On this World Health Day 2019, the World Health Organization (WHO) directs our attention to their number one goal - achieving universal health coverage for all.
Global Health Care Needs
Many consider health care a human right. That right stands in stark contrast to the global reality. According to WHO, at least half of the world does not have full coverage of essential health services. In many cases, a lack of access is the cause. Unaffordability is another top reason. Millions of people each year are forced to choose between needed health care and other basic necessities - food, clothing and shelter. One hundred million people are pushed into extreme poverty annually because of health care expenses. Of those who can both access the care and pay for the services, many continue to face poor-quality options. (1)
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When we achieve universal health care, everyone will be able to attain accessible, quality health services without undue financial burden. Most importantly, everyone should have accessibility to primary health care - services that help people improve their health or maintain their well being rather than treat a single disease or condition.
Although a few communicable diseases such as HIV/AIDS, tuberculosis, and Ebola understandably receive much of the world’s attention, it is the noncommunicable diseases such as heart disease, cancer, and diabetes that take a greater percentage of lives prematurely. In fact, noncommunicable diseases kill 15 million people under the age of 70 each year. Investments in noncommunicable disease prevention through primary care could save millions of premature deaths each year. (4)
A Snapshot of Health Care in Tanzania
Tanzania faces many challenges in its health care system, a system that precludes many from receiving the above-mentioned, essential primary care. This includes a shortage of healthcare workers (one doctor per 30,000 Tanzanians), a lack of facilities in rural areas, long distances to the existing facilities coupled with poor transportation systems and roads, and underfunding ($51 per capita in comparison to $4,000 per capita in the U.K.) (6).
In 2015 the Ministry of Health of Tanzania assessed the state of its health care system through a year-long evaluation of health facilities using a five-star rating system. Of the 7,000 facilities evaluated, only 2% met the minimum standard of quality (three stars of more). A whopping 34% received 0 stars (8).
One area of concern is women’s health and obstetrics. In a recent study reported in BMJ Journal, 13,266 Tanzanian women of reproductive age were interviewed in order to analyze the obstacles to health care access for women. Two-thirds of the women cited at least one of the following hurdles:
The study concluded: “The results of the present study provided evidence for additive effects of barriers to healthcare in low-income countries, such as Tanzania. Based on these results, improving access to health insurance and addressing social determinants of health represent the first steps towards reducing problems associated with accessing healthcare for women in low-income countries.” (3)
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A few statistics (2010) bring the challenge of inadequate medical access for women into greater focus:
Only an approximate 50% of deliveries were attended by skilled medical personnel.
A mere 40% of pregnant women received at least four prenatal visits with a skilled provider.
A dismal 45% of the country’s health centers have basic emergency obstetric care. (5)
It is not surprising then that in 2014 the maternal mortality rate was 398 deaths per 100,000 live births. Still, strides are being made to reduce such numbers. In 2005, that number was 605 deaths per 100,000 live births. (7) Compare that to the U.S. While having the worst rate of maternal deaths in the developed world, the U.S.still has a substantially lower rate at 26.4. Finland has the lowest rate at 3.8. (9)
Raising awareness of the global inequity in healthcare access is critical. Health care is not just a human need; it is a human right.