PharmAccess: Access to better-quality care

According to a 2018 report by The Lancet Global Health Commission, 5.7 million people in low and middle-income countries die each year due to poor quality healthcare, while another 2.9 million die for lack of access to care. Better-quality, more inclusive health services are sorely needed to prevent future deaths and health-related economic hardship. 

Zanzibar has provided free healthcare services since gaining independence in 1964 and today serves 1.8 million people through approximately 300 public health facilities. Unfortunately, its approach has become financially unsustainable, with service quality and health outcomes worsening over time. 

After introducing mandatory health insurance in 2023 to ensure equitable access, the government began partnering with the NGO PharmAccess to improve the quality of public healthcare. Adoption of SafeCare principles – a proven step-by-step methodology developed by PharmAccess to help healthcare providers systematically enhance service quality – has led to notable improvements, but significant gaps persist. 

For the country’s healthcare reforms to succeed, Zanzibaris need to trust that the services for which they’re pre-paying in the form of mandatory insurance premiums will be of consistently improved quality. 

SafeCare identifies quality gaps based on its standards of care and offers practical, affordable tools that even providers with limited resources can implement. Supported by a quality improvement plan and a resource-rich digital platform, its approach has been proven to reduce medical errors and to lead to more efficient, safer healthcare. 

Accredited, independent SafeCare assessors use a smartphone app to evaluate health facilities in all clinical and managerial areas of service delivery and create a tailored Quality Improvement Plan. Healthcare professionals receive ongoing support in implementing the plan through the digital platform, which offers support and progress tracking.  

In addition, healthcare managers can use the SafeCare Quality Analytics Platform to gain insights into, compare and improve facilities’ performance. Facilities are scored from 0 to 100 and graded from Level 1 (lowest) to Level 5 (highest) based on quality.  

SafeCare thus offers sustainable, cost-effective solutions to enhance healthcare delivery in resource-scarce settings while advocating the same quality standards as other international bodies. All public health facilities in Zanzibar have undergone an initial SafeCare assessment. 

In this project, PharmAccess is supporting the Ministry of Health in institutionalising the SafeCare-based quality improvement system in one-third of public health facilities, reassessing 80 primary care facilities and creating 10 centres of excellence (seven public and three private). It also aims to develop the capacity of government health authorities to deliver quality services by incorporating SafeCare standards into the national health infrastructure and harmonising them with ongoing quality programmes. The initiative is expected to impact 495 000 patient visits in total.  

The copyright for all images displayed lies with PharmAccess.