Leprosy and primary health care: Tanzania

Abstract

The greatest priority in health services in Tanzania is the extension of organized health services to every citizen within walking distance. A change in emphasis from hospital-urban-based health care to rural health services was made in financial allocations, manpower training and building of rural infrastructures since 1971. The health facilities which provide PHC are, in general, organized on a 4-level system and specific examples include the village health post, rural dispensary, the rural health centre staffed by 8-10 workers (part of the referral system for about five dispensaries and several village health posts), and a direct hospital manned by professional medical, nursing and other health personnel; it may cater for about 250,000 people. The implementation of the National Tuberculosis and Leprosy Programme specifies that the control measures must be applied throughout the country. The data presented show that leprosy control in Tanzania cannot be carried out by professional staff in specialized units. The staff working in rural health centres, rural dispensaries and auxiliaries in hospitals must be involved in order to obtain country-wide coverage. However, the involvement of all these conventional health facilities extends the care to the place of residence of only 45% of the rural inhabitants. It is, therefore, necessary in the near future to utilize village health workers in specific control measures for the remaining 55% of the rural population who do not have any health facility within the community.