The Thanzi Programme is a pioneering health system initiative designed to improve resource allocation and decision-making across the ECSA (East, Central, and Southern Africa) region. By generating high-quality health economics research, Thanzi equips policymakers with the evidence they need to make informed decisions that maximize health outcomes for their populations.

The programme is anchored in three foundational pillars:

• Research Evidence Generation: Producing data-driven insights into how resources can be most effectively allocated within health systems.
• Policy Engagement: Ensuring that research findings are translated into actionable policy recommendations by fostering strong connections between researchers and policymakers.
• Capability Building: Enhancing the technical skills of health professionals and policymakers to use economic modelling and other evidence-based tools to drive health system improvements.

Aligned with the African Leaders Meeting (ALM) Declaration, the Thanzi Programme works to support African countries in their efforts to improve health financing, optimize resource use, and strengthen health systems for better population health outcomes.

Goals of Thanzi

The primary goal of the Thanzi Programme is to assist African nations—particularly those in the ECSA region—in improving health systems by providing data-driven insights that inform how health resources can be used most effectively. This is achieved through:

• Optimizing Resource Allocation: By utilizing economic and epidemiological modelling, the Thanzi Programme helps countries understand how to allocate resources (such as funding, human resources, and equipment) to achieve the greatest public health gains.
• Building Regional Capacity: Through training and knowledge-sharing, Thanzi strengthens the ability of countries to generate and use evidence to inform health policies and planning processes.
• Fostering Policy Dialogue: The programme promotes closer collaboration between researchers and policymakers, ensuring that the evidence generated is translated into policies that improve health system performance.

Through these goals, the Thanzi Programme aims to contribute to the strengthening of health systems across the continent, resulting in healthier populations and more resilient health systems.

Objectives

The Thanzi Programme is focused on several key objectives to ensure the successful rollout of its health system model across the region:

1. Promoting the Use of Economic Modelling
   One of Thanzi’s core objectives is to encourage the use of economic and epidemiological models as essential tools for health system decision-making. The Thanzi Model, developed initially in Malawi, is designed to answer crucial policy questions such as:
   • How can health resources be allocated to achieve the greatest possible health benefits?
   • What health outcomes can be achieved through policy changes like task-shifting, better facility distribution, or enhanced access to medicines and equipment?
   • How should resources be distributed to maximize their impact if more funds are available?
   • How can health systems adapt to meet the challenges posed by evolving disease burdens?
   • Is there a trade-off between health system resilience, efficiency, and equity, and how can these be balanced?
2. Assessing Technical Capacity
   An important objective is to assess and enhance the technical capacity of countries to use the Thanzi Model effectively. This involves evaluating the capabilities of local health analysts, policymakers, and data experts to work with complex health data and produce actionable evidence that can inform health policies.
3. Strengthening Researcher-Policymaker Platforms
   Thanzi seeks to evaluate and strengthen the platforms through which researchers and policymakers engage with one another. By identifying any gaps in these platforms, the programme can recommend improvements that ensure research evidence is effectively integrated into policy discussions and decisions.

The Process: Rollout of the Thanzi Health System Model

The Thanzi Health System Model is being gradually rolled out across the ECSA region through a series of structured consultations and engagements with key stakeholders. These consultations are already underway, as the Thanzi Programme works to raise awareness and build support for the model in member states.

Step 1: Consultation Visits

The Thanzi Programme has already begun a series of consultation visits to selected ECSA member states. These consultations are designed to:

• Raise awareness about the Thanzi Model and its potential to support better decision-making in health systems.
• Assess the readiness of each country to adopt the Thanzi Model, including evaluating the technical capacity of local teams to use the model and generate evidence.
• Identify existing platforms for researcher-policymaker engagement and pinpoint any gaps that need to be addressed.

The first consultation visit took place in Uganda in August 2024, followed by visits to Tanzania, Eswatini, and Zimbabwe. In parallel, consultations have begun with West African countries, including Nigeria, Gambia, and Senegal, through the West African Health Organization (WAHO). The programme is also working with the African Union Commission and AUDA-NEPAD to ensure alignment with the broader ALM Agenda for health system strengthening across Africa.

Step 2: Outcomes of the Consultation

The consultations are expected to achieve the following outcomes:

• Commitments from policymakers in participating countries to integrate the Thanzi Model into their decision-making processes and policy development.
• Confirmation of technical capacity within each country to effectively engage with the Thanzi Model, ensuring that local teams are capable of generating the evidence needed to support policy changes.
• A detailed understanding of the researcher-policymaker platforms that exist within each country, as well as recommendations for improving or creating new platforms to ensure the evidence generated by the Thanzi Model is effectively used in policymaking.

Step 3: Developing the Rollout Plan

Following the consultations, the Thanzi Programme will develop a comprehensive rollout plan based on the insights gained during the visits. This plan will outline:

• Which countries will be prioritized for the next phase of the rollout based on their readiness to adopt the model and the identified needs of each country.
• Capacity development strategies to address any gaps in technical skills or resources identified during the consultations.
• Recommendations for enhancing or establishing new platforms for researcher-policymaker engagement to ensure the uptake of evidence generated by the Thanzi Model in decision-making processes.

Expected Impact

The Thanzi Programme is expected to have a profound impact on health systems across the ECSA region by:

• Improving Resource Allocation: By providing policymakers with evidence on how to best allocate health resources, the programme aims to improve the efficiency and effectiveness of health spending.
• Strengthening Health Systems: The model will help countries build more resilient, efficient, and equitable health systems that can better respond to both current and future health challenges.
• Facilitating Evidence-Based Decision-Making: Increased collaboration between researchers and policymakers will ensure that health policies are informed by the best available evidence, leading to more effective health interventions.
• Enhancing Population Health: Ultimately, the goal is to improve health outcomes across the region by ensuring that health resources are used in the most effective way possible.

What we are doing

The consultation process for the Thanzi Programme is already underway, with visits to Uganda, Tanzania, Eswatini, Zimbabwe, and West African countries taking place throughout 2024. As the consultations progress, the programme will work to finalize a comprehensive rollout plan that will detail the next steps for implementing the Thanzi Health System Model across the region.

Stay tuned for ongoing updates on the progress of the consultations and the full-scale rollout of the model. We look forward to collaborating with partners across the region to drive improvements in health system performance and population health.

Get Involved

We invite organizations, governments, and individuals to partner with us in the rollout of the Thanzi Health System Model. If you’re interested in learning more about the programme or getting involved, please contact us by sending an email to ekataika@ecsahc.org.

ECSA-HC received a Grant from the Global Fund to support countries improve TB diagnostics in the region. In this project ECSA-HC works in collaboration with the Uganda Supranational Reference Laboratory).

The four (4) year Global Fund project supports National TB Reference Laboratories in 18 countries which include all the Nine (9) ECSA Member States and nine (9) non-Member States namely: Botswana, Burundi, Eritrea, Kenya, Lesotho, Malawi, Mauritius, Mozambique, Namibia, Rwanda, Seychelles, Somalia, South Sudan, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe.

In this project, ECSA-HC coordinates the project activities and manages the grant while Uganda SRL as the Sub-recipient supports in building capacity and systems strengthening in the project countries. The goals/objectives of the project are;

• Build a regional network of NRLs for inter-state laboratory quality assurance and management in the ECSA countries;
• Improve Laboratory service provision for quality assured 1st and 2nd line Drug susceptibility testing accessible to people in need; and

Enhance impact of rapid molecular TB diagnostic testing in the region and building capacity of NRLs to undertake epidemiological/national level disease monitoring surveys such as Drug Resistance Survey (DRS) and TB disease prevalence

https://www.theglobalfund.org

EQUINET, the Regional Network on Equity in Health in East and Southern Africa is in partnership with the East, Central and Southern Africa (ECSA-HC) to promote shared values of equity and social justice in health. ECSA-HC works closely with EQUINET in building a forum for dialogue, learning, sharing of information, experience and critical analysis.

In this project, ECSA-HC has been able to support health Ministers and other policymakers on Health Diplomacy and international co-operation, shaping up of effective strategies, strengthening the voice of our policymakers to influence policy, politics and practice towards health equity and social justice.

This is in line with the Health Ministers’ Resolution to prepare and discuss issues on the 69th World Health assembly (WHA) agenda.

http://www.equinetafrica.org

ECSA-HC with support from the World Bank is implementing a capacity development for nutrition project targeting front line workers. ECSA-HC through this project has developed comprehensive in-service training packages and pre-service model curriculum to build technical capacity of front line workers who deliver essential nutrition interventions in health facilities and at community level.

Furthermore, through this project ECSA-HC has trained the trainers to scale up training in the project countries (Kenya, Uganda and Tanzania). A dissemination plan for the packages and training curricula has be developed and ECSA-HC with support from member states will be disseminating to the respective health cadres.

Furthermore, ECSA-HC wishes to scale up to other countries for regional harmonization. The Curricula can be accessed through the ECSA-HC Nutrition resources and we wish for these to be used beyond the ECSA region

USAID’s Health Evaluation and Applied Research Development (HEARD) project implemented by University Research Co., LLC is a global implementation science partnership of 30 plus entities encompassing policymakers, implementers, researchers, advocates and others necessary to address a range of emerging health and development priorities.  The HEARD partnership and its emerging Implementation Science Collaborative mobilize partners to generate, synthesize, and use evidence to improve the implementation of policies and programs in low and middle-income countries.  Focus areas include woman-centered care, mental health and psychosocial support, urban health, violence against children, disability assistive technologies and evaluation development and implementation. Activities currently span 17 countries and five regions.

ECSA-HC has joined a 13 partner consortium under the EU-Africa PerMed project, which builds links between Africa and Europe on Personalised/precision medicine. The overall aim is to integrate African countries into ICPerMed activities, thus contributing to a successful implementation of Personalised Medicine (PM) in the global context. Overall the project seeks to foster joint PM projects and programmes between Europe and Africa, as well as strengthening bilateral EU-AU science, technology and innovation (STI) relations in the area of health.

The project will run for 4 years, starting on the 1^st of February 2021. The project is organized around 7 main Work Packages:

• Coordination and management.
• Mapping the health R&I and policy landscape in Africa for the identification of key stakeholders, initiatives and expertise relevant to PM.
• Cross boarder collaboration and identifications of future actions in PM between Africa and Europe.
• Translating science to policy – Enhancing the dialogue between African countries and Europe in collaboration with ICPerMed and Era PerMed.
• Capacity building in Personalised Medicine.
• Communication and dissemination.
• Ethical issues.

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ECSA-HC as the Principal Recipient of the TB in The Mining Sector Phase 3 Project has received a Grant from the Global Fund to support 16 SADC countries in the reduction of the TB burden amongst key populations. (ex-mineworkers, mineworkers and their families and peri-mining communities, Labor sending areas.)

The three (3) year 2021-2024 Global Fund project shall ensure key population in 16 SADC Countries namely: Angola, Botswana, Comoros, DRC, ESwatini, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Tanzania, Zambia, and Zimbabwe, have access to quality TB prevention and treatment services and improved working and living environment.

In this project, ECSA-HC is responsible for management of all interventions as the Principal Recipient of the grant. ECSA-HC will collaborate with the SADC Secretariat who will play and enhanced role in implementing the grant.

The goals, objectives and approaches of the project are.

Goal

The goal of the project is to contribute achievement of the SDG 2030 targets for TB in all Southern Africa countries through reduction of TB burden amongst key population. Key population being ex-mineworkers, mineworkers and their families and peri-mining communities.

Objective

To ensure key population in southern Africa have access to quality TB prevention and treatment services and improved working and living environment.

Approaches

1. Effective multi-country collaboration amongst key stakeholders in the TB in the mining sector and integration of project interventions in national programmes
2. Effective involvement of key national level stakeholders including TB program, occupational health, mine health and safety and compensation stakeholders in the development of national programmes to ensure linkages and synergy to counter TB in the mines
3.  Implementation of interventions that are tailored to country contexts cognizant of variations of capacity and scope of interventions from country to country.(iv) Strengthened partnerships between public and private sector, including labour unions and chambers of mines, especially for countries where the public resources may be inadequate to sustain TB in the mines services.

Reports From TIMS initiatives

• SADC, TB CROSS-BORDER REFERRAL SYSTEM, A GAME CHANGER TO THE TB RESPONSE
• MAPPING OF ASM IN SOUTHERN AFRICA
• CRG Consolidated Regional report_final _July 2024
• CRG SNAPSHOT
• Regional CLM Report, Tanzania, Mozambique, Zambia and Zimbabwe
• Report on the Assessment of Women’s Capacity in Mining Groups in SADC- Two Years Post-TIMS Phase III
• TIMS ETR Report

The Southern Africa Tuberculosis and Health Systems Support (SATBHSS) Project is a World Bank (WB) funded regional project launched in 2016 with the aim of strengthening the health sector’s response to Tuberculosis and occupational lung diseases.

It is implemented in four (4) Southern African countries: Lesotho, Malawi, Mozambique and Zambia. In partnership with the WB and Member States, the East, Central and Southern Africa Health Community (ECSA-HC and the NEPAD Agency collaborate to provide technical support in project implementation in the participating countries.

The main aim of the Southern Africa Tuberculosis and Health Systems Support (SATBHSS) project is to improve coverage and quality of key Tuberculosis control and occupational lung disease services in targeted geographic areas of the participating countries and strengthen regional capacity to manage the burden of Tuberculosis and occupational diseases in the Southern African region.

For more information visit: http://www.satbhss.org/

BACKGROUND

​Surgery – a proven and often life-saving intervention – is only accessible to urban populations in many African countries, with only one surgeon per 2.5 million people in rural areas. Emerging evidence demonstrates that major surgery can be undertaken safely and effectively at district hospitals, making it accessible to otherwise neglected rural populations.​​Guided by a health systems-strengthening framework and a comprehensive programme of research, Scaling up Safe Surgery for District and Rural Populations in Africa (SURG-Africa) will scale up the delivery of accessible, elective and emergency surgery at district hospitals to national level programmes in three African countries: Malawi, Zambia and Tanzania. Scalable models will also be developed in up to seven other African countries. ​​

AIM

The overall aim of SURG-Africa is: to implement surgical systems, that deliver safe, affordable and sustainable essential surgical services to rural populations in LMICs.

OBJECTIVES

• Strengthen national surgical systems to scale to national level, deliver – and monitor through a national surgical information system – emergency and common elective surgery in district hospitals in Tanzania, Malawi, Zambia.
• Train surgeon specialists to supervise, mentor and provide surgical systems in-service training – comprising clinical, management and systems skills – to district hospital staff.
• Design and implement studies, including observational, intervention and community studies, costing studies and economic analyses, to compare processes, outcomes, patient experiences, costs and cost-effectiveness of surgery between district and referral hospitals.
• Design and implement participatory implementation research studies to identify and explore enablers and obstacles – at all levels, from community to national level – to accessing and delivering essential safe surgery at district hospitals.
• Disseminate findings to national decision makers and support them in making policy decisions, including assessing budget impacts and appraising options for making safe surgery accessible.
• Disseminate findings to seven countries in East Central and Southern Africa and support them in designing country-specific interventions for making safe surgery accessible.

For more information visit: http://www.surgafrica.eu/

​The project is funded by the European Union’s Horizon 2020 Programme (Grant Agreement no. 733391) SURG-Africa is a collaboration between: Royal College of Surgeons in Ireland, Tanzania Surgical Association, University of Malawi (College of Medicine), Surgical Society of Zambia, Radboud University Medical Centre (Netherlands), University of Oxford (UK), East Central and Southern African-Health Community (ECSA-HC), College of Surgeons of East Central and Southern Africa (COSECSA), and Ministries of Health in Malawi, Tanzania and Zambia.

The East Africa Public Health Laboratory Networking Project (EAPHLNP) is a World Bank Funded Project that focuses on strengthening Public Health Laboratory systems and explores strategies for improving the effectiveness of laboratories and performance of laboratory workers. The project covers 5 countries in East Africa (Burundi, Kenya, Rwanda, Tanzania and Uganda).

This World Bank-funded EAPHLNP, launched in 2010, aims to establish a network of efficient, high quality, accessible public health laboratories. The project has upgraded and networked up to six district hospital laboratories in the five countries, and one or two referral laboratories that act as national hubs.

In addition, the project supports innovations in service delivery and uses a learn-by-doing approach. Each country serves as a center of excellence in a thematic area, piloting innovations, and sharing lessons and good practices with the other countries.

The East, Central and Southern Africa Health Community (ECSA-HC) facilitates knowledge sharing across countries and shares policy implications with health authorities in member states. In this project ECSA-HC works with the East African Community.