TANZANIAN TRAINING CENTRE FOR INTERNATIONAL HEALTH

1.1 Introduction

The history of the Tanzanian Training Centre for International Health - Ifakara dates back to the 1960s when not only its predecessor, the Rural Aid Centre (RAC), was opened in 1961, but also the Saint Francis Designated District Hospital. The Swiss Tropical Institute Field Laboratory was already set up since the early 1950s, so that the triangular concept of combining health related research, training and medical practice became a reality in Ifakara.

The centre started as a Rural Aid Centre (RAC), set up and financed by the then Basle Foundation for Co-operation with Developing Countries. The Swiss Tropical Institute (STI) was responsible for the implementation and execution of the construction work and institutional capacity building.

 In 1973, the RAC was transformed to a Medical Assistant Training Centre (MATC) that offered higher medical training according to the national needs in the health sector. Eventually in 1978, the MATC was handed over from the Basle Foundation to the Government of the Republic of Tanzania. From then on, the Training Centre was like other health training institutions under the Ministry of Health and Social Welfare (MoHSW).

By 1990, after nearly thirty years the solid buildings and facilities of the Centre were run down, mainly due to tropical climatic conditions. Thus in 1990/91, a comprehensive renovation of the facilities was financed by the Basle Foundation.

In 1994, the Ministry of Health and Social Welfare changed the training program from Medical Assistants to Clinical Officers and hence renamed the centre to Clinical Officers Training Centre (COTC).

The TTCIH has a long history of successful training. Specifically, the centre's experiences span over four decades of producing a total of 1,766 different health professionals in Tanzania (see Table 1).

In 1998/99, the management of the COTC requested another renovation of the premises that had been once again deteriorated due to a number of factors including climatic conditions, poor quality of the building material used in 1990/91 and lack of appropriate maintenance strategy.

The Centre was not only characterised by a deterioration of infrastructure, but also by a weak financial position, shortage of human resource, and lack of ability to make use of opportunities. Hence, the partners ? Ministry of Health and Social Welfare, Novartis Foundation for Sustainable Development and Swiss Tropical Institute ? suggested for institutional and organizational changes that would also ensure a higher financial self-reliance, competent management as well as sustainable quality of the training facilities through regular maintenance.

 In 2002, a first step was the preparation of a concept paper that looked at three potential scenarios for the future of the Training Centre in Ifakara: These were:

• Strengthening the existing COTC
• Transforming the COTC into an Assistant Medical Officer Training Centre (AMOTC)
• Transforming the COTC into a Polytechnic

 The author of the concept paper argued for the transformation into an AMOTC which was also the wish of the MoHSW. Later in 2002/03, a first draft of a business plan was developed that dealt more with the question of how such an upgraded training centre in Ifakara could enhance its financial self reliance.

1.2 Comprehensive Transformation of the Centre between 2003-2006

In 2003 during a planning workshop that the Novartis Foundation and the MOHSW conducted together, a project document was prepared in order to set up a new frame for the training centre in Ifakara.

With the signing of a tripartite agreement between three partners in 2004, a public private partnership was created to remodel the existing training centre. This consists of the following set up:

 Partners

 Partners of this initiative are the:

1. Ministry of Health and Social Welfare (MoHSW)
2. Novartis Foundation for Sustainable Development (NFSD), and the
3. Swiss Tropical Institute (STI)

The Specific Project Goal

The specific goal that the public private partnership has been aiming to reach is to establish the Training Centre as an entity that:

• is capable of providing quality training, facilities and services on a sustainable basis; and
• has a high degree of institutional and financial self-reliance

The achievement of this goal is in line with the health sector reforms of the Tanzanian Government. In turn, once achieved, this project shall contribute to the strengthening of the human resource development in Tanzania, East Africa, sub Saharan Africa and the international health sector.

In order to reach the specific partnership goal, six expected results were formulated:

1. To introduce AMO training instead of the CO training programme

2. To renovate and upgrade the infrastructure and facilities of the Centre

3. To ensure regular and thorough maintenance of the facilities and infrastructure

4. To sustain and increase income of the training centre

5. To improve the efficiency of the centre?s management

6. To establish an efficient decision making body and supervision for the training centre

Supporting Organizations

Three other organisations have been giving substantial support to this public private partnership, namely:

1. Swiss Development Co-operation (SDC)
2. Ifakara Health Institute (IHI), and
3. St Francis Designated District Hospital (SFDDH)

The SDC has financed the basic renovation of the existing infrastructure. Another Swiss-based organisation, SolidarMed has been executing the renovation, upgrading and construction work. The IHI served institutionally as a model for creating a board-steered organisation.

1.3 Inaguration of TTCIH in April 2006

The Tanzanian Training Centre for International Health is an institution that was set up in 2006 following a public private partnership between the Ministry of Health and Social Welfare, Novartis Foundation for Sustainable Development and Swiss Tropical Institute. A grant of USD 1,325,000.00 was allocated towards its establishment. The Centre which was officially inaugurated in April 2006 by the Honourable Minister of Health Prof David Mwakyusa, is now potentially even more attractive to customers due to its combination with health research at the Ifakara Health Institute (IHI) and medical practice in one of the best hospitals in Tanzania, the St. Francis District Designated Hospital (SFDDH). The triangulation makes it possible to combine teaching at the Centre with medical practice at the SFDDH and research modules at IHI when offering own courses or hosting external courses.

TTCIH follows a threefold vision:

1. Create an institution of substance:

To build and develop an institution of substance, which can stand out amongst the best health training centres in Tanzania and East Africa, in terms of quality, range of courses, facilities and services.

2. Create an institution of sustainable growth:

To be amongst the leading public training centres in regard to financial and institutional self-reliance.

3. Create an institution of triangular image:

To strengthen Ifakara?s image as a "Centre of Excellence" in health training, research and practice in Africa; made up of the Tanzanian Training Centre for International Health (TTCIH-Ifakara), Ifakara Health Institute (IHI) and Saint Francis Designated District Hospital (SFDDH).

The mission of the training centre is to provide quality training programs in selected areas, facilities, and services for continuing education in health.

Although TTCIH primarily focuses on well-trained and motivated health workforce to meet the health needs of Tanzania and ultimately improve the health status of the Tanzanian population, it also promotes international collaborations thus aiming to promote global health. Key stakeholders of the TTCIH are the Ministry of Health and Social Welfare, Novartis Foundation for Sustainable Development and Swiss Tropical Institute, with direct beneficiaries being the Assistant Medical Officer students, other health workers and their various managers, trainers and policy makers. Immediately after its inauguration, the Centre embarked on the development of a five year strategic plan 2007-2011, which officially started to be implemented in August 2007.

In a recent review of the Centre?s strategic plan that was conducted in December 2007, a thematic prioritisation and investment in training was emphasised and strategies to improve the quality of training were formulated.

The core TTCIH?s mission is to provide and sustain quality training programmes, facilities and services in order to contribute to the strengthening of human resource development in Tanzania and beyond; and to achieve a higher institutional and financial self-reliance. In order to achieve this, the Centre is targeting the following six strategic 'core results' related to the development of human resources in Tanzania and the world at large.

1. To offer an AMO Course that meets national and international demand and standards;

2. To host national and international short courses with adequate services that meet the clients? demands and standards;

3. To develop courses based on existing expertise and a competitive advantage that meet national and international demand and standards;

4. To have effective and efficient administrative, financial and management structures and processes in place;

5. To create a marketing program to effectively communicate its strength;

6. To maintain the facilities including equipment on a high level.

TTCIH conducts residential short-term courses, seminars, workshops, conferences and a long course for Assistant Medical Officers. Nearly all the training activities at TTCIH are funded by development partners and are therefore not financially sustainable in the long term.

While the demand for International Health courses has increased and diversified, very few organizations have the capacity to define and effectively address the training needs in international health. TTCIH is best placed to provide the required training and training facilities in this critical area. In order for TTCIH to be able to provide this support to Tanzania and other countries, it has to have demonstrable expertise in selected thematic fields and financial resources. TTCIH requires a profile to be able to sustainably attract customers and donors to make its contribution in the area of international health.

• The team
• Our history