In 2024, Operation Smile established a presence in Tanzania, seeking to provide high-quality care for children born with cleft conditions.
To increase access to high-quality cleft surgery and care for all Tanzanians, Operation Smile plans to enhance access to medical education and target care delivery in underserved areas – all in support of Tanzania’s medical leaders.
Operation Smile’s work is locally-led, globally supported. To drive this work, Operation Smile has held meetings with plastic, maxillofacial and dental surgeons and a pediatrician from Muhimbili Hospital, the head of the Society of Anesthesiologists based at Muhimbili University of Health and Allied Sciences (MUHAS), and the Chief of Medical Services at the Comprehensive Community Based Rehabilitation in Tanzania (CCBRT).
THE NEED
One in 600. In Tanzania, one child is born with a cleft condition per every 600 births – approximately 2,500 children annually. Only 43% of newborns receive postnatal care. Because few newborns receive postnatal care, babies born with cleft conditions are not properly diagnosed and set on a care pathway.
Lack of health workers and resources. Tanzania has a shortage of physicians (0.014 per 1,000 population), nurses and midwives (0.6 per 1,000 people) and specialist surgical workers (0.46 per 100,000 population).
In 2019, there were reportedly only 22 anesthesiologists in the country, the equivalent of 0.05 specialist anesthesiologists per 100,000 population. Tanzania also suffers from limited essential surgical equipment, which creates further barriers to care for children born with cleft conditions.
Unequal access to care. Significant inequities exist in the distribution of practicing doctors, with 41% located in urban regions and 88% of surgical specialists employed by the six largest hospitals in the country. With 65% of Tanzanians residing in rural areas of the country, these residents rely heavily on local health facilities. These facilities often don’t receive access to the resources needed to safely treat patients. In rural areas, especially in the south of the country, some individuals must travel over 20 hours to reach a hospital.
Financial burden. Considering that 49% of Tanzanians live below the international poverty line, the cost of surgery represents a financial barrier to access surgery. Out-of-pocket expenses often prevent people from accessing the care that they need, which puts children living with cleft conditions at an even greater risk. 91% of the population faces impoverishing expenditure for surgical care, while 46% faces catastrophic expenditure in case of surgery.
OUR FORMULA FOR TRANSFORMATION
Operation Smile’s formula for transformational impact combines care delivery & capacity-building.
Education programs are at the center of Operation Smile’s strategy to increase access to surgery closer to the patient’s home.
Each surgical program brings together providers from all over the world for a unique opportunity to share knowledge and innovate. This type of bi-directional learning is essential to redistributing knowledge between providers and building capacity in the areas of greatest need.
Our work in health infrastructure & equipment addresses structural barriers to care and helps build robust health systems. Operation Smile’s research & innovation efforts inform all aspects of our decision-making and allow us to have a comprehensive understanding of the impact our programs have on patients.
POTENTIAL HUBS & SPOKES
To ensure that every child has access to care close to home, we equip the providers within our patients’ communities with skills and resources to deliver high-quality care. We build the needed capacity by harnessing the talent and resources that exist within the country, usually in the bigger cities, the hubs, to train providers in under-resourced areas, the spokes, where most patients lack access to care.
In Tanzania, our hubs at Catholic University of Health and Allied Sciences (CUHAS) in Mwanza and Muhimbili University of Health and Allied Sciences (MUHAS) in Dar-es-salaam will provide year-round surgical care for our patients.
We are currently exploring opportunities to establish spokes in the south of the country, in regions where there is a high need and a lack of health care resources.
During Fiscal Year July 2024-June 2025, Operation Smile Canada has committed to invest $315,420 CAD accounting for 86% of Tanzania’s budget which will directly contribute to providing top-quality surgery for around 45 patients and provide training for approx. 70 medical providers.
Cleft Care Programs
Over the next year, Operation Smile will provide surgical care for 45 patients and expand cleft care services by offering nutritional consultations to 30 patients. Surgeries will be conducted through local and international programs. We will recruit patients using printed materials, radio, and TV programs, and develop a patient database. Additionally, we will identify and establish new hubs through a fact-finding process and create a medical volunteer roster and referral network.
Education Programs
We will increase access to high-quality and safe surgical care in Tanzania by providing education and training for nearly 70 health workers. Operation Smile will deliver American Heart Association courses to medical professionals working across different fields. We will support training for surgeons through the College of Surgeons of East, Central and Southern Africa (COSECSA), the largest surgical training institution in Sub-Saharan Africa.
In addition, Operation Smile will provide training through our partnership with the World Federation of Societies of Anesthesiologists (WFSA), a global alliance of anesthesiologists dedicated to improving access to safe anesthesia.
