PHC in Tanzania

The fundamental ideas for the beginning of a Primary Health Care (PHC) and adjustment of health systems in Tanzania had taken place in the Arusha Declaration of 1967. The idea like that of Primary Health Care had been propagated by Ujamaa as a base of national health policy.
(Ujamaa: is a concept taken from Swahili ‘jamaa’= “clan, extended family”). This concept is used in Tanzania as a political vision for the African socialism. Ujamaa wants to create and build a new consciousness for social well-being on the principles of self-determination and self-responsibility
with a spirit of African extended family.

At this time all government health services were, as a result of colonialism, oriented and organized with curative medicine (treatment, hospitals, outpatients, medicines, operations, clinic medicine). The curative institutions such as hospitals, and outpatient services were centralized mainly in the town areas. Health services in the rural areas were poorly developed, although 80% of the population lives there. It was especially the institutions of the mission and churches that served in the remote areas.
Later, the main areas of state health policy began to deal with improvement of rural development
with a main focus on prevention and development initiatives (Efforts of motivating people to have healthy life).

The declaration of Alma Ata (1978) was for Tanzania only a confirmation of the already envisaged program in the Tanzanian politics of African socialism.


The envisaged goals of the government:

Establishment of a hospital in every district.
Establishment of an Health Centre for every
50,000 inhabitants.
Establishing a dispensary for every 10,000 inhabitants.
Establishment of village posts for health in every
village in Tanzania.

In 1980 72% of the population lived in the areas that with a distance not more than 5 Km from the Health institutions. Further 20% lived in the distance of 5-10 Km. The number of the so-called “Front line Health Workers” such as Medical Assistants, Rural Medical Aids, sisters, Health Assistants and Maternal Child Health Aids were educated. Programs such as Mother-Child-Health services, expanded programs of immunization (Vaccination programs), Tuberculosis and leprosy-control programs were started. Similarly educating village health workers was introduced. Many of these plans could not be implemented and they did not lead to success. Reasons for this failure are many, for instance, poor economic conditions in addition to poor infrastructures and poor communication. Also curative institutions like hospitals were and still are found in the towns; as such, the peripheral health centres in the rural areas are ignored.