Tanzanian Health: An Overview of the Problems and the System

1
Tanzanian HealthAn Overview of the Problems and
the System

• Anne McNulty

2
Country Stats

• Total population 39,459,000
• Gross national income per capita (PPP
  international ) 980
• Life expectancy at birth m/f (years) 50/51
• Healthy life expectancy at birth m/f (years,
  2003) 40/41
• Probability of dying under five (per 1 000 live
  births) 118
• Probability of dying between 15 and 60 years m/f
  (per 1000 population) 518/493
• Total expenditure on health per capita (Intl ,
  2006) 45
• Total expenditure on health as of GDP (2006)
  5.5
• (World Health Organization, 2009)

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Causes of Death

• HIV/AIDS 29
• Lower respiratory infections 12
• Malaria 10
• Diarrheal diseases 6
• Perinatal conditions 4
• Tuberculosis 3
• Cerebrovascular disease 3
• Ischaemic heart disease 3
• Syphilis 2
• Road traffic accidents 2
• (World Health Organization, 2009)

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Adult (aged 15-49 years) HIV prevalence in United
Republic of Tanzania regions, Population-based
survey, 2004
lt/ 2.0 2.1-3.7 3.8-6.0 6.1-7.4 gt7.4 Data not
available
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HIV/AIDS in Tanzania (UNAIDS/WHO 2008)
6
HIV in Tanzania (UNAIDS/WHO 2008)
7
HIV in Tanzania (UNAIDS/WHO 2008)
8
HIV in Tanzania (UNAIDS/WHO 2008)
9
HIV in Tanzania (UNAIDS/WHO 2008)
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Healthcare Structure

• 6 levels 8
• Village health service
• Dispensary services
• Health care centers
• District hospitals
• Regional hospitals
• Referral/consultant hospitals
• Muhimbili National Hospital - eastern zone
• Kilimanjaro Christian Medical Centre - northern
  zone
• Bugando Hospital western zone
• Mbeya Hospital southern zone

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Health Facilities2
12
Health Insurance

• User fees9
• Health Sector Reform (HSR) 1960s16
• National Health Insurance Fund (NHIF)16
• AIDS TACAIDS
• Community Health Fund (CHF)16
• Health Basket Funding System (HBFS) 16
• Exemptions and Waivers 9

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Problems in the System

• User fees likelihood of treatment
• Poor communication between upper governmental
  levels and grass roots levels
• Low trust in health system leaders
• Low sensitization
• Inability to pay
• Low quality of health care services

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Target Groups to Educate about Health Care

• Uneducated (as education increases, so does
  health care demand)
• 15-20 year olds (least likely to seek health
  care)
• Men (less likely than women)7
• Poor5
• Community wealth v. individual wealth
• Poverty and access to health care
  facilities/staff
• Prenatal
• Vaccinations/immunizations

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Researching Difficulties

• Organization
• Structural
• NGOs
• Governmental programs
• Technological
• Website navigation
• Difficult to find area-specific information

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Questions for Sakina

• Have you hear of NHIF/CHF/HBFS?
• Are you enrolled? / Is it beneficial?
• How do you feel about user-fees?
• What are the nearest health facilities and what
  services do they provide?
• Do you need to visit a healthcare facility before
  going to a dispensary?
• How would you rate the quality of service?

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Where to go from here

• Village health services specific to
  Arusha/Sakina
• TACAIDS
• Testing sites?
• Counseling?
• Contraception?
• Family planning?
• Other NGOs
• Engender Health

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Work Cited

• (2009). Tanzania - Health. Retrieved Feb. 20,
  2009, from World Health Organization, Ilinois.
  Web site http//www.who.int/imci-mce/Sites/tanzan
  ia.htm
• (2009). Health. Retrieved Feb. 20, 2009, from
  National Website of the United Republic of
  Tanzania, Tanzania. Web site http//www.tanzania.
  go.tz.
• (2009). Tanzania - Health. Retrieved Feb. 20,
  2009, from Encyclopedia of Nations, Ilinois. Web
  site http//www.nationsencyclopedia.com/Africa/Ta
  nzania-HEALTH.html.
• (2009). Tanzania. Retrieved Feb. 22, 2009, from
  Engender Health, New York. Web site
  http//www.engenderhealth.org/our-countries/africa
  /tanzania.php.
• Khan, M. M., Hotchkiss, D. R., Berruti, A. A.,
  Hutchinson, P. L. (2006). Geographic aspects of
  poverty and health in Tanzania Does living in a
  poor area matter? Oxford Journals, 21(2),
  110-122.
• Shiner, A. (2003). Shaping health care in
  Tanzania - who's pulling the strings? The Lancet,
  362, 829-830.
• Sahn, D. E., Younger, S. D., Genicot, G.
  (2003). The demand for health care services in
  rural Tanzania. Oxford Bulletin of Economics and
  Statistics, 65(2), 241-260.
• Arvidson, A. Nordstrom, M. (2006). Health
  sector policy overview paper. Enable, , 1-6.
• McIntyre, D., Garshong, B., Mtei, G., Meheus,
  F. (2008). Beyond fragmentation and towards
  universal coverage Insights from Ghana, South
  Africa, and the United Republic of Tanzania.
  Bulletin of the World Health Organization, 86,
  871-876.
• (2008). Programmes and Projects of the Ministry.
  Retrieved Mar. 28, 2009, from Ministry of Health
  and Social Welfare, Tanzania. Web site
  http//www.moh.go.tz/programmes20and20projects.p
  hp.
• (2006). District Health in Tanzania Arusha MC,
  Arusha Region. Retrieved Mar. 28, 2009, from
  Health Sector Reform Secretariat, Ministry of
  Health, Dar es Salaam. Web site
  http//www.districthealthservice.com/district_page
  .php?id10.
• Mubyazi, G. M., Mushi, A., Kamugisha, M.,
  Massaga, J. (2007). Community views on health
  sector reform and their participation in health
  priority setting Case of Lushoto and Muheza
  districts, Tanzania. Journal of Public Health,
  29(2), 147-156.
• Kamuzora, P. Gilson, L. (2007). Factors
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  health fund in Tanzania. Health Policy and
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• United Republic of Tanzania. Retrieved Apr. 12,
  2009, from World Health Organization, Illinois.
  Web site http//www.who.int/countries/tza/tza/en/
  .
• (2006). About UMATI. Retrieved Apr. 14, 2009,
  from UMATI, Dar es Salaam. Web site
  http//umati.or.tz/aboutus.asp.
• 2009). About the Fund. Retrieved Apr. 14, 2009,
  from National Health Insurance Fund, Tanzania.
  Web site http//www.nhif.or.tz/aboutTheFund.php.