Tanzania health sector strategy

To assist in the effort, this report reviews Tanzania"s health sector and serves as a background against which USAID/T health, nutrition, and population projects can be designed and evaluated. Reviewed are the population"s general health status; health sector organization and GOT sector policies and programs; sector contributions from donors, PVO"s, the private sector, and traditional medicine; main sector constraints; and the GOT"s future sector plans. The GOT"s main health sector goals are to reduce morbidity and mortality rates caused by malnutrition and communicable diseases (e.g., malaria) and to achieve self-sufficiency in providing health care to all Tanzanians. To this end, the GOT is decentralizing the health system with emphasis on rural facilities, personnel, and planning; developing preventive rather than curative services; and ensuring that donor support is consistent with self-determination in health care. To date, the GOT has successfully used paramedical personnel to extend health services, improved indices of health status, and assumed responsibility for AID-supported projects. Major health sector constraints include rapidly rising prices, a critical shortage of qualified personnel, poor communication and transport, and a paucity of information needed for planning and evaluation. To overcome these constraints and expand its health services, the GOT will continue to rely upon foreign financing and support, especially from A.I.D. The author recommends that USAID/T support GOT health sector priorities and requests since they are consonant with the health needs of the people and with broad development goals. Specifically, USAID/T should: (1) support community efforts to understand local health problems; (2) support community-initiated health interventions; (3) train and support community-level health workers; (4) assist in efforts to respond to Tanzania"s high population growth rate; and (5) promote administative and managerial capabilities of the health service delivery system at all levels. Detailed descriptions of the health sector in Tanzania and Zanzibar are appended.