The percentage of Tanzania’s population living on about $1.90 per day remains at 49.1% as of 2017, according to data from The World Bank. President Benjamin W Mkapa commented on the state of poverty in 2004 stating that ‘‘… the poor must be brought from the margins into the mainstream. The process must be inclusive. The weakest economies and communities need special and differentiated help.’’ President Mkapa shared his thoughts on including everyone in the process for universal aid and healthcare in Tanzania, which stretches from the cities to the rural agricultural communities. His words echoed the thousands of people living in extreme poverty where, like most other countries, their healthcare quality is dependent on wealth, status, location and transportation.

Effects of Poor Healthcare in the Poorest Communities

Masuma Mamdani and Maggie Bangser wrote a literary review in 2004 titled Poor People’s Experiences of Health Services in Tanzania, where they discussed the effects of poor quality of healthcare in Tanzania. Sexual and reproductive health was a major focus, especially with the implications it has for poor women in the region. ‘‘Many [poor women] cannot afford transport costs so they sell their food, borrow, use herbs or just wait to die,” a healthcare worker shared from Mpwapwa.

According to Mamdani and Bangser’s literary review, key barriers to the poor in this region include:

• The availability of drugs and medicines
• The shortage of qualified personnel
• Distance and transport issues
• Charges
• Governance

The government has written out and implemented a number of policies, but the issue of inaccessible healthcare for the poorest of the population is still prominent. Today, the United States is working in conjunction with the Tanzanian government to address a multitude of healthcare issues with USAID. For example, the strengthening of Tanzania’s own health system is imperative through supplies, more healthcare workers and supporting finances; but these efforts mostly concentrate within major cities and areas of high population density.

History of Healthcare Legislation

Since the East African country of Tanzania gained independence from Britain in 1961, there have been many ups and downs in the fight for healthcare for all citizens. The Arusha Declaration of 1967 moved towards the nationalization of public services, including medical, but ultimately failed due to economic decline. As the population rose and poverty levels increased through the years, especially in rural communities, even the numerous improvements in health services could barely keep up with the demand.

Healthcare in Tanzania today still does not receive enough funding and is nearly inaccessible outside of major cities. The funds directed towards the health sector have declined from 9.6% in 2014 to 7% in 2018, and the investments do not meet the estimated minimum requirement to guarantee basic health services to the population. There are a number of privatized health care options along with four main insurance programs available to the public, but even so, a large number of the population does not have insurance due to the high costs.

To combat this disparity, Tanzania enacted a Health Sector Strategic Plan from 2015-2020 to gain quality improvement in healthcare, provide equitable access to all and to achieve active community partnership. The Tanzanian government had implemented its fourth strategic plan, building on previously stated actions meaning to expand coverage of health insurance and extend quality health services to the poorer regions. For example, one of the core strategic objectives target the improvement of quality health services through ensuring essential services, a quality rating system, providing adequate staffing, performance management systems and more.

Independent Initiatives in Tanzania

Besides the government legislation that is currently in place and making changes, other independent NGO initiatives are making a difference for healthcare in Tanzania as well. An American initiative, Roads To Life, has dedicated itself to building and improving medical facilities in the Nkololo village, along with constructing roads and funding education. This nonprofit serves a primarily agricultural area with a population of 22,000, addressing the need for quality medical services outside of major cities and transport improvements between towns and regions. Roads To Life has also expanded and renewed the Songambele Health Center, which emerged in 1994. It can now treat up to 560 patients and has a new surgical center. After the addition of new operating suites which opened in 2016, there have been 149 surgical procedures. These new technologies and resources are vital to the health of Nkolo community members, who often had to go to the District Hospital for emergency procedures which was an hour away.

The combination of service and community makes all of the difference in healthcare in Tanzania. Influence from these discussed governmental and independent initiatives is still spreading throughout the country and there is still more work for the country to accomplish in terms of sexual and reproductive health. The efforts that Tanzania has put forth towards universal healthcare and providing quality medical services in more locations is a great push in the right direction to fight the effects of poverty in the poorest regions of this country.

– Savannah Gardner
Photo: Flickr