Faith-based hospitals decry delays in service contracts

DODOMA: THE Tanzania Christian Medical Association (TCMA) has called on local government councils to honour and promptly renew service agreements with church owned hospitals and health centres, warning that lapses are undermining government’s Public-Private Partnership (PPP) efforts in the health sector.

Speaking at the opening of the 88th TCMA Annual General Meeting in 2025, TCMA President, Dr Gresmus Ssebuyoya said that, in several instances, councils fail to renew agreements once they lapse, even though these facilities continue to provide services to communities using government resources.

“This situation places these facilities in a difficult position. When the Controller and Auditor General (CAG) conduct audits, the centres are required to explain how they have utilised government resources without valid contracts,” Dr Ssebuyoya explained.

He also noted other pressing challenges, including persistent delays in the disbursement of basket funds and the unilateral transfer of health workers from church facilities to government centres.

He noted that the latter often leads to critical staff shortages, negatively impacting service delivery.

Another issue raised was the inefficient routing of funds through council accounts, which causes delays compared to the streamlined direct transfer system used for government-owned health centres.

Despite these challenges, Dr Ssebuyoya acknowledged the government’s efforts to address some long-standing concerns, particularly in the area of tax matters.

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He praised the government’s decision to abolish the Service Development Levy (SDL) and to reduce the Workers’ Compensation Fund (WCF) contributions from 1 per cent to 0.5 per cent of workers’ salaries.

Dr Ssebuyoya also said that faith-based facilities contribute 42 per cent of all public health services in Tanzania, with the majority located in rural areas.

“For many years, the Church has been a key partner in providing healthcare services to Tanzanians, especially those in remote areas who rely heavily on these facilities,” he said.

He also commended the Christian Social Services Commission (CSSC) for its collaboration with the government to develop and improve guidelines for the partnership between the public sector and private healthcare providers, under the relevant ministries, including Health, Public Service Management and Good Governance and PO-RALG.

“We appreciate the government, through its ministries, for entering into agreements with some churchowned hospitals at various levels across the country,” Dr Ssebuyoya added.

Founded in 1937, TCMA oversees and advocates for quality health services in mission health institutions and strengthens cooperation with the government to improve healthcare delivery for marginalised populations.

The Church currently operates 105 hospitals, including three zonal referral hospitals—Bugando Medical Centre in Mwanza, Kilimanjaro Christian Medical Centre (KCMC) in Moshi and Arusha Lutheran Medical Centre (ALMC).

In addition, 12 facilities serve as regional referral hospitals and 37 are councildesignated hospitals (CDHs) under formal agreements with local government authorities.

Other facilities include 134 health centres, over 697 dispensaries and a specialised HIV/AIDS care centre, making the Church a critical partner in Tanzania’s healthcare system