafeCare-based quality improvement system in one-third of public health facilities in Zanzibar. 80 primary care facilities will be reassessed to track their improvement journey, and 10 centres of excellence will be developed, including seven public and three private facilities. Together, this initiative is expected to impact 495,000 patient visits by February 2027.
Project progress and next steps
The project aims to strengthen the capacity of government health authorities by integrating SafeCare standards into the national health infrastructure, aligning them with existing quality programs, and ensuring government and hospital ownership of quality improvement efforts.
Collaboration opportunities
If you would like to contribute to improving access to better quality healthcare in Zanzibar, please reach out to h.marwa@pharmaccess.or.tz, indicating the details of your proposal.
Photo: PharmAccess
