Health Care Delivery and Referral System in Tanzania
Health Care Delivery and Referral System in Tanzania
Students Learning Tasks
By the end of this session students are expected to be able to:
Define health care system
Mention goals of health care system
Mention levels of health care delivery system in Tanzania
Describe the referral system in health care delivery
Definition of Health Care System
Health care system is a system which consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health Source WHO 2005
Goals of Health Care System
The goals of health care system are;
Promoting a goal of universal health care
To ensure that all people obtain the health services they need without suffering financial hardship when paying for them.
To ensure good health for the citizens,
Levels of Health Care Delivery System
The organization structure includes five levels as follows:
National Level
The central level, is the Ministry of Health and social Welfare
Regional Level
This level sometimes referred to as an extension of the MOH. It has the regional secretariat and one hospital in the region.
District hospital level
The district is the focal point for the implementation of the national health policy managed by the local authorities.
Divisional Level
This consist of a health centre which provides both curative and preventive
Ward Level
This is the lowest level (dispensary) of the formal health care delivery system.
Referral System in Health Care Delivery
Referral System Is an organizational structure for coordinating, linking, & transferring responsibility of care.
May be done by:
a generalist to a specialist
a specialist to a specialist
one hospital to another
Government’s referral system assumes a pyramidal pattern of a referral system recommended by health planners that is from dispensary to Consultant Hospital (Better Health In Africa, 1993).
The following are health facilities from low level to the highest level through which a referral system go through;
Dispensary Services
The dispensary caters for 6,000 to 10,000 people and supervises all the village health posts in its ward. This is the first level where patients are attended to. If the patient cannot be attended to at this level because of the complexity of the condition is then referred to the next level which is a health centre
Health Centre Services
A health Centre is expected to cater for 50,000 people which is approximately the population of one administrative division. This is the second level where patients are attended to. If the patient cannot be attended to at this level because of the complexity of the condition is then referred to the next level which is a health centre
District Hospitals
The district is a very important level in the provision of health services in the country each district is supposed to have a district hospital. For those districts which donate have Government normally negotiates with religious organizations to designate voluntary hospitals get subventions from the Government to contract terms. Patients are referred to here from Health centres and dispensaries present within the District
Regional Hospitals
Every region is supposed to have a hospital. Regional Hospital offer similar services like those agreed at district level, however regional hospitals have specialists in various fields and offer additional services which are not provided at district hospitals. Patients from districts are referred to these hospitals for further management
Referral/Consultant Hospitals
This is the highest level of hospital services in the country presently there are four referral hospitals namely, the Muhimbili National Hospital which cater the eastern zone; Kilimanjaro Christian Medical Centre (KCMC) which cater for the northern zone, Bugando Hospital which cater for the western zone; and Mbeya Hospital which serves the southern Highlands.
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