Strengthening the primary healthcare as a vehicle towards achieving Universal Health Coverage in Tanzania: lessons from the first International Primary Health Care Conference

¹President's Office Regional Administration and Local Government, Dodoma, Tanzania, ²Department of Public Health, University of Dodoma, Dodoma, Tanzania, ³Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania, ⁴Council Health Management Team, Dar es Salaam City Council, Tanzania, ⁵Mathematics Department, University of Dar es Salaam, Dar es Salaam, Tanzania, ⁶Department of Public Health, St Francis University College of Health and Allied Sciences, Ifakara, Tanzania

^&Corresponding author
Pius Kagoma, President's Office Regional Administration and Local Government, Dodoma, Tanzania

Editorial     

Worldwide, Primary Healthcare (PHC) is critical in addressing the healthcare needs of diverse and often underserved communities [1]. A strengthened PHC has the potential to achieve UHC as one of the main targets of the 2030 Agenda for Sustainable Development under Sustainable Development Goal Three (SDG3) [2]. The goal is to ensure that everyone can access quality healthcare services without financial impoverishment. In Tanzania, the healthcare system is predominantly structured around PHC, with District hospitals, health centers, and dispensaries serving as most citizens' first point of contact [3]. Primary healthcare facilities provide essential services, including maternal and child health, immunizations, treatment of common diseases, and health education, accounting for over 98.6% of the country's total facilities. Achieving UHC hinges significantly on the strength and effectiveness of PHC.

Despite significant strides in improving healthcare delivery, Tanzania faces ongoing challenges in its health sector, including shortages of the healthcare workforce, particularly in rural areas[4], inadequate and aging infrastructure [5], underdeveloped health information systems, some are fragmented and lacking timely, reliable data to inform decision-making, limited capacity for health innovation, insufficient investment in health [6] and the burden of both communicable and non-communicable diseases [7]. A robust PHC strengthening agenda focused on UHC must address these challenges.

The first International Primary Health Care (iPHC) conference, held from 25-27 March 2024, brought together stakeholders (both domestic and International) from various sectors to discuss strategies, challenges, and best practices for enhancing PHC in Tanzania. Through collaborative efforts, the President´s Office of Regional Administration and Local Government (PO-RALG) organized the Conference. The main theme was "PHC as a Vehicle for Achieving UHC) in Tanzania. The conference received a total of 290 research abstracts; of these, 145 were accepted for presentation, resulting in an acceptance rate is exactly 50%. A total of 129 abstracts were presented and discussed, and 112 of the presented papers have since been published in the Pan African Medical Journal (PAMJ). Most of the abstracts emerged from programs and projects implemented at the level of primary healthcare facilities and communities. Seventeen (17) forums, with one forum specifically highlighting the unfinished agenda in the PHC towards the struggle to UHC, eleven (11) Best practices from the PHC facilities, and twelve (12) special issues, all are available at the conference´s digital archive [8]. Aggregates from the conference proceedings have led to four policy papers and one brief on the research agenda in primary healthcare. The policy papers that emerged from the conference themes highlight the lessons learned, best practices, and recommendations in community engagement, primary healthcare building blocks, and reproductive, maternal, neonatal, child, and adolescent health.

This editorial synthesizes the insights and recommendations from the conference, providing a roadmap for strengthening PHC to achieve UHC. The key recommendations from the four policy papers accompanying this editorial focus on a holistic approach to strengthening health systems. Policies should integrate various health services and outreach programs into routine community activities while providing frameworks for incorporating community healthcare workers (CHWs) into the broader health system. This integration is crucial for achieving UHC. Improvement efforts should target the health system's internal and external components.

Evidence-based policymaking is essential for creating a responsive and resilient health system. Using data to inform decision-making allows policymakers to design targeted interventions effectively. Sustainable funding, achieved through local resource mobilization, ensures consistent service delivery [9]. Integrating non-communicable disease (NCD) services with existing health programs is also important [10]. Finally, strategies to encourage performance and dissemination in other areas of Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCAH) should be implemented at PHC facilities. These recommendations collectively aim to build a stronger, more integrated, and sustainable health system.

Strategic investments in health infrastructure, workforce development, and community engagement are essential to ensure comprehensive, patient-centered care. Moreover, leveraging innovative approaches and collaborations can address systemic challenges and promote sustainability in healthcare delivery. The experiences shared at the conference serve as a valuable blueprint for other lower and middle-income countries like Tanzania, striving to attain UHC through reinforced PHC frameworks.

The next iPHC is scheduled to take place in 2026. These coming conferences will serve as a platform to convene scientists in Tanzania and beyond to discuss the PHC agenda and UHC, among other topics, to address the new need for scientific evidence-informed decision-making. It is thus the responsibility of policymakers and stakeholders to continue working collaboratively to implement the recommendations and insights for improving healthcare services in Tanzania. The findings from this editorial and the policy papers will also serve as a baseline for improvement in future conferences.

Competing interests     

The authors declare no competing interests.

Authors' contributions     

All authors had full access to the data used in this article and contributed to the conceptualization, development, data analysis, and/or review of this manuscript. They have read and agreed to the final version of this manuscript.

Acknowledgments     

The authors wish to extend sincere gratitude to the Ministry of Health (MoH) in Tanzania, the PORALG, Muhimbili University of Health and Allied Sciences, and The University of Dodoma, the World Health Organization (WHO), UNICEF, and all implementing partners for their invaluable support and guidance throughout the first International Primary Healthcare Conference 2024 held in Dodoma, Tanzania.

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