The crisis in the preventive health services of Tanzania: a case study of Morogoro rural district

Tanzania, like the other underdeveloped countries has as its principle concern, extension, and maintenance of health services to all of its people. The basic aim being to foster the well being of its people. The component parts of this attempt are the established curative and preventive services. Despite increased relevant cadres and institutions necessary for the preventive wing, the expected results are yet to come. Ill health has lingered on to everybody’s disappointment. Children continue dying of infectious diseases, malnutrition and malaria, while the adult’s die of tuberculosis and anemia. One wonders therefore whether we have been treading the correct path towards solving the problem of health in our country. Is it that we have not trained enough health workers, or it is that we have not built enough dispensaries? Its unfair to sit down and discuss out the answer to these questions. To be able to understand this problem it has been necessary to conduct this study. In Chapter One, we have attempted to define the problem of preventive services in the country. It is brought out clearly that, the issues of establishing a preventive service is beyond the reach of health professionals. If it is to succeed it must have the people participating as equal partners. There is need to delineate the people in the health issues, we should base the services on the people understanding and ability, so that by utilizing that, what is within their reach, they can achieve the desired objectives, i.e. A healthy society. It is pointed out in this chapter how studies of health in Tanzania, have overlooked the social aspect, and so giving inadequate recommendations. In chapter two, the historical development of the health sector particularly so, the preventive wing has been explored. In this chapter, we have noted that, the development of health services in the country was skewed to serve the minority of the population. Those who belonged to the effluent and the ruling classes. The rural areas went unmonitored, and totally uncured for. They were left to grapple with nature, loosing here, but winning there. Their fate was in mercy of nature. The theories used to build the infrastructure dictated, a subjugated position for the peasants, and so the service developed evaded them. In chapter three we have the study area, where we note much ill health and repulsive poverty. The Socio-Economic conditions in which the people are languishing spells nothing but, apathy. People drinking from rivers and ponds, highly infective pests. People eating root tubers conducive to kwashiorkor. As such these are people who have not been able on their own to master the environment and natural catastrophes. They therefore remain prey to all sorts of diseases, and ilhealth. The scanty muscle power they have is wasted by the primitive productive forces they have. These are proved in the survey carried out and reported in chapter four on statistical magnitudes showing how ill health loves the company of poverty and ignorance. Some reasons have been brought out to explain this subject conditions. Besides proliferation of a social sector which withdraws people from direct production, the productive forces have remained very low. Those engaged in production have much of their attention diverted from producing food crops to production of cash crops, whose proceedings never reach the villagers. We have also the people sown social beliefs playing some role in the under utility of the services already established. The Health worker likewise, has his own attitude which underplays the establishment of health. In chapter five, a few recommendations have been given. These are simple and based on the observations, and are supposed to be operative within what the villagers can reach ie., what they have within their villages. The last part of this chapter has some long term recommendations, which call for protracted struggle, and consolidated alliance with other nations of the world who think like us. These must be increased on all of each one of our frontiers, so that the struggle to redistribute wealth can succeed to ultimately bring to everyone better health