1. Introduction

The pastoral Health Care of the Sick by the Catholic Church in Tanzania dates back in the 1880￢ﾀﾙs with the coming of the early missionaries. After Tanganyika gained its independence in 1961, the government embarked on extensive health infrastructure and human resource development. The Catholic Church supported government initiatives through building health facilities and training centres. It was due to this move that Bugando Consultant Hospital was built. The Catholic Church in Tanzania continued to maintain the health system in the form passed over by the missionaries until 1967 when the Arusha Declaration brought about policy changes geared to provide free medical services. Since then, the Tanzania Catholic Church health facilities provided health care services in the new context. However, in the mid 1980s in response to the new World socio-economic order Tanzania embarked on extensive health sector and local government reforms. The reforms brought about a lot of changes in the National Health System in response of which the church health facilities heavily engaged in adjusting to the new situation. 

 

2. Catholic Church Health System.

The Catholic Health System operates in the existing Catholic Church operational structure which extends from Small Christian Communities (SCCs) to the national level. The system consists of service levels in line with government structure. Currently, at level one, there are 46 hospitals (20 Designated District Hospitals (DDHs)/Council Designated Hospitals (CDHs) and 26 Voluntary Agency Hospitals (VAHs), 52 Health Centres, 328 Dispensaries and maternity waiting homes almost in all hospitals.  At level two there are seven officially recognized Referral Hospitals at Regional level. These hospitals that are now upgraded to referral hospitals at regional level are:  Peramiho, Ndanda, St. Gaspar, St. Francis Hospital Ifakara, Kabanga, Nyangao and Rubya. At level three, there is one Zonal Consultant and Teaching Hospital ￢ﾀﾓ Bugando Medical Centre (BMC) which has been categorised as a super specialised hospital.

 

The system provides curative, preventive and promotive, reproductive and child health, restorative and rehabilitative, Chaplainancy services and research.

 

The Catholic health system is coordinated by TEC Health Department. The department, which was established in 1987, is responsible for coordination, technical assistance in areas of policy advocacy, health financing, human resource development, quality improvement, planning and monitoring and evaluation.  Furthermore, the department collaborates and promotes linkages with local and external institutions, as well as people of goodwill who through the Catholic Church contributes towards improvement of health welfare to majority of Tanzanian communities, particularly, the marginalized groups. 

These services are provided for the fulfilment of the mission statement, vision and goal of the Tanzanian Catholic Church: 

a) The vision of the department is to have a mentally and physically healthy society with integral and sustainable human development which is evident of a fulfilled mission. 

b) The mission statement of the department is the continuation of the healing ministry of Jesus Christ by providing a holistic, quality, and sustainable health care, in line with the Roman Catholic Church Moral and ethical Values.

c) The goal of the department aims at guiding the provision of sustainable high quality health care which fulfils the Healing Mission of the Catholic Church in Tanzania.

 

3. The structure of the Health Department

The department under the Chairmanship of the Most Rt. Rev. Jude Thaddaeus Ruwa'ichi OFMCap, who is assisted by the Vice Chairman Rt. Rev. Severine NiweMugizi in ensuring that the TEC health policies and management of the department are implemented accordingly. 

The Executive Secretary, Dr. Frederick Kigadye, reports to the Bishop Chairman, but also, on day to day activities he is accountable to the Secretary General of the conference. The Executive Secretary has the role to coordinate and facilitate the efforts of the Catholic Dioceses in Tanzania in providing quality health services. The department ensures that the caring of the sick is being carried out as part and parcel of evangelization and pastoral care. Thus, main functions of the Executive Secretary are to ensure the provision of quality health services in all Catholic dioceses and TEC institutions.

 

Secretary General Fr. Raymond Saba (left) and Dr Frederick Kigadye (right), Executive Secretary 

In the daily management of the department, the Executive Secretary is responsible for coordination of five units namely:  Policy Advocacy, Technical Support, Psychological and Spiritual Counseling, HIV/AIDS Services and Reproductive and Child Health Services.  Units are headed by program officers/coordinators who assist the Executive Secretary on management of the units and programs. The coordinators/officers report directly to the Executive Secretary. 

 

4.0 The functions

 

The following are the main responsibilities/functions of the department:

 

To ensure that health care services in all Catholic dioceses and institutions are carried out in line with Catholic moral and ethical values 

 

To ensure that planning, implementation, monitoring and evaluation of health services in the Catholic health system adhere to the national health policy and the Tanzania Catholic Church Health Policy

 

To build capacity to the dioceses and Catholic institutions on good governance in areas of accountability, transparency, communication, team work, reporting, care and maintenance, human resource management and planning, financial management and procurement 

 

To ensure that there is an effective working system for the care of those in need 

 

To facilitate collaboration of Catholic health services with the Government and other stakeholders involved in the provision of health services in the country

 

To coordinate the provision of health services within the Catholic health system with Christian Social services Commission (CSSC), government and other stakeholders

 

To lobby and advocate for support /assistance on behalf of Catholic health care facilities for  the acquiring of  adequate resources and training from the government and other partners

 

To facilitate consultancy/advisory support services to dioceses on all matters pertaining to the management of health services such as strategic management of health care organizations, management of human resources for health, aspects of good governance, health policy, health sector reforms, economics of health care industry, health care planning and financing, health information management systems, legal aspects of health care, gender and development, project write ups and implementation, and costing of health services 

 

To maintain a regular pastoral care visit mechanism of Catholic Church health facilities

 

To provide the Tanzania Episcopal Conference regular reports on the performance of the health services and inform the Conference of any major changes that occur in the medical field which may affect their operations

In general, the department is responsible for the provision of policy guidance for the implementation of policy in the dioceses as outlined in the Tanzania Catholic Church Health Policy in the areas of Curative; Restorative; Rehabilitative; Preventive; Promotive; Reproductive and Child Health; Support Services; Alternative Therapy; Care of Vulnerable Groups; Emergencies and Disasters; Research; Pastoral Care; Traditional Medicine; Governance and Management (Finance and Human); Care and Maintenance of health infrastructure and medical equipment.

 

4.0 The Units of the Department

4.1 Policy Advocacy and Technical Support  

The Policy Advocacy and Technical Support Officer, Mr. Japhet Kalindu is accountable to the Executive Secretary and responsible for:

Policy guidance for implementation of the policy in the dioceses as outlined in the Tanzania Catholic Church Health Policy

Provide guidance in Monitoring and Evaluation (M&E).

Coordination of diocesan and TEC health activities

Enhancing and promoting communication and networking with organizations, institutions, and people of goodwill

Report writing and dissemination

Collaborating with diocesan health secretaries in conducting pastoral care visits of health activities implementation in the dioceses and TEC institutions

Participation to meetings, forums, symposiums, conferences, etc relevant to assigned roles and responsibilities

Management of departmental records and documents 

Analyzing information, data, monitoring government policy changes including fiscal year budget guidelines and document issues arising thereof for appropriate action including policy advocacy 

Ensuring provision of quality health care according to national standards and Catholic Church teachings using appropriate tools and maintaining a register of health facilities with all basic data 

Organizing Annual Meetings for Diocesan Health Secretaries and Hospital Management Teams

Participating in developing strategic plans, budgets and action plans

Establish/strengthen links and collaboration with other stakeholders

Any other assigned activities by Executive Secretary health and or TEC Secretary General.

 

4.2 Reproductive and Child Health (RCH)

The Reproductive and Child Health (RCH) Coordinator, Sr. Mariana Francis Sitta, is accountable to the Executive Secretary and responsible for:

Promotion of the engagement of Catholic Church Health System all areas of RCH services including Maternal, New born, Child and Adolescent health in accordance to the Catholic moral and ethical values 

Promotion of human dignity practices in RCH including Natural Family Planning

Maintaining Catholic Church moral and ethical values in the provision of RCH services

Improvement of governance and management of RCH services in the Catholic health system

Improvement of coordination of RCH services in the Catholic health system.

Improvement of collaboration between the Catholic Church, the government and people of good will

Improvement of Human Resource for Health (HRH) capacity in RCH services in the Catholic Health system

Ensuring adequate availability of HRH in RCH services in the Catholic health system

Ensuring accessibility of RCH services to the poor, marginalized and vulnerable groups in a manner that truly advances their human dignity

Ensuring the establishment/strengthening of reliable sources of funding for RCH services

Ensuring the development and maintenance of RCH infrastructure in accordance to established standards 

Ensuring adequate supply of RCH equipment, medicine, medical supplies and that both medical and non medical equipment are regularly maintained 

Ensuring male participation in RCH services

Improving the capacity of Catholic Church health leaders in the management of RCH

Participation to meetings, forums, symposiums, conferences, etc relevant to assigned roles and responsibilities

Analyzing information, data, monitoring government policy changes including and document issues arising thereof for appropriate action including policy advocacy.

Report writing and dissemination

Provide guidance in Pastoral Health Care Visit (M&E) in RCH services.

Provide guidance in Pastoral Health Care Visit (M&E) in RCH services.

Any other assigned activities by Executive Secretary health and or TEC Secretary General.

 

4.3 HIV and AIDS Services

The HIV and AIDS Service Coordinator, Mr. Aloys Madulu is accountable to the Executive Secretary and responsible for: 

Coordinating HIV and AIDS services 

Organizing meetings and workshops for Diocesan HIV and AIDS coordinators for sharing experiences and information

 Facilitating training for capacity building 

Identifying HIV policy issues for advocacy

 Collecting data/information on HIV and AIDS 

Preparing and disseminating reports to relevant authorities and stakeholders.

Developing proposals for funding

 Attending meetings related to HIV and AIDS

 Participating in developing strategic plans, budgets and action plans

Establish/strengthen links and collaboration with other stakeholders

Any other assigned activities by Executive Secretary health and or TEC Secretary General.

In general, the unit is responsible for HIV Testing and Counselling (TC) services, Home Based Care (HBC) services, Care and Treatment (CT) services, Preventive AIDS education through Information Education and Communication (IEC), Prevention from mother to child transmission (PMTCT), Sexually Transmitted Infections (STIs), Orphans and Vulnerable Children (OVC). Thus, the department joins hands with the government and other providers of goodwill on combating against the further spreading of the HIV and AIDS pandemic and for those infected providing them brotherly love. 

 

4.4 Psychological and Spiritual Counselling 

The Psychological and Spiritual Counselling Coordinator is accountable to the Executive Secretary and responsible for: 

Ensuring the presence of  chaplaincy in Catholic hospitals and training institutions;

Ensuring capacity building of chaplaincy and counselling 

Ensuring the establishment of  spiritual and psychological counselling in all Catholic health facilities and training institutions

Ensuring the continuity of spiritual and psychological services in all Catholic health facilities and training institutions

Strengthening the Chaplaincy in all hospitals and training institutions in order to encourage and provide psychological and spiritual counselling to the sick, relatives, students and staff 

Ensuring monitoring of the performance of the hospital and training institutions as per Catholic moral and ethical values

Coordinating spiritual and psychological services provided by other religions;

Any other assigned activities by Executive Secretary health and or TEC Secretary General.

 

4.4 Accounts Office

The Accountant is accountable to the Executive Secretary and Financial Controller of TEC and is responsible for:

Management of departmental finances

Developing, maintaining and analysing budgets, preparing periodical budgetary reports that compare budgeted costs to actual costs.  

Preparing cheques on various transactions 

Computing taxes  and preparing tax returns such as Pay As you Earn (PAYEE) and other social contributions such as National Social Security Fund (NSSF), and National Health Insurance Fund (NHIF) to ensuring compliance with payment, reporting and other tax requirements

Monitoring bank account transactions on daily basis through bank reconciliations 

Preparing invoices and monitoring payrolls, controlling debtors, creditors, receipts and payments. 

Establishing tables of accounts and assigning entries to proper accounts

Making corrections between the books of accounts by journal transactions 

Preparing quarterly and final financial reports.

Providing internal and external auditing services

Any other assigned activities by Executive Secretary health, financial Controller, and TEC Secretary General

In addition to the above, the Accountant attends monthly meetings of the Health Department. 

 

4.5 Personal Secretary

The Personal Secretary, Anastazia Francis, is accountable to the Executive Secretary and responsible for: 

Meeting and receiving visitors at all levels of seniority 

Dealing with incoming and outgoing calls, e-mails, faxes and posts

Ensuring cleanliness and general upkeep of the office

Ensuring necessary equipment and working tools are in place

Organizing and maintaining diaries and making appointments

Organizing and arranging venue for conferences and trainings

Arranging travel, visa and accommodation and providing general assistance during presentations.

Maintaining and balancing petty cashbook

Maintaining confidential files and other records

Performing routine office functions including copying, faxing and report preparation

Organizing and taking minutes of departmental meetings and ensuring the Executive Secretary is well prepared for the meeting.

Management and logistics in the department. 

Devising and maintaining office systems, including data management and filling 

Producing document, briefing papers, reports and presentations.

Any other assigned activities by Executive Secretary health and TEC Secretary General