Tanzania has experienced relatively high economic growth over the last decade, averaging 6 to 7 percent a year, but not everyone has benefited. Nearly half the population remains below the income poverty line of $1.90 per day. With few resources, deteriorated facilities and a stunning shortage of doctors (just three for every 100,000 people), the government of Tanzania has long faced enormous barriers to ensuring equal access to healthcare for its people.
It was in this context that the Abbott Fund saw an opportunity to form a partnership that could bring innovative solutions to deep-rooted challenges in improving healthcare. The partnership is based on a willingness to think outside the typical development approach — not just to address the specific issues but to bring in business expertise, create comprehensive innovative solutions and build sustainability into programs at their inception.
Abbott's presence in Tanzania dates back to 2000, when the Abbott Fund established partnerships to provide community support to vulnerable children affected by the HIV/AIDS epidemic in Tanzania, Burkina Faso, India and Romania. Through close collaboration with the Tanzanian government, the need for a broader approach to improve healthcare was identified, and a partnership that began as a response to the HIV/AIDS epidemic quickly grew to take on the system-wide deficiencies in delivering healthcare. Not long afterward, the Abbott Fund began a partnership to build the capacity of Muhimbili National Hospital. Eventually, Abbott expanded the reach of the work to 23 regional and municipal hospitals.
Across a nearly 20-year partnership with the Tanzania Ministry of Health, Abbott and the Abbott Fund have invested more than $130 million and helped accomplish the shared goal of bringing positive change to Tanzania's healthcare system. Together, Abbott, the Abbott Fund and the Government of Tanzania have created a model for public-private partnership and developed sustainable improvements in the quality of testing, treatment and care across the country. In addition, Abbott also is continuing its work to serve the country's most vulnerable communities, with a focus on strengthening education, protecting the legal rights of women and children, and providing sustainable economic opportunities.
Improving treatment and care
When Abbott began funding infrastructure improvements at Muhimbili National Hospital in 2002, it quickly recognized a need for a comprehensive solution. That funding helped create a new four-story outpatient department building that attracted medical staff from private facilities. It also helped install the hospital's first IT system, which improved records and billing. And in 2010, Abbott created emergency medical facilities and a residency program at MNH — both of which were the first in Tanzania.
These investments have saved lives. Mortality rates dropped by 40 percent in the first two years after the emergency medical department opened, saving thousands of lives. Today, the department provides critically needed care for 60,000 people each year. MNH's improved outpatient department also serves the less critically ill, providing treatment and care for more than 1,000 people each day.
Modernizing labs and technology
In 2002, Abbott drew on its expertise in laboratories to begin modernizing the Central Pathology Laboratory (CPL) building at Muhimbili National Hospital (MNH), and it's continued to build the CPL's infrastructure, provide mentorship to its workers and donate materials to support it in providing world-class diagnostic services. Abbott then expanded on the work with the Government of Tanzania to further strengthen public laboratory services by replicating the work it did at the CPL in 23 regional laboratories across the country. These 23 Regional labs provide support for more than 120 district laboratories, improving healthcare for millions of people across the country who have HIV, diabetes and other chronic diseases.
A key factor in the success of the laboratory project has been building capacity through ongoing mentorship and training. In addition to providing infrastructure, the Abbott Fund helps ensure that labs have the staff and systems they need to work effectively. Abbott has supported scholarships for more than 100 laboratory students, and in 2001 established a mentorship program. To date, 70 Abbott experts have provided 65,000 hours of in-country support and training – the equivalent of more than 32 years of individual work. Abbott mentors, whose vast breadth of knowledge covers laboratory technology and facilities management, are paired with local counterparts to develop unique solutions to local challenges.
Abbott also worked with the government to create a nationwide IT system, LabNet, that connects regional labs with the CPL for referral testing and knowledge sharing. Whereas it once took weeks and long travel days to get lab results, it now often takes minutes or hours. In fact, results can often be delivered on the same visit — which means better treatment, faster.
Since 2011, Abbott has drawn on its business expertise to help the Emergency Medicine department sustainably offer world-class care for decades to come. Originally seeded by Abbott Fund's donor funding, the Emergency Medicine department became financially self-sustaining in less than five years. Today, the department delivers excess revenue that is reinvested to further strengthen broader hospital operations. Insured patients turn to the public Muhimbili National Hospital to take advantage of its high-quality, in-demand services. The revenue generated by these insured patients ensures that free and subsidized care can be provided to the patients who cannot afford to pay.
Professional sustainability is as important as financial sustainability. Since the first group of specialists graduated from the Emergency Medicine Residency program in 2013, the department is now led and fully staffed by a Tanzanian team. Graduates of the Emergency Medicine Residency program have gone on to fill leadership and teaching roles at the MNH, regional public hospitals and in private hospitals. Physicians trained in the program not only practice emergency medicine, they also conduct and publish internationally recognized original research, and teach and share their knowledge as well.
The Abbott Fund is committed to improving more than access to healthcare in Tanzania; it also works to build up communities and help the most vulnerable. This work started in the early 2000s to address critical areas of need in the fight against HIV/AIDS, providing aid to orphans and vulnerable children hit hardest by the epidemic.
The program has since expanded to support nine programs to serve some of the country's most needy communities. A few examples: we donated 300 dairy cows in Mkinga district to provide nutrition and income to the district's residents, and started farming and poultry co-ops throughout the country. We trained more than 5,000 paralegal volunteers who have resolved more than 80,000 paralegal cases to protect the rights of women and children since 2005. We enrolled more than 1,000 families in community health insurance. We built schools for vulnerable children, and provided millions in grant funding to implement community-development activities.
More than employment, nutrition and skills, these projects provide income that families can reinvest in children's education and in improving living conditions.
By deploying the same approach of innovation, partnership, business expertise and sustainability across all our work in Tanzania, Abbott is helping to provide the country with a clearer path to a healthier future.