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 Tanzania - Country Assessment
In Tanzania, public and mission hospitals are the major providers of health care, especially in rural areas, where 75 percent of the population lives. The SEAM assessment found that a major problem is inadequate availability of drugs in the public sector, especially at the primary health care level. Although medicines are available free of charge in the public sector, when public facilities have gaps in stock, patients This can impose a significant financial burden on the patient. For example, in the private sector, a single course of adult outpatient treatment for mild pneumonia can cost 18 to 59 percent of a day's wages.
Public facilities rely heavily on the government Medical Stores Department (MSD) for supplies. However, the MSD has the capacity to meet only about 65 to 70 percent of customer needs, making it difficult for public facilities to get the medicines they require. Mission facilities also purchase from the MSD, but they have access to alternate, private sector resources when the MSD is out of stock, helping them better meet patient needs. Although the MSD is financially secure and is an experienced purchaser and distributor of essential drugs and medical supplies, demand for these commodities in the public and church-based health sectors is outpacing the MSD's supply capacity, regardless of planned improvements. When the MSD is unable to meet demand, clients resort to using local private wholesalers and distributors, which often sell products at less favorable prices and of dubious quality. The quality of pharmaceutical products and services offered is also a concern, in both the public and private sectors. The SEAM assessment found that 11 percent of samples collected from public facilities and 13 percent of those collected from private pharmacies failed quality testing. (These results are consistent with data previously collected by the National Quality Control Laboratory testing program.) Poor-quality drugs, including counterfeits, are thought to be widely available, especially in the private sector. In the first five months of 2001, 30 percent of the samples tested by the National Quality Control Laboratory failed, with a quarter of those being counterfeit drugs. It is estimated that half of the drugs on the market are unknown to the local drug authority. Quality of service is also a problem. For example, the SEAM assessment found that, at private pharmacies, 18 percent of simulated clients presenting with the common cold were recommended unnecessary antibiotics. Resource constraints do not permit the Pharmacy Board to carry out regular inspections of all the organizations and businesses providing pharmaceutical products and services Related Information» View the Assessment Report (PDF, 635KB) » View the Survey Data (PDF, 410KB) |
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The rural population's access to these costly drugs is through a large network of duka la dawa baridi, or private drug outlets, which are unregulated and provide services and products of unreliable quality. Some professional pharmacies do exist in Tanzania; however, they are few in number and located exclusively in the main urban centers.