Chloe Manchester via Crowdrise
February 13, 2012
The scale of suffering and preventable loss of life caused by the health crisis in sub-Saharan Africa is staggering. Each and every day, over two thousand children under five years of age die of malaria, a preventable and easily treatable disease. In fact the region has one quarter of the global disease burden but tragically only three percent of the health workers.
The international community has donated hundreds of millions of dollars to improve health outcomes in sub-Saharan Africa, and African leaders have pledged to dramatically increase their domestic spending on healthcare. However, many of these programs have targeted specific diseases, perhaps by providing more medicines, without necessarily ensuring that the hospitals and wider health systems handle them. In other words, the system remains broken or damaged because there has been little or no workforce development or improved hospital management. When so many resources are lacking – hospitals, drugs, transportation and communication systems – it can seem difficult to know where to begin.WHY ARE HEALTH WORKERS IMPORTANT?
The World Health Organization has stated that the shortage of trained health workers – doctors, nurses, laboratory technicians and others – is a fundamental barrier to improving health around the world. Without trained health workers, no amount of money, medication, or equipment can save lives.THE PROBLEM IN TANZANIA
In Tanzania, the health worker shortage is particularly severe – and mortality rates are persistently high. To meet the recommended 2.3 health workers for every 1,000 people, which the World Health Organization says are needed to provide basic care, Tanzania requires 110,000 health workers today. In fact the country has only 26,000 health workers – not even a quarter of the need – and the population is set to increase. In practice this means that there are insufficient public clinics, where most Tanzanians seek care, and those that exist average only three workers when they should have ten; private dispensaries average only one. So patients who have traveled days to reach a clinic may find no one there to help them. Read more about the situation in Tanzania.THE TANZANIAN GOVERNMENT’S STRATEGY
The Tanzanian Government is determined to improve health care and pledged in 2007 to build hundreds of new clinics and health centers to ensure that no one is more than five kilometers (three miles) from medical care. This infrastructure is essential, but without medical staff, managers, drugs, and other resources, its impact will be limited.THE OPPORTUNITY
The Touch Foundation is tackling the problem at its root – using a systems-based approach. We have assessed the need and we are currently putting in place innovative solutions, which must be both comprehensive and sustainable. These achievements will be relevant to other African nations as well, as we ultimately aim to develop a model that we and others may tailor to the health care needs across sub-Saharan Africa.TANZANIA A diverse country on the east coast of Africa, Tanzania is a democratic nation on the Indian Ocean in East Africa just south of the equator. At nearly twice the size of California, Tanzania has Africa’s highest peak, Mlima (Mount) Kilimanjaro, within its borders, and shares Africa’s largest lake, Nyanza (Lake) Victoria, with neighboring Kenya and Uganda.
ECONOMIC GROWTH AND DEVELOPMENT THREATENED BY POOR HEALTH
The Tanzanian population stands at 40 million people with agriculture, mining and tourism the most profitable sectors of the economy. The country has enjoyed more than decade of political stability and the wealth of natural resources has promoted strong economic growth. However, poverty and poor health remain endemic, particularly in rural areas. The health toll of HIV/AIDS, malaria, tuberculosis and other infectious diseases is high; of every 1,000 children born, 122 will die before their fifth birthday. Other indicators such as the low number of mothers who give birth assisted by a trained health worker, and the great delay in referring patients from health centres up to more specialist hospitals, highlight inadequacies in the existing health care system. Greater numbers of health care workers and improved health care facilities are therefore crucial factors in ensuring Tanzania’s future development.
The Tanzanian Ministry of Health and Social Welfare (MoHSW), faith-based organizations, nonprofits, and private institutions operate health facilities ranging from rural dispensaries staffed by one person to the four, large hospitals in the Lake Zone region of the country, which include Weill Bugando Medical Centre.JOINING WITH PRESIDENT KIKWETE
The Government of Tanzania, led by His Excellency, President Jakaya M. Kikwete, has made a commitment to improving equity of access to quality health services – through construction of over five thousand basic health care facilities, and a significant increase in the number of health workers. To realize this goal, Tanzania has engaged various partners to improve the nation’s health care and health worker training systems. The Touch Foundation is proud of what it has achieved in partnership with the Tanzania Government and is grateful for President Kikwete’s explicit and public support.MISSION & APPROACH Our goals are not unusual, but our approach is said to be inventive and pioneering. Yet in the end we actually want to make ourselves redundant, leaving behind a sustainable and functioning health care system that employs sufficient health workers to serve their communities.
We will improve Tanzanian healthcare only if we tackle problems in context, engaging local organizations and government from the beginning. Our model is not to build a new health care system; rather, it is to rebuild the existing one.
To do this, we tailor our activities to meet the needs of our partner institutions. Typically, a partner will present us with a strategic goal – for example, doubling the size of a medical training school or increasing productivity of a hospital laboratory. The Touch Foundation will analyze the problem, identify the costs, and prioritize and plan for what needs to be done. Where critical resources do not exist, we seek to bring in partners or direct donor funds to overcome the hurdle.THE IMPACT OF OUR APPROACH
- Because we are invested for the long-term: We can invest in the ten-year training cycle of Tanzanian specialists – pediatricians, surgeons and obstetricians – who will be able to train others and become the leaders of their national health system tomorrow.
- Because we collaborate with the public, private, and nonprofit sectors: We can leverage the experience of donor agencies, analytical skills of management consultants, and expertise of leading medical institutions to craft innovative and sustainable solutions.
- Because we work in partnership with the Tanzanian Government, hospital management, and community leaders: We ensure that our work supports national strategic goals, avoids duplication, and that the activities we undertake will continue under local ownership long after we have gone.
- Because we begin with rigorous analysis: We understand the real challenges faced and ensure our resources, and those of our partners, are directed efficiently to obtain the greatest possible impact.
- Because we seek to improve the existing system and not to create a new one: We learn from what others have done and are doing and we do not create a second system that only serves some of the population. In other words, our programs will be sustainable.
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