Health and Medicine Policy – Complete Full Notes
Session
1: Introduction to Health System in Tanzania
1
Learning Tasks
By the end of this session students are expected to be able to:
Define terms related to health system
State the vision and mission of the
MoHCDGEC
List levels of health care in Tanzania
List roles of the
MoHCDGEC
(Ministry of Health, Community Development, Gender, Elderly and Children) in Health care System in Tanzania
2
Definition of Terms Related to Health System
Health
is a state of complete physical, mental, and social well being, and not merely the absence of disease or infirmity. (WHO)
Policy
is a law, regulation, procedure or administrative action created by government or non-government institution
Health policy
is a visionary program of action adopted by the government to have a healthy society, with improved social wellbeing that will contribute effectively to personal and national development.
3
Definitions Cont…
Medicines Policy
is a written document specifying the medium – to long – term goals set by the government for the pharmaceutical sector, their relative importance, and their main strategies for attaining them.
It is a political commitment to a goal and a guide for action.
It provides a framework for coordinating activities for pharmaceutical sector.
4
Vision and Mission of Ministry of Health in Health and Medicine system
Vision
To improve health and wellbeing of all Tanzanian, with a focus on those most at risk, and to encourage the health system to be more responsive to the needs of the people
5
Cont…
Mission
To facilitate the provision of basic health services that are good, quality, equitable, accessible, affordable, sustainable and gender sensitive
6
Levels of Health Care in Tanzania
Community health services
Dispensaries: village/ street level
Health centres: ward level
District hospitals: district level
Regional/referral hospitals: regional level (are consultant hospitals)
National, Consultant and specialized hospitals: national level
7
Community Health Services
It is the responsibility of each individual and/or household to take care of its own health
Village Government should recognize and enhance the essential role of communities in directing local health services.
The community will have the mandate to choose their own community health worker who will be the main linkage between the community and the nearest health facility.
8
Dispensary Services
This is the first formal health unit of level one health services.
It is a primary health facility which offers outpatient services including reproductive and child health services, and diagnostic services.
A dispensary caters for 5,000 people and oversees all the village health services.
Dispensaries shall provide primary health care services to the community.
Refer the references to identify the primary health services to be provided at dispensary level
9
Health Center Services
This is the second formal health unit of level one-health services.
It is a primary health facility, which offers Outpatient and In-patient services, maternity care, laboratory, dispensing and mortuary services.
A Health Centre shall cater for 50,000 people and supervise all the dispensaries in the Division.
10
District Hospital Services
It is also a level one health services and plays the following roles:
Out-patient and In-patient care
Act as the second referral level
f
or the primary health care facilities in the district or catchment’s area
Perform general surgical and obstetric operations
Conduct teaching, training and research programs in the district concerning community health
Give supportive supervision and inspection and provide technical skills to lower health facilities in the district and refers patients to the regional hospital.
11
Regional Hospital Services
This is a hospital establishment providing level two (Secondary) referral services from level one hospital
This level have the following functions:
To provide all services offered at district level but at a higher level of expertise
Conduct health research programs in the Region
Provide technical skills to lower health facilities in the Region and offer specialized treatment in Medicine, Surgery, Obstetrics and Gynaecology and Paediatric, and shall include Eye, Dental, Mental illnesses, Orthopaedics and Trauma
12
National, Consultant and Specialized Hospital Services
This is level three and the highest level of hospital services in the country
It acts as referral centre for level two hospitals.
13
National Hospital
Muhimbili
is the currently national hospital
It also acts as Eastern
zonal
referral hospital
14
Zonal Consultant Hospitals
At present there are four
zonal
referral or consultant hospitals.
Muhimbili
National Hospital
Two voluntary agency hospitals:
Bugando
Medical Centre and Kilimanjaro Christian Medical
Center
(KCMC)
Mbeya
Referal
Hospital (owned by the government)
15
Specialized Hospitals
There are two specialized hospitals
Mirembe
Hospital (Dodoma) and
Kibongoto
(
Moshi
)
They provide services to the mentally sick and TB patients respectively
16
Roles of the
MoH
in Health and Medicine Policy
Policy formulation, health legislation, regulation and control
Resource mobilization and allocation
Management support of level three hospitals including National,
Consaltant
and Special Hospitals
Supervision and Monitoring of special and Consultant Hospitals owned by NGOs
Monitoring and evaluation of health services countrywide
Activity:
Use the given references for extra roles of
MoH
17
Key Points
Health Policy is important in a country like ours where resources and technology are more limited than in other countries.
Medicines Policy is a written document specifying the medium – to long – term goals set by the government for the pharmaceutical sector, their relative importance, and their main strategies for attaining them.
MoHCDGEC
mission is to facilitate the provision of basic health services that are good, quality, equitable, accessible, affordable, sustainable and
gender
sensitive
18
Review Questions
What is the vision and mission of the
MoH
of
health care in Tanzania?
What are the levels of health care in Tanzania.
19
References
URT (2007):
The National Health Policy
, Dar
es
Salaam, Tanzania. Government Printer
URT (2016):
Task sharing policy guidelines for health sector services in Tanzania
, Dar
es
Salaam, Tanzania. Government Printer
URT (draft – 2017):
The National Health Policy
, Dar
es
Salaam, Tanzania
20
Session 2: Introduction of Primary Health Care (PHC)
1
Learning Tasks
By the end of this session students are expected to be able to:
Define primary health care
List principles of primary health care
Mention components of primary health care
Explain WHO strategies of primary health care
Explain the basic requirements for sound primary health care
List rights and responsibilities of all participants in PHC
2
Introduction
Primary Health Care (PHC)
is essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self determination
It is the first level of contact of individuals, the family, and the community with the national health system
3
Determinants of Health
Internal
Biological and cognitive
Genetics, race, sex and age (diabetes, breast cancer are genetic in nature; diarrheal more common in children)
Psychological and spiritual
Life stress causes mental disorders, hypertension, heart attack, diabetes, gastric ulcer
4
Cont…
External
Environmental
Socio-economic conditions
Welfare services
Food and nutrition
Education
Occupation
Culture
5
Activity
What are the emphasizes of government on primary health care?
Brainstorming
:
What could be the principals of primary health care?
6
Principles of Primary Health Care
Equity
Accessible
Acceptable
Affordable
Appropriate Technology
Community Participation
Intersectoral
Coordination
Decentralization
Health Prevention and Promotion
7
Components of Primary Health Care
Health education
Food supply and nutrition
Safe drinking water and sanitation
Maternal and child health, family planning
Expanded programme in Immunization (EPI)
Prevention and control of endemic diseases
Appropriate treatment and prevention of common diseases, injuries and accidents
Provision of essential drugs
8
Global Targets on Primary Health Care
All people globally will have ready access at least to essential health care and to first-level referral facilities
All people will be actively involved in caring for themselves and their families in community action for health
Communities throughout the world will share government’s responsibility for the health care of their members
All governments will assume the overall responsibility for the health of their people
Safe drinking water and sanitation will be available to all people
9
Cont…
All people will be adequately nourished/fed
All children will be immunizes against the major diseases of childhood
Communicable diseases in the developing countries will be of no greater public health significance
Essential drugs will be available to all
10
WHO Strategies of Primary Health Care
Reducing excess mortality of poor marginalized populations
Reducing the leading risk factors to human health
Developing Sustainable Health Systems
Developing an enabling policy and institutional environment:
Primary Health Care
policy must be integrated with other policy domains
11
Basic Requirements for Sound Primary Health Care
Appropriateness
Availability
Adequacy
Accessibility
Acceptability
Affordability
Assessability
Accountability
Completeness
Comprehensiveness
Continuity
Review clarification of each requirement
12
Rights and Responsibility of all participants in PHC
Individual
Responsibility
Personal hygiene
Healthy lifestyles
Healthy environment
Sanitation
Family planning and population management
Rights
Vaccination and preventing diseases
Medical examination/ treatment
Safe water
13
Cont…
Community
Responsibility
Utilizing health facilities
Supporting and strengthening health centres
Activist for health promotion and protection
Improving sanitation and environment
Rights
Community health workers training
Promoting family planning, breastfeeding, healthy lifestyles
Restricting causative factors of ill health like poverty
Food safety, adequate water
14
Cont…
Government
Policies and plans
Resources
Accessibility
Awareness – building
Human resources development
Monitoring/ support
Outbreak control
Exchanging of experiences
15
Cont…
International
Human resources development
Capacity building
Technical corporation among developing countries
Information sharing
Technical support
Building partnerships
Financial support
16
Activity
Refer Handout 1: Essential Health Care Package to understand more about primary health care
17
Key Points
The principles of primary health care are: equity, accessible, acceptable, affordable, appropriate technology, community participation,
intersectoral
coordination, decentralization, health prevention and promotion
The following are components of primary health care; health education, food supply and nutrition, safe drinking water and sanitation, maternal and child health, family planning, expanded programme in Immunization (EPI), prevention and control of endemic diseases, appropriate treatment and prevention of common diseases, injuries and accidents, provision of essential drugs
18
Review Questions
What are the WHO strategies of primary health care?
What are the basic requirements for the sound primary health care?
19
References
Declaration of Alma-Ata International Conference on Primary Health Care, Alma-Ata, USSR, 6–12 September 1978. (2004).
Development,
47
(2), 159-161. doi:10.1057/palgrave.development.1100047
Alma Ata Conference 1978 Report. (
n.d
.). Retrieved from https://www.scribd.com/document/158435776/Alma-Ata-Conference-1978-Report
WHO (2012).
Who Expert Committee on Specifications for Pharmaceutical Preparations:
Geneva, Switzerland:
Forty-sixth report
.
20
Session
3: Alma-Ata Declaration
1
Learning Tasks
By the end of this session students are expected to be able to:
Define Alma-Ata declaration
Mention themes leading to Alma Ata
List objectives of Alma Ata declaration
Explain components of Alma Ata declaration
2
Activity: Brainstorming
What could you explain about alma-
ata
declaration?
3
Definition
Alma Ata declaration
is the International Declaration on Primary Health Care expressing the need for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all the people of the world
It identified primary health care as the key to the attainment of the goal of health for all
4
Themes of Alma-Ata Declaration
Changing theories of health and development
Concerns about poverty and population control
Increasing reliance upon alternative approaches to medical care model
Success of community health workers and associated emphasis on community participation
Revival of interest in public health: tackling causes of ill health rather than symptoms
5
Objectives of Alma-Ata Declaration
To promote the concept of primary health care in all countries
To exchange experience and information on the development of primary health care within the national health systems and services
To evaluate the present health and health care situation throughout the world as it relates to primary health care
To define the principles of primary health care as well as the operational means of overcoming practical problems in the development of primary health care
6
Cont…
To define the role of governments, national, and international organizations in technical cooperation and support for the development of primary health care
To formulate recommendations for the development of primary health care.
7
Components of Alma-Ata Declaration
Current world health situation
Primary health care approach
Primary health care and development
Technical and operational aspects
National strategies and international support
8
Current world health situation
The conference declared that the health status of hundreds of people in the world today is unacceptable, particularly in developing countries.
More than half the population of the world does not have the benefit of proper health care.
The conference analyzed the magnitude of health problems and the inadequate and inequitable distribution of health resources between and within countries
The Conference called for a new approach to health and health care to achieve more equitable distribution of health resources.
9
Primary health care approach
The Conference considered primary health care to be essential
It is the first level of contact of individuals, the family, and the community with the national health system
The Conference reaffirmed that governments have a responsibility for the health of their peoples
Each country must interpret and adapt particular, detailed aspects of primary health care within the country’s own social, political, and developmental context
All persons have the right and duty to participate individually and collectively in the planning and implementation of their health care
The Conference affirmed that the primary health care approach (health for all) would be attained by the year 2000
10
Primary health care and development
The Conference considered the close interrelationship and interdependence of health, social and economic development
Health activities should be undertaken concurrently with measures such as those for the improvement of nutrition, increase in production and employment and protection and improvement of the environment
The Conference
Emphasized the importance of full and organized community participation in the recognition and solution of their health problems
Self-reliance.
Affirmed the need for a balanced distribution of all available resources.
11
Technical and Operational Aspects in Primary Health Care
The varied experience of countries dealing with diverse health problems in rural and urban areas was discussed.
Thus the national health system have to support primary health care through appropriate training, super-vision, referral, and logistic support.
The government should ensure the main health problems in the community are identified and taken to action with special attention to vulnerable groups
The agreed translation of the principles of primary health care into action would require the priority allocation of budgetary resources to primary health care, better distribution and use of existing resources
Also research with full involvement of populations especially in health services should be carried out
12
National strategies and international support
Each nation should now make a strong and continuing commitment to primary health care at all levels of government and society.
National strategies are required to:
Translate policies into action
Make health care available, equitably to the entire population.
Take into account socioeconomic factors and policies, available resources and the particular health problems and needs of the population
The Conference emphasized that the strategies should be formulated and applied with fullest participation of communities and sectors of the government.
Countries can learn and benefit from each other’s experience
13
Cont…
International organizations, multilateral and bilateral agencies, nongovernmental organizations, and other partners should actively promote the national development of primary health care and give technical and financial support with full respect for the principles of national self-reliance and self determination and maximum utilization of locally available resources.
Any progress towards universal peace would release resources that could be used to accelerate socioeconomic development including primary health care and also benefit populations .
14
Key Points
Alma Ata Declaration is the International Declaration on Primary Health Care, expressing the need for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all the people of the world
The components of the Alma Ata declaration are Current World Health Situation, Primary Health Care Approach, Primary Health Care and Development, Technical and Operational Aspects, National Strategies and International Support
15
Review Questions
What are the objectives of Alma Ata declaration?
What was the world situation before declaration?
List themes which led to Alma Ata declaration
16
References
Declaration of Alma-Ata International Conference on Primary Health Care, Alma-Ata, USSR, 6–12 September 1978. (2004).
Development,
47
(2), 159-161. doi:10.1057/palgrave.development.1100047
Alma Ata Conference 1978 Report. (
n.d
.). Retrieved from
Declaration of Alma-Ata International Conference (
n.d
.). Retrieved from http://www.who.int/publications/almaata_declaration_en.pdf
17
Session 4: National Health Policy
1
Learning Tasks
By the end of this session students are expected to be able to:
Define policy
State the vision and mission of the national health policy
List objectives of national health policy
2
Activity: Brainstorming
What is policy?
3
Introduction
Policy directs how the government has to achieve its goals and objectives with regard to a specific area such as health, education, agriculture.
It can be described as a deliberate plan of action to guide decisions and achieve rational outcome
4
Vision and Mission of National Health Policy
Vision
To have a healthy community that contributes effectively to individual and nation’s development
To improve the health and well being of all Tanzanians with a focus on those
most
at risk, and to encourage the health system to be more responsive to the needs of the people.
5
Cont…
Mission
The mission is to facilitate the provision of basic health services that are of good quality, equitable, accessible, affordable, and sustainable and gender sensitive
This will help to reduce disability, morbidity and mortality, improving nutritional status and raising life expectancy.
The policy recognizes that, good health is a major resource essential for poverty eradication and economic development.
6
Objectives of National Health Policy
Effective health promotion services
Reduced malnutrition in the country
Comprehensive and sustainable immunization services
Improved reproductive, maternal, newborn, child and adolescent health services.
Reduced prevalence of communicable diseases
Efficient prevention and management of Neglected Tropical Disease (NTD)
Reduced morbidity, disability and mortality due to non-communicable diseases.
7
Refer handout 2:
National Health Policy Statements
for further reading
8
Key Points
Policy is a statement on how the government is to achieve its goals and objectives with regard to a specific area such as health, education, agriculture. It can be described as a deliberate plan of action to guide decisions and achieve rational outcome(s).
Health policy is a visionary program of action adopted by the government to have a healthy society, with improved social wellbeing that will contribute effectively to personal and national development.
The vision of the government is to have a healthy community that contributes effectively to individual as well as to the nation’s development towards becoming a middle income country.
9
Review Question
What are the objectives of National Health Policy
?
10
References
URT(2007).
The National Health Policy
, Dar
es
salaam, Tanzania: Government Printer
URT(1991).
The National Drugs Policy
, Dar
es
salaam, Tanzania: Government Printer
WHO (2012).
Who Expert Committee on Specifications for Pharmaceutical Preparations:
Geneva, Switzerland:
Forty-sixth report
.
URT. (Draft – 2017).
National Health Policy
. Dar
es
Salaam, Tanzania
11
Session 5: National and International Health Initiatives
1
Learning Tasks
By the end of this session students are expected to be able to:
Define medicine policy
Explain links between National Health Policy with National and International Initiatives
Explain factors which influences implementation of National Health and Medicines Policy
2
Definition
National Medicines Policy (NMP) is a political commitment guide for action that shows how the government will ensure that efficacious and safe medicines of good quality are affordable, accessible, and rationally used
It provides a frame work for coordinating the activities of all the parties involved, such as public and private sectors, nongovernmental organizations (NGO’s), donors and other interested stakeholders.
3
Links Between National Health Policy with National and International Initiatives
Refer handout 3:
National Health Policy and National and International Initiatives
4
Factors which Hinder Implementation of National Health Policy
Weak implementation structure for quality improvement approach
Attitude change problem among health workers
Shortage of human resources
Unreliable resource supplies and allocation
Poor implementation of several approaches to health sector
5
Factors that Influence Decision Making
Past experiences
A variety of cognitive biases
An escalation of commitment and sunk outcomes
Individual differences i.e. age and socioeconomic status
A belief in personal relevance
Policies and beliefs of a nation
6
Factors that affect community health.
Housing
Financial security
Community safety
Employment
Education
Environment
Risk behaviours of a population
Health status
Others???
7
Key points
Tanzania’s One Health Strategic Plan focuses on five thematic areas in consonance with its objectives
The Task Sharing Policy Guidelines constitutes an important guiding document regarding the expansion of a task sharing approach as one method of strengthening and expanding the health workforce rapidly to a health services
8
Review Questions
Which factors hinder implementation of quality improvement approach?
What are factors which influence implementation of National Health Policy?
9
References
URT (2015):
National One Health Strategic Plan 2015 – 2025
, Dar
es
Salaam, Tanzania: Government Printer
URT (2016):
Task Sharing Policy Guidelines for Health Sector Services in Tanzania
, Dar
es
Salaam, Tanzania: Government Printer
WHO (2012).
Who Expert Committee on Specifications for Pharmaceutical Preparations:
Geneva, Switzerland:
Forty-sixth report
.
URT. (Draft – 2017).
National Health Policy
. Dar
es
Salaam, Tanzania
10
Session 6: Millennium Development Goals
1
Learning Tasks
By the end of this session students are expected to be able to:
Define millennium development goals
Explain objectives of millennium development goals
Explain the achieved millennium development goals
List factors hindering implementation of millennium development goals
2
Definition
The Millennium Development Goals (MDGs) were the eight international development goals for the year 2015 that had been established following the Millennium Summit of the United Nations in 2000, following the adoption of the United Nations Millennium Declaration
About 191 United Nations member states and 22 international organizations participated
3
Objectives of Millennium Development Goals
To eradicate extreme poverty and hunger
To achieve universal primary education
To promote gender equality and empower women
To reduce child mortality
To improve maternal health
To combat HIV/AIDS, malaria, and other diseases
To ensure environment sustainability
To develop a global partnership for development
4
Achieved Millennium Development Goals
Eradication of extreme poverty and hunger
Achievement on universal primary education
Promotion of gender equality and empower women
5
Activity: Brainstorming
What are the hindering factors for achievement of other development goals?
6
Factors Hindering Achievement of Millennium Development
Poor enlightenment and public mobilization
Poor support of Millennium Development Goals
Cultural differences and problems
Economic problems
Political instability
Poor leadership and administrative bottleneck
7
Cont…
Sub-Saharan Africa has had the best record of improvement in primary education of any region since the MDGs were established
Many more girls are now in school compared to 15 years ago. The developing regions as a whole have achieved the target to eliminate gender disparity in primary, secondary and tertiary education.
8
Key Points
The Millennium Development Goals (MDGs) were the eight international development goals for the year 2015 that had been established following the Millennium Summit of the United Nations in 2000, following the adoption of the United Nations Millennium Declaration
Extreme poverty has declined significantly over the last two decades.
9
Review Questions
What are millennium development goals?
The Concept of
Millenium
Development Goals was based on what aspects?
Which factors hinders implementation of millennium development goals?
10
References
The Millennium Development Goals Report 2013. (2013).
Millennium Development Goals Report
. doi:10.18356/2e9902b5-en, Publisher
:
UN Department of Economic and Social Affairs
WHO (2012).
Who Expert Committee on Specifications for Pharmaceutical Preparations:
Geneva, Switzerland:
Forty-sixth report
.
URT(2003).
The National Health Policy
, Dar
es
salaam, Tanzania: Government Printer
URT(1991).
The National Drugs Policy
, Dar
es
salaam, Tanzania: Government Printer
11
Session
7: Sustainable Development Goals
1
Learning Tasks
By the end of this session students are expected to be able to:
Define agenda 21 of Rio de Janeiro
List components of the agenda 21
Explain concept of sustainable development
Explain sustainable development goals
2
Introduction
Agenda 21 is a non-binding action plan of the United Nations with regard to sustainable development
Is a global action plan for sustainable development into the 21
st
century.
Sustainable development
is a process that aims to meets the needs of the present generation without harming the ability of future generations to meet their needs
The agenda sought to provide a comprehensive blueprint of action to be taken so as to combat environmental damage, poverty and diseases.
3
Components of Agenda 21
The Agenda comprises 40 chapters arranged in 4 Sections:
Section I. Social And Economic Dimensions
Section II. Conservation and Management of Resources for Development
Section III. Strengthening the Role of Major Groups
Section IV. Means of Implementation
4
Cont…
Each chapter describes a programme area and comprises four parts:
The basis for action
Objectives
Activities
Means of implementation
Refer Handout 4: Components of the Agenda 21 for further reading
5
Concept of Sustainable Development
Emerged during United Nations Conference on Human Environment held in Stockholm, Sweden in 1972 and the report of the
Brundtland
Commission (1982) called Our Common Future.
The conference was held to agree to act together to reduce pollution so that the cost would be equally shared, however the developing countries wanted more development to reduce poverty
It was clear that what we do has an impact on the environment (change in atmosphere) that lead to increase in deserts, destruction of forests and disappearance of species.
6
Cont…
The gap between the poorer nations and the richer nations has become wider which can be measured in such terms as the average income per person and the number of people who live below the poverty line.
This finally led to the world community holding the United Nations Convention on Education and Development (UNCED) in Rio de Janeiro, Brazil in 1992 where the Convention on Biological Diversity, the Framework on Climate Change and the Rio Declaration of Agenda 21 were agreed.
7
Sustainable Development Goals
The 17 Sustainable Development Goals (SDGs) are part of a wider 2030 agenda for Sustainable Development-build on the Millennium Development Goals (MDGs)
The eight goals set by the United Nations back in 2000 to eradicate poverty, hunger, illiteracy and disease, expired at the end of Sept. 16, 2015
8
Cont…
No poverty
Zero hunger
Good health and well being
Quality education
Gender equality
Clean water and sanitation
Affordability and clean energy
Decent work and economic growth
Industry, innovation and infrastructure
Reduced inequality
Sustainable cities and communities
The 17 sustainable development goals includes
9
Cont…
Responsible consumption and production in agriculture and waste management
Climate action
Life below water(oceans)
Life on land
Sustainable cities and communities
Peace and justice
Partnerships in achieving the goals
10
Key Points
Agenda 21 is a non-binding action plan of the United Nations with regard to sustainable development
It is an action agenda for the UN, other multilateral organizations, and individual governments around the world that can be executed at local, national, and global levels
11
Review Questions
What are the components of agenda 21?
What are the objectives of sustainable development goals
?
12
References
Overview. (2018).
The Sustainable Development Goals Report 2018 The Sustainable Development Goals Report,
4-15. doi:10.18356/9eb36828-en,
WHO (2012).
Who Expert Committee on Specifications for Pharmaceutical Preparations:
Geneva, Switzerland:
Forty-sixth report
.
URT. (Draft – 2017).
National Health Policy
. Dar
es
Salaam, Tanzania
13
Session 8: Primary Health Services Development Programme
Learning Tasks
By the end of this session students are expected to be able to:
Define primary health services development programme
Explain concept of primary health services development programme
List objectives of primary health services development programme
List components of primary health services development programme
Overview
In 2007, Tanzania initiated a 10-year Primary Health Care Services Development Program focused on improving the Primary Health Care (PHC) delivery system, with special attention on rural areas.
Tanzania PHC system is embedded throughout the country's health and development goals
Concept of Primary Health Services Development Programme
Since independence in 1961, the Government has consistently focused its development strategies on combating ignorance, diseases, and poverty.
The aim of government commitments is to ensure fair, equitable and quality services to the community.
Furthermore, empowering communities and involving them in health services provision.
Cont…
Unfortunately fair, equitable and quality services remain to be desired, since burden of diseases (communicable and non-communicable ) are still very high.
As a result, communities are still faced with many cases of mortality and morbidity
The biggest problem is inadequate coverage of the health system to deal with the health service needs of all people in the country.
Cont…
This state of affair is due to:
Uneven distribution of health services
Some areas people need to travel long distance or many hours before reaching the point of health services delivery.
Poor infrastructure especially in rural areas.
Poor quality of services as some of communities are left out of health services participation.
Objectives of Primary Health Services Development Programme
To accelerate provision of quality primary health care services to all by 2017 through the following specific objectives:
To rehabilitate, upgrade and establish facilities at primary level to ensure equity and access of quality health care to all Tanzanians
To upgrade and establish more training institutions to ensure quality and adequate availability of skilled Human resources for Health.
To fast track capacity building, upgrading and on job skills development for allied health workers to meet the needs of the primary health facilities.
Cont…
To strengthen and maintain human resource database
To provide standardized medical equipment, instruments, pharmaceuticals and sundries to all primary health facilities to ensure optimal performance
To ensure that referral system is operational, and where necessary to establish teams of consultants to conduct mobile clinics and outreach so as to minimize unnecessary referrals.
To increase financial allocation to the sector with a view to attain the Abuja Call of 15% of the annual budget.
Components of Primary Health Services Development Programme
Human Resources for Health
District Health Services (Infrastructure, Pharmaceuticals and Supplies, Equipment, Transport, Furniture and Plants)
Maternal, Newborn and Child Health
Malaria
HIV/AIDS
Tuberculosis and Leprosy
Environmental Health Services
Health Promotion and Education
Nutrition
Traditional Medicines
Neglected Tropical Diseases
Public Private Partnership
Advocacy
Institutional Arrangements
Health Care Financing
Monitoring and Evaluation
Key Points
In 2007, Tanzania initiated a 10-year Primary Health Care Services Development Program focused on improving the Primary Health Care (PHC).
The policy aimed to accelerate provision of quality primary health care services to all Tanzanian by 2017.
Unfortunately fair, equitable and quality services remain to be desired, this is because the burden of diseases is still very high due to continued existence of communicable and non-communicable diseases.
Review Questions
What are the objectives of the primary health services development programme?
Mention components of the primary health services development programme.
What are the reasons for inadequate health care services?
References
URT (2007):
Primary Health Services Development
Programm
, Dar
es
Salaam, Tanzania: Government Printer.
URT(2003).
The National Health Policy
, Dar
es
salaam, Tanzania: Government Printer
URT(1991).
The National Drugs Policy
, Dar
es
salaam, Tanzania: Government Printer
WHO (2012).
Who Expert Committee on Specifications for Pharmaceutical Preparations:
Geneva, Switzerland:
Forty-sixth report
.
Session
9: Concept of National Development Visions
Paulo
1
Learning Tasks
By the end of this session students are expected to be able to:
Describe concept of national development visions
List impediments of the concept of national development visions
2
Introduction
Tanzania has gone through two national visions:
First vision
was to achieve independence.
Every Tanzanian understood and accepted that goal, which was a basic human right.
However, having attained independence implied hard work hence the post independence catchword "
Uhuru
na
Kazi
".
That catchword was intended to exalt the importance of hard work in realizing the development which was championed in the struggle for independence
3
Cont…
The second
national vision was the
Arusha
Declaration.
It articulated a philosophy of socio-economic liberation based on
socialism and self-reliance
as the long-term national goal.
The Declaration was accepted by the majority of Tanzanians and galvanized them behind its realization.
Thus since February 1967, the development vision of Tanzania as well as the policies for social and economic transformation have been guided in the
Arusha
Declaration
.
4
Cont…
The
aim of the first two visions
was to achieve substantial progress in attaining higher standards of living as reflected in the various development plans.
Tanzania vowed to eradicate
poverty, ignorance and disease.
Although reasonable progress has been achieved in the fields of education and health, there was a concern that the momentum and the level of progress made in these areas has not been equal to expectations.
5
Activity: Brainstorming
What are the cause of progress failure in national developmental visions?
6
Impediments
of the Concept of National Development Visions
A donor dependency syndrome and a dependent and defeatist developmental mindset.
A weak and low capacity for economic management.
Failures in good governance and in the organization of production
Ineffective implementation
7
Key Points
The Government has consistently focused its development strategies on combating ignorance, diseases, and poverty.
Thus Tanzania today prides itself of and enjoys national unity, social cohesion, peace and stability largely as a result of the Declaration's core social values.
The declaration credibly sought to realize a set of fundamental moral, spiritual, ethical and civil values which stand the test of time.
8
Review Questions
What are the impediment of national development visions?
What is the second goal of national development visions?
9
References
URT (1999):
The Tanzania development vision 2025
, Dar Es Salaam, Tanzania: Government Printer.
URT(2003).
The National Health Policy
, Dar
es
salaam, Tanzania: Government Printer
URT(1991).
The National Drugs Policy
, Dar
es
salaam, Tanzania: Government Printer
WHO (2012).
Who Expert Committee on Specifications for Pharmaceutical Preparations:
Geneva, Switzerland:
Forty-sixth report
.
10
Session
10: Tanzania National Vision 2025
1
Learning Tasks
By the end of this session students are expected to be able to:
Explain the concept and description of the Tanzania vision 2025
Explain background of the driving force towards Tanzania Vision
Explain vision driving forces
Explain attributes for implementing vision 2025
2
The Concept of Tanzania Vision 2025
The government (in the mid-1980s) realized that the past policies and strategies were not adequately responding to changing market and technological conditions in the regional and world economy and were also not adapting to changes in the domestic socio-economic conditions.
In the mid-1986, the government adopted socio-economic reforms which continue to be implemented to date.
However, these socio-economic reforms are not adequately informed by a national long-term development philosophy and direction.
3
Cont…
Moreover, the Government recognized the importance of re-kindling the hopes and expectations of the people thus reinforcing the need for a national vision.
A national vision therefore seeks to actively mobilize the people and other resources towards the achievement of shared goals.
4
Tanzania Vision 2025
What kind of society will have been created by the year 2025?
Tanzanians will be living in a substantially developed high quality livelihood.
Horrible poverty will be a thing of the past. In other words, Tanzanians will have graduated from a least developed country to a middle income country by the year 2025 with a high level of human development.
The economy will have been transformed from a low productivity agricultural economy to a semi-industrialized one, led by modernized and highly productive agricultural activities which are effectively integrated and supported by industrial and service activities in the rural and urban areas.
A solid foundation for a competitive and dynamic economy with high productivity will have been laid.
5
Attributes of Tanzania Vision 2025
High quality livelihood
Peace, stability and unity
Good governance
A well educated and learning society
A competitive economy capable of producing sustainable growth and shared benefits
Refer Handout 5: Tanzania Targets 2025 for further reading
6
Background of the Vision 2025
The bases of the vision 2025 were the success and/or failure of the previous developmental plans.
The Vision 2025 can be realized by capitalizing the strengths and engage the appropriate driving forces for development and effectively avoid the impediments which have held back the development.
The major strengths in our nation are unity, social cohesion, peace and stability
7
Cont…
Tanzanians have to adapt and recognize the new changes for the national and global economy like:
The on-set of political and economic pluralism.
The limitations of policies of public sector-led development and administrative control of the economy in a centrally planned fashion.
The recognition of individual initiative and the private sector as the central driving forces for building a strong, productive and renewing economy
8
Cont…
State welfare responsibilities are more focused on cost-effective ways of enhancing access to and the quality of social services.
The fast changing market conditions and technological developments
Nation-state economic
behavior
is being transformed by globalization and regionalism
9
Vision Driving Forces
A developmental mindset imbued with confidence, commitment and empowering cultural values
Competence and a spirit of competitiveness
Good governance and the rule of law
10
Attributes for implementation of Tanzania Vision 2025
Developmental Mindset and Competitiveness
Democratization and popular Participation
Monitoring, Evaluation and Review
Governance and the Rule of Law
Review handout 6:
Attributes for implementation of Tanzania Vision 2025
11
Key Points
In the mid-1986, the government adopted socio-economic reforms which continue to be implemented to date.
However, these socio-economic reforms are not adequately informed by a national long-term development philosophy and direction.
Horrible poverty will be a thing of the past. In other words, it is envisioned that Tanzanians will have graduated from a least developed country to a middle income country by the year 2025 with a high level of human development.
12
Cont…
Tanzanians have to adapt and recognize the new changes for the national and global economy.
In order to counteract the present challenge deliberate efforts were made to rekindle the hope, confidence; faith and commitment of the entire citizens
The key driving forces needed to be promoted and utilized includes: a developmental mindset imbued with confidence, commitment and empowering cultural values, competence and a spirit of competitiveness, good governance and the rule of law.
13
Review Questions
What are the attributes of the nation by 2025?
What is the spear head towards mobilizing people to achieve shared goal?
What are the attributes for the implementation of the vision 2025?
What are the vision driving forces?
14
References
URT (1999):
The Tanzania development vision 2025
, Dar Es Salaam, Tanzania: Government Printer.
URT(2003).
The National Health Policy
, Dar
es
salaam, Tanzania: Government Printer
URT(1991).
The National Drugs Policy
, Dar
es
salaam, Tanzania: Government Printer
WHO (2012).
Who Expert Committee on Specifications for Pharmaceutical Preparations:
Geneva, Switzerland:
Forty-sixth report
.
15
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