As one of the poorest countries in Africa, Tanzania faces significant health challenges. The public sector cannot reach all corners of the largely rural country. The private sector contributes additional skilled health workers and facilities, thereby increasing access to quality care.

  • 34%
    of women use contraceptives
  • 5%
    of Tanzanians are HIV positive
  • 93%
    of the HIV response is funded by PEPFAR and other donors
  • doctor
    more trained private providers needed to fulfill staffing needs
  • 30%
    of health facilities are in the private sector

The government of Tanzania has made significant strides in improving the delivery of essential health services, including services for family planning, HIV, and malaria. Despite improvements, there are still substantial health and development challenges. Tanzania’s ability to address these challenges is constrained by the severe shortage of human resources for health.

The country’s high disease burden is coupled with limited public sector resources, leading the government to collaborate with the growing private sector. While the private sector delivers key health services, it could be better leveraged to relieve the pressures on the public sector and contribute more substantively to improving health outcomes.

SHOPS Plus works to increase access to quality care through the private sector. The project addresses the interrelated problems of inadequate access to quality health services, the lack of qualified health professionals, and challenges in health financing. The overall objective is to increase the use of priority health services through the strategic expansion of private sector approaches in the health system. SHOPS Plus builds private providers’ capacity to improve and sustain the delivery of high quality priority health services, and works to strengthen the sustainability of Tanzania’s accredited drug dispensing outlets. SHOPS Plus also facilitates private providers’ access to finance, so that they can expand or improve their services.

Program Components

Improve Quality and Content of Nurse and Midwife Training

SHOPS Plus is developing a private sector-focused clinical practicum aimed at strengthening the practical clinical skills of nursing and midwifery students studying at private medical training institutions (PMTIs). The team collaborates closely with the Office of the Chief Nursing Officer in the Ministry of Health to contribute toward the joint agency development of national nurse and midwife practicum guidelines. SHOPS Plus will pilot the guidelines in the private sector on the ministry’s behalf.

Increase Provider Access to Finance

A study conducted by the World Bank in 2013 found that overall financing by commercial banks within the health sector is very limited. In 2014, USAID signed a five year Development Credit Authority Guarantee with CRDB Bank designed to finance women-owned or operated for-profit health facilities. Studies have shown that women-owned businesses are underserved compared to those owned by men, making access to finance a particular challenge for these facilities.

Mobilize Private Sector Resources for a Sustainable HIV Response

In Tanzania, PEPFAR and other donors currently provide over 90 percent of HIV funding. SHOPS Plus contributes to PEPFAR’s Sustainable Financing Initiative goal of achieving an AIDS-free generation through shared financial responsibility with country counterparts, public and private. The project identifies and supports opportunities to increase domestic financing for HIV and to improve the efficiency of the national response by engaging private sector entities. This work includes pursuing new corporate partnerships, increasing access to finance, expanding the scope of private sector providers, and helping increase the number of micro health insurance products in PEPFAR priority areas.

Promote Sustainability among Accredited Drug Dispensing Outlets

For Tanzania’s rural and urban poor, accredited drug dispensing outlets (ADDOs) are often the entry point to the health system. Underserved populations depend heavily on ADDOs for access to essential health commodities and services. While ADDOs play an important role in health service provision, their quality and financial sustainability vary widely. Numerous ADDOs operate without formal registration, and many struggle to accumulate sufficient working capital, particularly rural facilities that are challenged to replenish inventory during the rainy season.



Sustaining Health Outcomes through the Private Sector (SHOPS) Plus is a five-year cooperative agreement (AID-OAA-A-15-00067) funded by the United States Agency for International Development (USAID). This website is made possible by the generous support of the American people through USAID. The information provided on this website is not official U.S. government information and does not represent the views or positions of USAID or the U.S. government.