Does preventive health care have a chance in the changing health sector in Tanzania?
Msuya, J.M.; Nyaruhucha, C.N.M.; Kaswahili, J.
East African Medical Journal 80(3): 135-139
2003
ISSN/ISBN: 0012-835X PMID: 12762428 Document Number: 566463
Objective: To investigate the status and practice of preventive health care (relative to curative) in the health delivery system at the time when the health sector reforms are taking place. Design: A cross-sectional, descriptive study. Setting: The study was conducted in Morogoro District, Tanzania between January and May 1999. Subjects: Eighty six medical personnel and two hospital administrators from 34 health facilities. The health facilities included 25 dispensaries, five health centres and four hospitals. Care was also taken to include health facilities owned by various institutions and organizations, including governmental and non-governmental. Results: Generally, preventive health received little attention compared to the curative health measures whereby more than 80% of the medical personnel in some of the facilities were assigned to curative services. Health personnel reported to spend an average of up to six h per day providing curative services such as chemotherapy, surgical treatment, psychotherapy and radiography. On the contrary, they spent about four h or less on providing child immunization and education on nutrition, health and family planning. As expected, the type of ownership of a health facility influenced the extent to which preventive measures were included. For example, while all the government owned facilities did provide child immunization, nutrition education and family planning services, some non-governmental facilities were lacking such services. Conclusion: It is obvious that while the provision of curative health care can be left to the hands of the private suppliers, that of preventive health care needs strong government involvement. It is suggested that deliberate efforts be taken to shift resources from curative to preventive measures. One way in which such a strategy can be attained is for the government to set, as a condition for private operators, a minimum level of preventive measures to be provided by every operator before a permit is issued. However, caution should be taken to ensure that such deliberations do not discourage investors in the health sector.