A public/private partnership experiment in the area of social health protection in Tanzania

An NGO, the Centre International de Développement et de Recherche (CIDR, International Centre for Development and Research), supported a network of mutual health organisations in the Mbozi district of the Mbeya region in Tanzania. The target population were households living in rural areas from the informal sector that had access to the services of a private religious hospital. The project was not in line with the national policy that, for this population category, promoted Community Health Funds (CHFs), voluntary health coverage organisations that only provide access to the district's public care structures and are therefore managed by district authorities. The results obtained by the network of mutual organisations provided an incentive for a partnership between public and private stakeholders. The partnership gave rise to the development of hybrid mutual and CHF organisations and allowed mutual organisations and the private hospital to benefit from subsidies reserved for CHFs. The partnership was replicated in the neighbouring district of Kyela, with the subsidising of contributions by the district and a private company (Biolands) that sells cocoa. The coverage by mutual organisations of people living with HIV/AIDS was organised thanks to the Elton John Foundation and associations of patients. The results of this extended partnership were even better than in the neighbouring district. The conditions for the success and sustainability of the experiment are discussed here