Analysis of the State of African Healthcare in the 21st Century

June 1, 2015

With Afrolehar’s permission, we have decided to republish this blog on Abrabrand as the topic remains relevant. This blog was written and published by Afrolehar LLC.

By Thomas Omogi, Healthcare Commercial Markets Analyst.

Africa is a continent of many different countries in various stages of development. While most of them are coming into the modern world, all but a handful still have a long way to go before they can be considered developed nations. One of the biggest issues facing the nations of Africa in the 21st century is health care. Each nation has its own unique issues it is facing in this are, but all of them need to be brought more into the modern world with health care up to modern standards to ensure the health and well-being of all of its citizens…something that is a basic human right. This is where Tanzania currently stands in this area.

Health Care Availability and Spending in Tanzania

Among African nations, Tanzania has one of the more modern health care systems, though it still needs some work to be a truly excellent one. Quality health care is available, but its accessibility depends on a person’s income and geographic location. Those with higher incomes and who live in urban rather than rural areas have better access to top quality health care in Tanzania than other citizens. Health insurance is available, but is still a relatively new thing for the nation, and has a lot of limitations associated with it that makes it impractical for most. There are currently four publicly owned health insurance companies in Tanzania and seven private health insurance companies that operate in the nation.

There has been an increase in spending on health care in Tanzania in recent years. In fact, the increase has been significant, going from US $374 million in 2003 to US $1.75 billion in 2010. Most of the money has come from private donors. Government spending on health care is only seven percent of the total health care spending in Tanzania, even though the government pledged as part of the Abuja Declaration (1) to spend 15 percent in this area. Still, Tanzania relies heavily on private donors and charitable organizations to fund its health care initiatives, from hospital upgrades, doctor education, and public education of health care issues.

Disease Issues in Tanzania

Tanzania deals with many of the same diseases that plague much of Africa, such as malaria. The HIV epidemic is one of the largest and most serious of these diseases. There are 1.4 million people with HIV and/or AIDS in the nation. Among these people, 70.5 percent of them are between 25 and 49 years old, while 15 percent are between 15 and 24 years old. The rate of HIV/AIDS is a full percentage point higher in young women in Tanzania than among young men. As a result of the prevalence of the HIV/AIDS epidemic, over half of the available hospital space in the nation is used by patients suffering from this disease.

Malaria is the biggest cause of death for people under the age of five in Tanzania. Other common diseases that can be a problem for the residents of Tanzania include sleeping sickness and cholera. Sleeping sickness is caused by the bite of the tsetse fly, and is a prevalent issue for people who live in rural areas or areas close to wildlife refuges. It can kill children if it is not treated, and children are the most vulnerable among the population for getting this disease.

Cholera is common where there is bad sanitation, which leads to contaminated water. Thousands of cases a year are reported from Tanzania (2), and dehydration is a very problematic complication of this disease. Again, children are the most vulnerable to it, with pregnant women coming in a close second.

Health Care Providers in Tanzania

Many people in Tanzania go to their local indigenous healer when they are ill, be it with HIV, malaria, or any other disease they are prone to in the nation’s tropical climate. Indigenous healers have a high rate of success with treating simple diseases with herbs, but are not equipped to deal with more serious diseases or harsh injuries. These require hospital or medical center access, and it is not always available.

About sixty percent of people who go in search of health care services in Tanzania go to a local indigenous healer first, with 53 percent of these encounters being home visits where the healer comes to the patient. The vast majority of these house calls are for childbirth attendance. If a patient decides they need further medical care, they will seek it out if getting to the proper facilities and paying for treatment are possibilities for them.

While indigenous healers are considered the first level of care in Tanzania, village health workers are the second level. Each village in Tanzania has its own local government, and most local governments have one or two village health workers on their payrolls. Village health workers receive basic health care training, then get assigned to run community health posts in the village. They will give health education to the villagers and provide care for issues that are too complex for indigenous healers, but not serious enough for a medical center. Sometimes, they provide these services to patients in their homes, but more often, the patients come to them.

These village health workers also run medication dispensaries, for which they usually have medical school students to assist them. Dispensaries are overseen and regulated by health centers that cater to areas with populations of around 50,000. Health centers are considered the third level of care in Tanzania, and are staffed by medical school graduates with at least three years of training in the field. Some centers are run by qualified nurses. They mainly provide preventive care, though they usually have between 10 and 20 beds each for providing obstetric services and minor surgical procedures to those who need them. However, because there is an acute shortage of qualified health care workers in Tanzania, many rural community health posts and dispensaries are not staffed, or are staffed by untrained people.

The fourth level of health care in Tanzania is the hospital level. Within Tanzania, there are 132 districts with varying numbers of people, ranging from just over a million in urban areas to only in the tens of thousands in rural areas. Most, but not all, districts have a hospital that is run and supervised by the Tanzanian government. Some of the few districts without a government run hospital have hospitals run by religious organizations. These hospitals are usually eligible to receive government subsidies

The government run hospitals have the best health care in the nation. They offer both inpatient and outpatient services, and have diagnostic equipment that lower level health care providers don’t. Patients who go to the nations hospitals will get access to x-rays, lab work, and more extensive surgical services. Some of the hospitals have medical doctors on staff, but due to the health care worker shortage in the nation, most hospitals are staffed by assistant medical officers. Assistant medical officers are clinic workers who are qualified to run community health posts, but with an additional two years of clinical training.

Finally, there are four teaching hospitals in Tanzania, each in a different area of the country to provide access to as many people as possible. These teaching hospitals provide the highest level of health services with the most complex and skilled care in the nation. They are also staffed by the most skilled staff. Two of these teaching hospitals are run by the government, and two are run by religious groups (3).

Public Health Programs in Tanzania

There are a number of public health programs in Tanzania which are run by the government. Some of the best known and most used of these programs are:

The School Health Program
The Leprosy Control Program
The Reproductive and Child Health Program
The National AIDS Control Program

Of course, there are many others, each catering to a special area of public need in the health care environment. These programs are led by district medical officers, who are generally medical doctors.

Health Care in Tanzania–The Final Word

Tanzania has some of the more progressive health care programs in Africa. Compared to many other African nations, it is on the cutting edge. It is clear that Tanzania is moving in the right direction. While it still has a ways to go before it can be considered competitive with health care programs in the developing world, it is clear that Tanzania will get there. With just a little more investment by the government and private donors (4), and a recruitment program for foreign doctors and medical students at local universities, Tanzania will become a shining example of what health care in Africa should be.

Sources

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