Abstract

PIP: Since its independence, Tanzania has consistently followed a socialist policy with a strong emphasis on the development of the rural areas and on an equal distribution of goods and services. In the health field, this policy has taken the form of establishing a network of rural health centers, training auxiliaries, and involving the communities through mass mobilization campaigns. Community participation in health care services is hindered by 3 sets of problems related to lack of cohesion, lack of structure, and the autonomous and sometimes paternalist attitude of the health profession. In Tanzania much emphasis is placed on self-reliance. It is in the field of education that policies of self-reliance have been most successfully implemented. Traditional practitioners represent 1 of the health resources that can be tapped. The medical profession cannot claim credit for the major improvements in health, for at times it has even blocked health development. Health standards and quality are important in the 3rd world. Staff must be properly trained to function at a particular level, supplies must be provided regularly, and there must be constant supervision. A health care system that is appropriate to the 3rd world must also emphasize disease prevention. To increase health coverage there must be a program of health service that is within reach of the people, including the rural population. Health cannot be furthered by the health services as tradtionally conceived; an intersectoral approach is essential. It is important that a commitment to an integrated development of the rural areas, with health as a component, be made.