Fixing health systems
Date
2008
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Volume Title
Publisher
IDRC, Ottawa, ON, CA
Abstract
In Africa, health care has been in a state of crisis for several decades. The Tanzania Essential Health Interventions Project (TEHIP) has sought to test a premise that called for health reforms based not just on increased funding but on more strategic investments in health. Two large districts in Tanzania — already engaged in health reforms centered on devolving management of resources to the local level — attempt to bring health spending more in line with cost-effective approaches to the local disease burden. Information from Demographic Surveillance Systems makes it possible for planners to determine spending priorities. A series of simple management tools enable those district planners to allot funds to interventions that will have a greater impact on local causes of mortality. New means of planning lead district health teams to budget more proportionally to address major contributors to mortality such as malaria and a cluster of childhood illnesses. Effectively addressing those problems, however, requires that a modest funding top-up be applied to increasing capacity within the health system. This allows for better training, more effective deployment of resources such as drugs, better clinical practice, and increased patient satisfaction. The overall result is a dramatic decline in mortality in the two districts. The two districts’ success in substantially lowering mortality demands that the tools for achieving that success be disseminated more widely, both within Tanzania and internationally. The primary lesson arising from the TEHIP experience is that investing in health systems is an effective way of improving population health.
Description
French version available in IDRC Digital Library: Réforme du système de santé
Published in collaboration with the Ministry of Health and Social Work, Tanzania
2nd ed.
Published in collaboration with the Ministry of Health and Social Work, Tanzania
2nd ed.
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IDRC Book
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Text
Keywords
HEALTH PLANNING, HEALTH EXPENDITURE, HEALTH SYSTEM, RESOURCE ALLOCATION, DECENTRALIZATION, MORTALITY DECLINE, RURAL COMMUNITIES, HEALTH PERSONNEL, CAPACITY BUILDING, POLICY MAKING, PARTICIPATORY RESEARCH, TANZANIA