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Evaluating Equity in the Provision of Primary Health Care in Tanzania

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  • Equitable access to primary health care is vital to the overall health and development of a country. Since its independence in 1967, Tanzania has established a clear objective of achieving primary health care for all. Yet achieving the goal of health care for all is especially difficult considering Tanzania’s poverty and rural population base. This essay 1) explores the extent to which equitable primary health care services are available to all citizens in Tanzania and 2) explores the changes in health status of key primary health care-related health indicators to assess the effectiveness of Tanzania’s efforts. To conduct this analysis, a desk-based literature review was performed examining relevant peer-reviewed research in addition to government reports and polices from Tanzania’s Ministry of Health and Social Welfare. Ultimately, this review found that the Tanzanian government has utilized various PHC strategies—decentralization, user fee abolition, and contracting out of services—with varying degrees of effectiveness in their quest for health care for all. Decentralization and the use of non-governmental actors to extend services can be seen as strengths, while the government’s ability to enforce user fee exemptions and waivers at facilities was found to be a weakness. This proves that while PHC strategies are supported by health policy, policy goals are not always realized. Consequently, in the midst of a decentralized health system, local autonomy is needed to ensure that efforts across all levels are working towards improved access in the delivery of PHC.
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