News that the Muhimbili National Hospital (MNH) is implementing a programme intended to reduce the growing influx of referral cases to it from other hospitals is most encouraging, indeed. As the biggest hospital in Tanzania, Muhimbili is tasked with the mission of providing “effective, efficient and high quality tertiary specialist medical services for referred patients from all areas of Tanzania, while providing a conducive environment for training and research.”

As of last year, Tanzania had 269 hospitals across the country, 120 of them public hospitals under the Health Ministry, the Military and parastatal organisations. The remaining 149 are privately-owned by faith-based organisations, as well as private-for-profit or non-governmental organisations.

To receive medical attention at MNH, one has to either be referred thereto by a regional or municipal hospital as a public patient, or as a private patient under private hospital referral or self-referral or health insurance case.

In the event, Muhimbili has of late been so overwhelmed by untold numbers of referral patients that it frantically embarked upon a strategic, ‘outreach’ programme intended to (hopefully) alleviate the problem. This has specialist medics visiting referral hospitals countrywide to work with local medics for a few days, exchanging experiences and treating on-the-spot patients who would have otherwise been referred to MNH. However, this strategy in and by itself only postpones the referrals problem – and doesn’t tangibly build the capacity of those hospitals to effectively handle their patients instead of routinely referring them to MNH.

At best, this is a short-term strategy that should be replaced by a more solid, sustainable capacity-enhancing programme for ‘upcountry’ hospitals. It means more investments – preferably in Public Private Partnerships mode – in facilities or equipment, human resources, motivating incentives… the whole gamut of healthcare skills, products and services.