DOES PREVENTIVE HEALTH CARE HAVE A CHANCE IN THE CHANGING HEALTH SECTOR IN TANZANIA?

Abstract

ABSTRACT
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. Health services that were considered to be
preventive included child immunisation, chemoprophylaxis, dental care, family planning
services and provision of health and nutrition education- Curative health services
included chemotherapy, psychotherapy, physiotherapy, surgical treatment and
radiography.
Setting: The study was conducted in Morogoro District between January and May 1999
whereby thirty-tour health facilities of varying nature were selected using purposive
sampling technique. Care was taken to include all types of health facilities available
and operating in the area.
Subjects: Eighty-six medical personnel and two hospital administrators from thirty-four
health facilities. The health facilities included twenty-five dispensaries, five health centres
and four hospitals. Care was also taken to include health facilities owned by various
institutions and organisations, 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 6 hours per day providing curative services such as chemotherapy,
surgical treatment, psychotherapy and radiography. On the contrary, they spent about
4 hours or less on providing child immunisation 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 immunisation, 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.