Over the past five years, Zanzibar has registered notable improvements in its health sector. This includes leadership and governance of the health sector, investment in infrastructure and human resource development, health financing, service delivery, medical products and technology.
On October 13, 2025, the Revolutionary Government of Zanzibar and Jiangxi International Economic and Technical Cooperation Co. Limited signed a contract for the renovation, construction, and expansion of Mnazi Mmoja Hospital.
Speaking at the signing ceremony held at State House Zanzibar, the President of Zanzibar, Hon. Dr. Hussein Ali Mwinyi, said that apart from the signed project, the Revolutionary Government of Zanzibar intends to build two more state-of-the-art referral hospitals which will provide high quality specialised medical services for heart disease, cancer, brain and spinal cord illnesses.
The plan to build the Mnazi Mmoja Hospital is parallel to the initiative to construct five regional hospitals, one in each of Zanzibar’s five regions. The regional hospital for the Urban West, Lumumba Hospital, has been completed and has begun offering services.
This followed the completion of construction and commencement of service delivery at eleven hospitals across all the islands of Zanzibar, which comprises a total of 11 districts.
To learn the secret behind these successes, ZiBi Magazine sought out interview with Dr. Mngereza Mzee Miraji, Principal Secretary, Ministry of Health Zanzibar, who discussed various strategies that have led to achievements in Zanzibar’s health sector.
The secret of Zanzibar’s success in the health sector is an increase in the health sector’s budget and innovation in planning, managing, and implementing of the five years health sector strategic plan.
Crucially, health sector budget in Zanzibar has increased from TSH 119 billion for Financial Year 2020/2021 to TSH 406 billion for Financial Year 2025/2026.
For the first time, we have outsourcing agreements with private sector for hospital operations, supplies, sanitation, and catering services aside from establishment of the Zanzibar Health Service Fund.
Q. What are the major achievements in leadership and governance of the health sector in Zanzibar?
A. Over the past four years, the Ministry has successfully implemented a number of programs and initiatives aimed at enhancing healthcare for the people of Zanzibar and visitors as well.
We have reviewed the 2011 Health Policy and prepared a draft for the 2024 Health Policy. We have also reviewed the 2007 Essential Health Care Package for all service delivery.
Furthermore, we recategorised primary health facilities — currently totaling 142 (90 dispensaries and 52 health centers), developed service quality guidelines for all levels, including the Basic Health Facility Standards and Quality Improvement Guidelines (2022).
The ministry has also prepared key policy and operational guidelines such as the Laboratory Services Guideline (2024) and ICT and Health Information Management Guidelines (2023). We also established the Department of Nursing and Midwifery in 2022.
Q. Infrastructure for provision of health services is critical for effective service delivery. What has been achieved in this regard?
A. The Ministry has significantly strengthened health infrastructure at all levels through the following accomplishments:
Completion of 76 staff housing units at Abdalla Mzee Referral Hospital in Pemba, valued at TZS 16.48 billion; equipment installation, and commencement of services at 10 district hospitals (Ijitimai, Chumbuni, Mbuzini, Mwera Pongwe, Kitogani, Pangatupu, Kivunge in Unguja; Michweni, Kinyasini, and Vitongoji in Pemba) and one regional hospital (Lumumba), with a total cost of TZS 104.4 billion;
We are also proud of the completion of an ICU unit at Abdalla Mzee Hospital in Pemba, costing TZS 828.3 million as well as installation of three medical oxygen generation plants at Mwera Pongwe, Vitongoji, and Lumumba Regional Hospital, producing 350 cylinders (50 liters each) daily, costing TZS 3.16 billion.
Other milestones are completion of two high-tech medical waste incinerators at Kibele (Unguja 900 kg/hour) and Vitongoji (Pemba 750 kg/hour), valued at TZS 5.21 billion plus the now near completion staff housing at Mwera Pongwe, Kitogani, Pangatupu (Unguja), and Kinyasini, Vitongoji (Pemba), valued at TZS 20.4 billion.
There is ongoing construction of 15 health centers Magomeni Wandaras, Sebleni, Tunguu, Kinduni, Nungwi, Tumbatu, Welezo, Mtoni Basra, Rahaleo in Unguja; Konde, Chonga, Mtambile, Kiuyu Minungwini, Maziwa Ng’ombe and Jadida in Pemba) valued at TZS 34.14 billion, and 35 dispensaries funded through a loan of Euro 30 million under Government of China via MEHECO Group of Companies.
We have also completed Kizimkazi Health Center at a cost of TZS 8.6 billion as well as the Lumumba Regional Hospital Skills Laboratory worth TZS 1.25 billion which has already been inaugurated.
We have also enhanced ICT infrastructure across regional and district hospitals, increased ambulances from 10 in 2020 to 26 in 2024, worth TZS 2.29 billion.
We have also completed the Zanzibar Food, Drugs, and Cosmetics Agency’s modern laboratory which meets WHO Biosafety Level 2 Standards, costing TZS 9.9 billion.
Q. Quality healthcare requires a competent workforce. What progress has been made in human resources development?
A. Over the past five years, the Ministry has strengthened the health workforce by increasing the number of health personnel from 559 in 2020/21 to 2,008 in 2023/24, including 487 doctors and 892 nurses.
We have sponsored 497 staff for further studies, including 84 medical specialists, 45 senior nurses, 128 doctors, and others in laboratory sciences, radiology, and pharmacology.
A total of 191 staff have completed their studies and returned, including 19 medical specialists such as obstetrics, pediatrics, cardiology and ophthalmology.
Furthermore, we have improved employee welfare through salary and allowance adjustments and formalized 2,300 community health volunteers, with 1,104 (797 in Unguja, 307 in Pemba) now receiving formal training — enhancing community-level service coverage.
Q. Collaboration with the private sector, local authorities and foreign partners enhances efficiency. What has been achieved in this regard?
A. Key achievements in service delivery collaboration include partnership with the private sector in diagnostic services, hospital management, sanitation, catering, and laundry across district and regional hospitals.
The ministry has strengthened specialist care in collaboration with local and international experts, including hip and knee replacements, neurosurgery, and cardiac interventions (pacemaker implantation). We launched orthopedic surgeries (knee and hip replacements) at Lumumba Regional Referral Hospital and 50 patients have already been operated on since July 2024.
The commencement of dialysis services at Lumumba Regional Referral Hospital (Unguja), where 145 patients are now receiving life-saving treatment, and at Abdalla Mzee Hospital (Pemba), where 35 patients have begun the programme, marks a landmark achievement for our ministry.
This expansion not only reflects our unwavering commitment to equitable, high-quality healthcare, but also strengthens Zanzibar’s emergence as a robust investment destination in the health sector — elevating patient access, reducing costly referrals, and unlocking new opportunities for public-private collaboration across the Isles.
Other notable achievements include reduction in maternal mortality from 166 (2019/20) to 145 per 100,000 live births (2023/24); immunization coverage for under-five children increased from 83% (2020/21) to 95% (2023/24); cervical cancer vaccination among girls (aged 9–14) rose from 45% to 98.5%; expansion of neonatal ICUs from one (2020) to 13 hospitals (2024); increase in emergency care hospitals from two to 14; growth in operating theatres from 22 (2020) to 47 (2024); expansion of ICU services from one to 13 hospitals; diagnostic capacity increased: MRIs from one two, CT Scans from one to three, Digital X-rays from three to 15), Ultrasound from 10 to 34), and laboratories from eight to 20.
Additionally, we increased delivery trucks from 5 (2020) to 10 (2024/25), costing TZS 1.25 billion; increased hospital bed capacity from 1,445 (2022) to 2,659 (2024), and maternity beds from 229 to 427. We have updated the Standard Treatment Guidelines and Essential Medicines List for the first time since 2014.
The establishment of the Zanzibar Health Call Centre for emergency disease reporting, timed perfectly with Zanzibar’s status as a premier tourism hub receiving visitors daily, is nothing short of a triumph. With a remarkable 7,330 services provided to date, our ministry proudly marks this as a cornerstone of our health-system advancement.
Q. Procurement and distribution of medicines and medical supplies are vital. What improvements have been made?
A. The Ministry has enacted the law establishing the Zanzibar Medical Stores Agency in February 2024, empowering it to procure, manufacture, store, and distribute medicines and supplies. The government has increased the medicine budget from TZS 21 billion (2020/21) to TZS 40 billion (2024/25).
Medicine availability improved from 57% (2020) to 92% (2024) at hospital level and from 63% to 80% at health center level. We also improved supply frequency — from quarterly to monthly distribution with direct shipment of medicines to Pemba without routing through Unguja.
Q. Sustainable health financing remains a challenge. What measures have been taken to reduce out-of-pocket expenditure?
A. Key progress includes development of the National Health Financing Strategy for Zanzibar and enactment of the Zanzibar Health Services Fund Act No. 1 of 2023 and commencement of services with 306,377 registered members, 63,563 contributors and 242,814 dependents.
Zanzibar Health Services Fund (ZHSF) members now access services both in Zanzibar and mainland Tanzania. We have developed digital systems including membership registration, service portal, doctor registry, claims processing, and mobile app.
As of June 2025, ZHSF has registered 426,275 people, including 63,704 public servants with 227,629 dependents, 15,384 private sector workers with 21,238 dependents, 53,896 informal sector workers with 42,899 dependents and 1,525 students which is about 20% of the population.
Q. Health Information Systems are essential in the digital era. What has been done to modernize data management?
A. Digital health information systems are indeed central to transforming our health landscape in this digital era. At the Ministry of Health in Zanzibar, we have committed ourselves to modernising data management as a critical enabler of high-quality, efficient, and equitable health services for the entire population.
Over the past five years we have made significant progress. Under our Zanzibar Digital Health Strategy 2020–2025, aligned with our Health Sector Strategic Plan and wider national development goals, we have implemented 65 % of the planned activities, with about 35 % currently underway and around 4 % yet to begin. This accomplishment demonstrates our strong momentum and sets the foundation for the remaining phases of the strategy.
To give you a more concrete view, our approach spans five inter-linked system domains, each designed to address a core dimension of the health system.
Firstly, systems for disease detection and management. We have deployed Electronic Integrated Disease Surveillance and Response system (eIDSR) enabling real-time detection of epidemic diseases so that our providers can intervene before outbreaks escalate.
Concurrently, our community-level digital platform known as Jamii ni Afya equips community health workers with digital tools to detect illness early in households, identifying patients while still at home and initiating care before their conditions worsen. A total of 1,200 community health workers to date are using the system to deliver health services in the community.
Next, systems for health-service delivery in hospitals and health centres. We have rolled out digital service-delivery systems across hospitals and primary health centres to professionalise care, shorten outpatient (OPD) turnaround time, capture health records electronically and ensure that every medicine dispensed is traceable to the recipient. By September 2025, 12 hospitals and 23 Primary Health Centres have already started using digital systems.
Further, is a dedicated digital enabled referral transport system for pregnant mothers and newborns in emergency health conditions, ensuring they reach the facility in time and receive appropriate care, strengthening the referral link within the service delivery chain and has helped reduce deaths among pregnant mothers and newborns in emergency health conditions by ensuring they reach the hospital early and receive services.
By September 2025, 4,489 pregnant mothers and 522 newborns have received emergency transport from various health centres in Unguja and Pemba. Of the 4,489 pregnant mothers transported via the M-Mama programme, 99.79 % survived, while 64.25 % of the transported newborns survived.
At the central store level, we deploy systems for procurement, distribution and control of medicines and medical supplies. The mSupply platform is for forecasting needs and recording stocks; while the Electronic Logistics Management Information System (eLMIS) handles distribution to hospitals and health centres. These logistics platforms give us real-time visibility of stocks, reduce drug-stock-outs and expiries, and allow for data-informed supply-chain planning.
For human-resource and leadership management, we have a digital HR system that enables us to know our health-workforce by cadre, work-location and age-profile, thus identifying those approaching retirement and forecasting staffing needs relative to service-demand. Complementing this is our biometric attendance system across district hospitals and health facilities, which enhances staff accountability and supports leadership oversight.
Finally, is our flagship District Health Information System 2 (DHIS2 platform), which aggregates data from hospitals and health centres across Unguja and Pemba. This system supports analysis of key health indicators to inform decision-making at multiple levels of the system.
On top of this, we have developed dashboards that make this information accessible to managers, leaders and decision-makers, thereby strengthening evidence-based policy and operational action.
We remain committed to completing the remaining phases of the strategy, scaling what works, refining as we go and embedding digital health into every aspect of our health-system operations.
Q. What are the Ministry’s future priorities and strategies?
A. Looking ahead, the future strategies of the Ministry of Health in Zanzibar build on the gains we have already achieved and aim to take our health system to the next level of performance and equity.
We will intensify efforts to strengthen the referral system across the islands, including the construction of new regional hospitals and upgrading of infrastructure at all levels to ensure that every patient can access timely, high-quality specialist care.
We have already established institutes for cardiac, orthopaedic, neurosurgery and mental-health services, alongside efforts to secure continuous availability of medicines and medical supplies to support those services.
We also recognise that human-resource capacity is central to delivering improved health outcomes. Therefore, we will recruit and train additional qualified health professionals, deploy them strategically and build their capacity in line with evolving needs.
At the same time we will expand our health-financing mechanisms via the Zanzibar Health Services Fund to make sustainable the goal of Universal Health Coverage. A key part of this is strengthening community-level primary healthcare, where prevention and early detection are most effective.
Reducing maternal and neonatal mortality remains a top priority. In line with the Zanzibar Vision 2050, we aim to bring maternal mortality down from 145 to 123 per 100,000 live births, and ultimately to 70 by 2030 in accordance with the Sustainable Development Goals.
We also aim to reduce neonatal mortality from 28 to 26 per 1,000 live births by Vision 2050 and further reduce it to 12 by 2030. To achieve this, we will intensify our efforts in epidemic preparedness and response, and accelerate the fight against both communicable and non-communicable diseases.
Delivering quality health services on our densely populated and frequently visited island cannot be treated as a one-time activity, it is a continuous task. We will continue developing health policies and guidelines to improve service delivery, maintain quality standards and adapt to new challenges.
On the financing front, the Government is committed to achieving Universal Health Coverage and we are implementing reforms to ensure that all Zanzibaris have health insurance and financial protection.
The Government is working to enroll every citizen into a mandatory health insurance scheme, operating through the Zanzibar Health Services Fund, while increasing domestic resource mobilisation through Direct Health Facility Financing so that all dispensaries and health centres begin to operate with autonomy, improving efficiency and equity in resource allocation and use of the Health Services Fund.
In addition, the digitalisation of our health system remains a fundamental pillar. We are accelerating efforts to move toward a unified and interoperable digital health platform that will enable seamless service delivery, robust data-driven management, integration across all levels of care, and increased system responsiveness.
These strategies reflect our commitment to building a resilient, equitable, efficient and high-quality health system for the people of Zanzibar, and we will persist in scaling what works, refining as we go, and embedding digital health into every aspect of our operations.
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