In recent years, digital health has emerged as a powerful tool to revolutionize health care systems worldwide. Tanzania, a country in East Africa, embraced this transformative potential through a government-led initiative called the Data Use Partnership (DUP). This groundbreaking project reshaped the health care landscape, integrating a people-centered approach into digital health and leveraging comprehensive health information. In this article, we summarize the remarkable journey of Tanzania’s digital health transformation, explore the successes and impact of the DUP project, and discuss how it can serve as a blueprint for other countries seeking to implement similar initiatives.
Setting the stage for transformation
Tanzania’s efforts to digitize information collection and improve health care outcomes date back to the early 2000s. The introduction of District Health Information Software 2 in 2002 and the establishment of an information and communication technology unit within the Ministry of Health (MOH) in 2006 marked significant milestones. In 2013, the country developed its first electronic health strategy, setting the groundwork for a comprehensive digital transformation.
The Digital Health Investment Road Map
In 2017, the Tanzanian government, in partnership with the Bill & Melinda Gates Foundation and PATH, published the Digital Health Investment Road Map, which outlines 17 strategic investment recommendations aimed at enhancing health services and outcomes. DUP was born out of this roadmap, with a specific focus on implementing a portion of the investment recommendations. With government leadership, DUP sought to address key challenges and create sustainable digital health solutions.
“For the first time in Tanzania, we have an electronic medical record from the dispensary to the health center and to the district hospital levels and to the community. And that is one of the key successes of the digital transformation.”— Seif Rashid, MPhil, DUP Project Director & former Minister for Health.
Building a strong foundation
One of the goals under DUP was the establishment of a robust digital and data governance structure. The National Digital Health Steering Committee, composed of experts from the health and private sectors, government, and donor community, played a vital role in driving the initiative forward. This collaborative approach helped to ensure that Tanzania's digital health systems at all levels adhere to the same guiding principles and data standards, fostering effective health information exchange.
Transforming health care delivery
The DUP initiative transformed Tanzania’s health care system, strengthening digital governance and policy, developing health care worker capacity, co-creating connected digital health systems, and coordinating the digital health ecosystem. By supporting the government in creating policies and standards for health data collection and use, DUP facilitated improved decision-making and data-driven interventions.
Under DUP, Tanzania designed and implemented new ways to manage and govern coordination, development, deployment, and institutionalization of digital health initiatives, systems, and large volumes of health data. Through the initiative, the government developed policies, guidelines, and strategies to determine who can take which actions, upon which data, in which situations, and using which methods.
The DUP initiative equipped Tanzania’s health sector with skills for the country’s changing digital landscape. This included training health care workers to make better use of digital platforms and data, updating curricula, developing digital and data use toolkits, and employing electronic learning platforms to reach the most remote individuals.
“I have benefited through the health digital library as a lecturer at the University of Dodoma by getting access to many publications, covering health policies, guidelines, and health strategies.”— Thobias Makaranga, Lecturer, University of Dodoma, Tanzania.
Under the project, the government of Tanzania formed the Capacity Building Consortium consisting of universities, health research and training institutes, and zonal health training centers—to foster a culture of data use. So far, more than 70,000 learners have joined the eLearning platform.
Under DUP, Tanzania committed to building for scale, sustainability, and health impact by developing an integrated digital health system that considers stakeholders at every level. Photo: Bill & Melinda Gates Foundation/Riccardo Gangale.
Digital tools for improved health care
One of DUP’s notable achievements was the creation of critical digital health applications and tools. These tools were developed through a human-centered design process to ensure they meet the needs of health care providers and the local context. For instance, the Afya Supportive Supervision (AfyaSS) system, a digital tool with offline capabilities, empowers supervisors in remote areas to access and utilize health data effectively. AfyaSS has been rolled out to all 26 regions in Tanzania and is actively in use in 24, with plans to continue training users and implementing change management strategies to increase system use.
“Having the ability to view multiple health supervision checklists on one page through the AfyaSS system is a significant step toward improving the quality of supportive supervision, and we are proud of it.”— Chrisogone German, MD, Supportive Supervision Coordinator, MOH.
DUP connected Tanzania’s 160+ digital health systems and ensured they are interoperable, addressing prior fragmentation due to lack of coordination of efforts by donors and implementing partners.
Lessons learned and future outlook
As DUP’s seven-year journey ends in August 2023, it leaves behind a legacy of valuable lessons and a roadmap for sustainability. DUP’s success can be attributed to the government-led approach and the development of digital champions who will continue to drive governance and coordination efforts. In addition, PATH supported the establishment of the Center for Digital Health, which will serve as a central coordination point focused on governance, technology, workforce capacity, research, and change management, ensuring that Tanzania remains at the forefront of digital health innovation.
Embracing a digital future
Tanzania’s digital health transformation is an inspiring example for other countries seeking to embark on similar journeys. By integrating a people-centered approach, fostering strong partnerships, and leveraging comprehensive health information, Tanzania paved the way for a future of integrated digital health practices. PATH colleagues and stakeholders have an opportunity to contribute to Tanzania’s continued digital transformation by identifying potential investors for the Center for Digital Health and sharing learnings with other nations.
The successes of the DUP project demonstrate the immense potential of digital health to improve patient outcomes, enhance health care efficiency, and build a healthier nation.
“DUP has played a vital role in reshaping the health care system in Tanzania, putting people at the center, and making the most of health information.”— Nanthalile Mugala, Chief of Africa Region, PATH
Additionally, “DUP has led to better training for health care workers, stronger digital governance and policy, improved coordination of digital health efforts, and significant advancements in primary health care in Tanzania,” says Nanthalile.
As Tanzania continues to champion digital innovation with the ongoing support of its partners, it serves as an inspiring example for other countries looking to embark on similar transformative journeys.
