Health technology assessment system in Tanzania: Is it a championing system or still a system lagging behind?

Health Technology Assessment (HTA) is a cost-effective solution that decreases inefficiencies and improper investments in health systems. Tanzania has made remarkable efforts in the field of HTA with the establishment of the national HTA committee in 2017; yet, literature on its institutionalization is limited. Using a systems thinking and analytical approach, this study examined Tanzania's HTA system, focusing on conceptualization, management, implementation, capacity, and use in policy and decision-making. The study was conducted between 2021 and 2023, purposely targeting experts and organizations involved in HTA. Six national HTA experts participated in virtual In-Depth Interviews (IDIs) of HTA from a policy perspective, and eight members of HTA-associated organizations from governmental and non-governmental sectors. Each organization completed one electronic institutional survey to understand HTA from a technical perspective. Findings from both data sources were consistent; half (n = 4) of the participating organisations surveyed affirmed an understanding of the HTA, but the majority showed limited knowledge of a central HTA agency or formal process. The Ministry of Health (MOH) is the main recipient of the HTA reports. Sustainable funding allocated for HTA is limited, and it is irregularly funded by private companies. Key values included safety, cost, economic evaluation, feasibility considerations, and community acceptability. HTA reports were used to inform clinical guidance, healthcare coverage, and pricing decisions. Experts identified the need to strengthen HTA awareness, advocacy, implementation, and institutionalization, supported by political commitment and inclusive governance. Strengthening the Tanzanian national HTA system through a more inclusive national body is essential to address these challenges.