the united republic of tanzania health sector hiv and aids strategic plan

The already over-stretched health sector has suffered multiple effects due to HIV and AIDS: increased
number of patients due to opportunistic infections, increased demand and sometimes reallocation of
resources from other equally important health problems, and decreased number of health workers.
Therefore there is serious impact on the health services in terms of quality of care as a result of increased
service demand coupled with attrition of the workforce and stigma attached to HIV and AIDS.
The average HIV+ adult in Tanzania has an average of 17 illness episodes before death, leading to
healthcare costs per patient which can be twice the Tanzanian GDP of US$478 per capita.
1.2 HEALTH SECTOR RESPONSE TO HIV AND AIDS
1.2.1. National Health System Response and Capacity
The health system in Tanzania has two major components; the public and the private sector. The public
share is 56%, the private share is 44% (which includes Faith Based Organizations (FBOs) 30% and private
for profit 14 %). The system works at four levels; the community, the ward where we have a dispensary
and a health center at the division level. As we move further we have the district and regional hospitals at
district and regional levels. At the zonal and national level are the consultant/ refferal hospitals.
Table 2: Levels of Health Service Delivery
Level Type of health Service
Remarks
facility population
Country National Hospital 36 million There is only one national hospital, serves 36 million because
offers some specialized services not generally available in other
consultant hospitals
Zone Consultant Hospital 8 million Serve as the referral centre for the hospitals in the surrounding
regions in the zone. There are four consultant hospitals in total
including the national hospital
Region Regional Hospital 1-1.5 million 17 regional hospitals
District District Hospital 250-500,000 A number of FBO hospitals function as designated district
hospitals (DDH). More than 1 hospital may be available in each
district, usually run by FBOs (219 hospitals)
Division Health centre 50-100,000 481 health centres
Ward Dispensary 5-10,000 More than 1 dispensary may be available in a ward (4679)
Village Health post, ADDO 2-5,000
Currently in Tanzania there are a total of 5,379 health facilities geographically distributed so that 70% of the
population is within 5 km of a facility and 90% is within 10 km as at the end of 2005. v
Administratively, the health system is largely decentralized. The MoHSW has direct responsibility for the
referral and regional hospitals, and regulatory power over all health facilities. To accomplish this
responsibility, the Ministry’s functions are divided into six directorates which include:Hospital Services,
Preventive Services, Human Resource Development, Policy and Panning, Social Welfare, Adminstration
and Personnel. These departments are further divided into sections for a more effective implementation as
reflected in the organogram. The organisation and management of HIV and AIDS services is undertaken
within the parameters of the Preventive Services of MoHSW mandate through NACP.
The district facilities are independently run by the PORALG.
16 |FINAL COMBINED-HSHSP 2008-2012: June 24 th 2007