Building a resilient, universal healthcare system

DAR ES SALAAM: TANZANIA’S ambition to become a one-trillion-dollar economy will ultimately depend not just on what the country builds, but on the health of the people who build it.

Roads, railways, factories and digital infrastructure may drive economic transformation, but they cannot deliver lasting prosperity without a healthy, productive and resilient population. That is why healthcare occupies such a central place in Tanzania’s Development Vision 2050.

While public debate often focuses on industrialisation, technology and infrastructure, the vision recognises that human capital is equally critical to the country’s long-term success.

Building a healthier population is not simply a social objective; it is a strategic investment in productivity, innovation and sustainable economic growth. No country can achieve sustained prosperity without a healthy population.

Economic growth depends on workers who are productive, children who can learn, mothers who survive childbirth, communities protected from disease and healthcare systems capable of responding to both everyday illnesses and national emergencies.

That reality is reflected throughout Tanzania’s Development Vision 2050, which places human development alongside economic transformation as one of the defining pillars of the country’s future.

The vision seeks not only to create wealth but also to improve the quality of life of citizens through better healthcare, education, social protection and access to essential services.

For the health sector, the challenge is both enormous and urgent. By 2050, Tanzania’s population is expected to exceed 118 million people.

Those citizens will require healthcare systems that are larger, more sophisticated and more resilient than anything the country has previously built.

They will need access to quality medical care regardless of whether they live in major cities, regional centres or remote rural communities.

They will expect healthcare services that are affordable, efficient and responsive to the changing disease burden of a rapidly modernising society.

Recognising this reality, the government has embarked on an ambitious programme to strengthen health infrastructure, expand specialised services, improve emergency care, increase medical training, embrace digital technologies and move steadily towards universal health coverage.

The reforms now underway are not simply about expanding hospitals or purchasing equipment. They represent an effort to create a healthcare system capable of supporting Tanzania’s social and economic aspirations for decades to come.

Presenting his ministry’s 2026/27 budget proposals in Parliament, Health Minister Mohamed Mchengerwa described healthcare as one of the foundations upon which national development must be built.

His message was clear: a healthy population is not merely a social objective but a national asset. The argument is difficult to dispute. A child who receives proper healthcare is more likely to attend school regularly and perform better academically.

A healthy workforce is more productive and innovative. Families protected from catastrophic medical expenses are less likely to fall into poverty.

Businesses benefit when employees spend fewer days away from work because of illness. Viewed through that lens, healthcare becomes much more than a service sector.

It becomes an investment in human capital, economic resilience and national competitiveness. This thinking aligns closely with Vision 2050, which envisages a society where Tanzanians enjoy longer lives, better health outcomes and improved social wellbeing.

The document sets an ambitious target of increasing life expectancy to 75 years by 2050 while achieving universal health coverage and eliminating preventable maternal, newborn and child deaths.

The progress made in recent years suggests the country is already moving in that direction. Across Tanzania, the healthcare landscape has been changing rapidly.

New hospitals, health centres and dispensaries have expanded access to services, particularly in previously underserved areas. According to government data, the number of health facilities nationwide increased from 10,153 in 2021/22 to 13,683 by March 2026.

The growth includes thousands of additional dispensaries, hundreds of new health centres and dozens of new hospitals, significantly increasing the reach of healthcare services. Beyond the numbers, these facilities are bringing healthcare closer to communities.

For a pregnant woman in a rural district, a nearby health centre can mean safer delivery and access to skilled healthcare professionals.

For a child suffering from malaria, pneumonia or other common illnesses, shorter travel distances can mean earlier treatment and better outcomes. For many communities, improved access to healthcare is measured not in statistics but in lives saved.

The government’s investment drive has also focused heavily on strengthening referral services and specialised care. Ten new regional referral hospitals have been constructed while district-level hospital coverage has expanded significantly.

Additional investments in oxygen production facilities, staff housing and modern medical equipment are helping improve the quality of care available throughout the system.

One of the most significant developments has been the rapid expansion of emergency medicine.

A few years ago, specialised emergency treatment services were available in only a handful of facilities.

Today, emergency departments have become increasingly common across the country. The expansion reflects a growing recognition that survival often depends on what happens during the first few minutes or hours following an accident, injury or medical complication.

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Emergency medicine has become particularly important as Tanzania experiences rapid urbanisation, increased road traffic and growing demand for advanced healthcare services. Intensive care capacity has also expanded dramatically.

The number of ICU beds in public health facilities has increased several-fold over the past five years, strengthening the country’s ability to respond not only to everyday emergencies but also to future public health crises.

The lessons of the Covid-19 pandemic remain fresh. Around the world, the pandemic exposed weaknesses in healthcare systems and demonstrated the importance of preparedness.

Governments that had invested in healthcare infrastructure, intensive care capacity and trained personnel were generally better positioned to respond.

Tanzania’s efforts to strengthen its healthcare system are therefore also investments in resilience. Maternal and child health remains another area receiving considerable attention.

Few indicators reveal the effectiveness of a healthcare system more clearly than maternal mortality. When women die while giving birth, it often reflects broader weaknesses in access to healthcare, emergency treatment, skilled personnel and essential medicines.

For that reason, the government’s efforts to reduce maternal mortality have become a major focus of health sector reforms.

Investments in neonatal intensive care units, maternal health services, healthcare worker training and specialised equipment are contributing to improvements that have already attracted international recognition.

According to the 2022 Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHSMIS), the maternal mortality ratio (MMR) for Tanzania is 104 maternal deaths per 100,000 live births for the seven-year period before the survey.

This marks a steep drop from 556 deaths per 100,000 live births recorded in the 2015/16 TDHS. It represents a significant decline from previous decades, reflecting improvements in emergency obstetric care and facility-based deliveries.

The decline in maternal mortality over recent years represents one of the country’s most important public health achievements and aligns closely with Vision 2050’s aspiration of eliminating maternal, newborn and child mortality altogether.

Yet healthcare transformation is not only about buildings and equipment. It is also about people. Hospitals cannot function without doctors, nurses, pharmacists, laboratory technicians and other healthcare professionals.

Recognising this, the government has invested heavily in workforce development, recruiting tens of thousands of health workers and expanding specialist training programmes.

The emphasis on local expertise is particularly important. As healthcare systems become more sophisticated, demand for specialists in cardiology, oncology, neurosurgery, nephrology and other advanced disciplines continues to grow.

Building local capacity reduces dependence on foreign expertise and strengthens long term sustainability. Tanzania is notably increasingly positioning itself as a destination for specialised healthcare services within the region.

Growing investment in advanced diagnostics and specialised treatment has reduced the need for overseas referrals while attracting patients from neighbouring countries seeking treatment.

The emergence of medical tourism may still be in its early stages, but it reflects growing confidence in the country’s healthcare capabilities.

Technology is expected to play an equally important role in the future, with Vision 2050 identifying digital transformation as one of the key drivers of national development, recognising technology’s ability to improve efficiency, productivity and service delivery across sectors.

Healthcare is no exception. Electronic medical records, digital referrals, integrated health information systems and telemedicine services have the potential to transform how care is delivered.

A doctor in a regional hospital can consult specialists elsewhere. Patient records can be accessed more quickly. Health authorities can monitor disease outbreaks and service delivery in real time. For citizens, the benefits often translate into shorter waiting times, better coordination of care and improved access to services.

The government’s push towards Universal Health Insurance represents another major pillar of reform. Healthcare costs remain one of the leading causes of financial hardship for families around the world.

A serious illness can quickly wipe out savings, force households into debt or prevent people from seeking treatment altogether.

Universal Health Insurance aims to address this challenge by expanding financial protection and ensuring that access to healthcare is not determined solely by a person’s ability to pay.

The reform aligns directly with Vision 2050’s commitment to universal health coverage and broader social protection. Efforts are underway to strengthen domestic pharmaceutical production.

The Covid-19 pandemic highlighted the vulnerabilities associated with dependence on imported medicines and medical supplies. Countries with stronger local manufacturing capacity were generally better positioned to maintain supplies during periods of global disruption.

For Tanzania, increasing local production is therefore both an economic and strategic priority. It supports industrial development, creates jobs, strengthens supply chains and improves national resilience. Looking ahead, the healthcare challenges facing Tanzania will continue to evolve.

Non-communicable diseases such as diabetes, hypertension, cancer and cardiovascular illnesses are becoming more prevalent. Urbanisation is changing lifestyles and creating new public health pressures.

Climate change is expected to influence disease patterns and place additional demands on healthcare systems. Meeting these challenges will require continuous adaptation, innovation and investment.

Fortunately, Vision 2050 provides a long-term framework for navigating that future. The vision recognises that prosperity cannot be measured solely by economic output. It must also be reflected in the health, wellbeing and dignity of citizens.

That is why healthcare occupies such a prominent place within the national development agenda. A nation where people live longer, healthier lives is also a nation with greater productivity, stronger communities and more sustainable growth.

Ultimately, Tanzania’s healthcare transformation is about far more than hospitals, insurance schemes or medical equipment. It is about creating the conditions that allow every citizen to reach their full potential.

It is about ensuring that children grow up healthy, that mothers survive childbirth, that families are protected from financial hardship caused by illness and that communities have access to the care they need.

As the country begins the long journey towards Vision 2050, healthcare is emerging not merely as a social service, but as one of the foundations upon which the future will be built. Because a prosperous nation begins with healthy people.