Equity in health sector sesponses to HIV/AIDS in Tanzania
| dc.contributor.author | Semali, Innocent A. | |
| dc.date.accessioned | 2020-07-21T09:44:16Z | |
| dc.date.available | 2020-07-21T09:44:16Z | |
| dc.date.issued | 2003 | |
| dc.description.abstract | This paper presents an analysis of the manner in which economic and health inequalities in Tanzania influence equity in access to health care and responses to HIV/AIDS. It is estimated that globally there are 42 million people suffering from AIDS of whom 29.4 million are found in Sub- Saharan Africa. HIV/AIDS was first described in 1983 in Tanzania, and has since spread dramatically. The prevalence in Tanzania has been found to vary between 1.6% of the population in rural areas to 28.6% in urban areas. HIV/AIDS has had an impact on all sectors of the society. It has been the leading cause of adult death with a proportional mortality ratio from AIDS ranging from 30.2 percent to 44.5 percent. The number of tuberculosis patients has increased substantially. The morbidity and mortality from AIDS has negatively affected schooling, agricultural and economic sectors in Tanzania. Industrialized countries have been able to use their ample resources to control and treat HIV/AIDS. However the overwhelming poverty in Sub-Saharan Africa countries has left a massive social deficit that has undermined efforts to manage the AIDS epidemic. Hence even while the United Nations has made a global commitment to the Millennium Development Goals (MDG), including addressing HIV/AIDS and poverty, the poverty burden and weakness on economic and social institutions threatens the achievement of these goals. Like other developing countries with high HIV/AIDS burdens, Tanzania faces significant challenges in meeting its UNGASS commitments on the goals. The paper explores these challenges and the responses to them. The paper draws from secondary data sources and interviews. The evidence indicates that poor economic performance in Tanzania has compromised its ability to address HIV/AIDS. While the most critical constraint is an absolute shortfall of resources, there are several equity issues that arise within the health sector. Within Tanzania, there is a significant variation in resource availability for health by geographical area. The health service referral system has performed poorly, leaving the primary health care services poorly supported and financed, even though these are the services most relevant to support of community prevention Home Based Care (HBC) initiatives. Government and Donors have made efforts to increase financial resources to these levels, but this is threatened by capacity shortfalls at district level, in both human and material resources. At the same time the clients to lack the information and means to make more effective use of services. Such factors threaten equity in access to new antiretroviral treatments for HIV/AIDS and the implementation of HIV/AIDS control activities, despite political commitments and the comprehensive policy intentions. Strategies are needed to address these equity gaps. Such strategies should address the absolute and relative resource shortfalls to rural areas, to certain districts and to district and primary care levels of health systems. Health sector reforms that have placed significant emphasis on district roles and powers, need to also address the capacities to 4use these roles and thus to ensure equitable access to ART. Financing reforms and new funding mechanisms need to ensure that they provide for the risk pooling and comprehensive cover that is needed if health services are to reach poor people as a vehicle for equitable access to ART. There are lessons from experience in Tanzania for new programmes, including for the Global Health Fund. The experience of donor participation in primary health care indicates that while donor funds can provide necessary resources, specific attention needs to be paid to measures for ensuring integration into national health systems and for ensuring the sustainability and continuity of those programmes supported by donor funding. This demands an increased share of financing from government funds and greater attention to supporting overall health systems capacities within specific programmes. | en_US |
| dc.identifier.citation | Semali, I. and Kimambo, A., 2003. Equity in Health Sector Responses to HIV/AIDS in Tanzania (No. 8). EQUINET Discussion Paper. | en_US |
| dc.identifier.uri | https://equinetafrica.org/sites/default/files/uploads/documents/DIS8aids.pdf | |
| dc.identifier.uri | http://hdl.handle.net/123456789/562 | |
| dc.language.iso | en | en_US |
| dc.publisher | EQUINET Discussion Paper | en_US |
| dc.subject | HIV/AIDS | en_US |
| dc.subject | Tanzania | en_US |
| dc.subject | Health inequalities | en_US |
| dc.title | Equity in health sector sesponses to HIV/AIDS in Tanzania | en_US |
| dc.type | Article | en_US |