HPSS – Health Promotion and System Strengthening Project in Dodoma, Morogoro and Shinyanga Regions

Project completed
Enrolment in the health insurance system in the Dodoma region in Tanzania. © SDC SDC

The Health Promotion and System Strengthening project (HPSS) is improving access to and the quality of health services both in terms of the demand (health promotion, health insurance) and the supply side (drug procurement; health technology maintenance). After a successful pilot phase in the Dodoma region, the Tanzanian government is requesting the SDC to expand this approach to two other regions with a focus on those most at risk (the poor, women, children, youth and the elderly).

Country/region Topic Period Budget
Health systems strengthening
Primary health care
01.08.2015 - 31.10.2019
CHF 18'475'000

Tanzania has shown impressive results in the achievement of Millennium Development Goals 4 and 6 (infant mortality and the fight against communicable diseases), thanks to massive external funding. But without a significant acceleration of efforts, especially related to strengthening the health system and the delivery of public health services, it is likely that many of the remaining health-related MDG targets will not be met.  The sector is facing financing challenges. The sector’s budget support (Health Basket Fund) has been decreasing over the past years, and the share of local funding (including General Budget Support) to the sector is also expected to decline from approximately 8% in Fiscal Year 12/13 to 6% in FY 13/14. The government is currently working on a strategy to show short term results and at the same time mobilise additional resources for health (Big Results Now! Initiative). The main challenge will be to keep focused on strengthening the health system in order to secure long-term development objectives.


The health status and wellbeing of the Tanzanian population in the Dodoma, Morogoro and Shinyanga regions has been improved by supporting the health system to become more responsive to the health needs and demands of the various population groups.

Target groups

Communities, health facility workers, district authority staff

Medium-term outcomes
  1. Social health protection and public financial management mechanisms to protect the population of the Dodoma, Morogoro and Shinyanga regions against health risks (pro-poor funding) have been strengthened.
  2. Public health facilities in the Dodoma, Morogoro and Shinyanga regions are able to provide quality essential medicines and medical supplies and to follow treatment guidelines.
  3. Communities in the Dodoma region are aware of their health needs and are taking action to improve their health status and are able to influence district planning for health promotion activities.
  4. Equipment and building infrastructure in public health facilities in the Dodoma region are well maintained and contribute to improved delivery of health services.

Results from previous phases:  

  • 425,000 households and more than 2 million Tanzanians living in rural areas have health insurance coverage and therefore free access to health services in any health facility in the Dodoma region.
  • The insurance health coverage (community health fund) in the Dodoma region increased from 4% to 14% between 2011 and 2014. TZS 726 million (USD 490,000) in premiums was collected between July 2012 and September 2014.
  • Availability of medicine in the region improved from 53.7% (2011) to 69.6 % (2014).
  • 273 health facilities are able to manage their technical equipment using a software program that tracks inventories and status.
  • 220 village communities are well aware of health risks and have developed health plans which are currently being implemented with government and funds and the support of local authorities.
  • Ownership: all the districts are allocating resources in their Comprehensive Council Health Plans (CCHPs) to complement to project interventions.

Directorate/federal office responsible SDC
Credit area Development cooperation
Project partners Contract partner
Swiss Academic and Research Institution
  • Other Swiss Non-profit Organisation
  • Swiss Tropical and Public Health Institute

Budget Current phase Swiss budget CHF   18'475'000 Swiss disbursement to date CHF   17'400'997
Project phases

Phase 2 01.08.2015 - 31.10.2019   (Completed)

Phase 1 01.02.2010 - 31.03.2016   (Completed)