How Zanzibar’s PPP is transforming public health care

ZANZIBAR: WHEN President Hussein Ali Mwinyi took office in 2020, he declared that Public Private Partnership (PPP) would be a central pillar of his development agenda.

He argued that partnerships with the private sector, backed by a results-driven culture, could deliver efficiency and better performance across government services.

That vision is now becoming reality in Zanzibar’s public health sector, where the outsourcing of hospital management has begun to show remarkable results.

One success story is the management of two district hospitals—Vitongoji in Pemba and Ijitimai in Unguja, by ZED Co. Limited under a six-month contract with the Zanzibar Ministry of Health.

Between February and July 2025, the company introduced new systems and innovations that have won praise from both patients and staff.

At Ijitimai District Hospital, almost all patients report improvements. “This hospital is always full because the services are good and free-of charge,” said Fatma Abdulmajid, who recently gave birth there. “From reception to delivery, everything is smooth. Delays are minimal and the care is excellent.”

Ijitimai now handles about 700 childbirths a month, operating almost 24 hours a day. Staff say more workers are needed to ease the workload and ensure medical teams get sufficient rest.

According to Dr Lwanyumba Joram Lwegasila, Chief Medical Officer at Ijitimai, the PPP has transformed service delivery through “strategic interventions and a people-centred approach.”

Among the most notable achievements are: Specialised Services: Regular visits from consultants in internal medicine, paediatrics, gynaecology, orthopaedics and surgery have reduced the need for patients to travel to referral hospitals, saving time and money.

Inclusive Care: Special provisions have been introduced for vulnerable groups, including the elderly, people with disabilities, pregnant women and the hearing-impaired.

Confidential counselling sessions on emotional well-being and family support are also offered free of charge.

Sign Language Support: Qualified interpreters are now available, removing communication barriers for deaf and hard-of-hearing patients; and ‘Hand-to-Hand’ Assistance: Trained staff guide patients throughout their hospital journey, from admission to discharge, reducing confusion and improving satisfaction.

Pharmaceutical Services: A more reliable supply of medicines has reduced stock-outs and improved prescription filling; and Laboratory Upgrades: New diagnostic equipment, extended hours and more staff have boosted the hospital’s testing capacity and accuracy.

24-Hour Surgical Services: Emergency operations are now conducted round the clock, reducing delays in critical care and saving lives; More Health Workers: Additional doctors, nurses, lab technicians, and support staff have been recruited to cut waiting times and strengthen service delivery.

Community Engagement Local leaders (Masheha) are actively involved in hospital development initiatives and health campaigns, building trust between the community and the facility.

The introduction of PPP in hospital management is not only about improving services but also about restoring public confidence in the health system. Patients at both Ijitimai and Vitongoji say they feel respected and cared for.

Vulnerable groups, who often struggle with access, now report better experiences, thanks to tailored services and inclusive policies.

The approach has also raised staff morale, with many medical workers noting improvements in resources, management support, and workplace organisation. However, they stress the need for further recruitment to match the growing patient load.

Dr Suzan Homeida, a haematologist and head of ZED Co. Limited, credits President Mwinyi for pushing forward the PPP model. “We thank the President for his strong commitment to improving healthcare, and the Presidential Delivery Bureau (PDB) for initiating this contract,” she said.

She added that ZED Co. plans to expand training services for medical staff across Zanzibar. “Our goal is to provide the best healthcare to all Zanzibaris.” The success of the sixmonth trial has positioned PPP as a model worth expanding across Zanzibar.

With rising patient satisfaction and measurable improvements in efficiency, the government is now considering rolling out similar arrangements in other public hospitals.

As Zanzibar’s health sector evolves, PPP is proving to be more than a management experiment. It is emerging as a practical strategy to balance efficiency, inclusivity, and accountability. bringing the island closer to President Mwinyi’s vision of a healthier, more resilient nation.