2. WHY STUDY INTERNATIONAL
HEALTH?
• Studying international health permits in the
discovery of beneficial factors leading to
the improvement of health across the
nation.
• "The more tools you have in the toolbox, the
better prepared and useful you'll be.”
– Dr. Steven Reynolds
3. TANZANIA
• Why?
• As a group we decided to
choose a country in Africa.
• We wanted to learn about how a
country in Africa dealt with
diseases, and how their health
care worked if they had any.
11. CHALLENGES TO REACHING THAT
GOAL
• Finances
• Acquiring vaccinations
• Space to refrigerate it
12. WHAT CAN HELP PREVENT
PNEUMONIA?
• Vitamin A supplements
• Promotion of breast feeding
• Handwashing
• House sanitation
• VACCINATIONS!!!!
13. SIGNS AND SYMPTOMS
• High fever
• Chills
• Cough producing phlegm
• Shortness of breath
• Chest pain when you breath or cough
• Feeling worse after cold or flu
• Nausea
• Diarrhea
• Vomiting
21. POPULATION MAKE UP
• Total Population: 46,912,768
• 0-14 years: 45%
• 15-64 years: 52.1%
• 65 years and over: 2.9%
• By Ethnicity
• African 99% (consisting of more than 130 tribes)
• other 1% (consisting of Asian, European, and Arab)
22. BIRTH RATES
• 5.08 children born/ woman
• 37.7 births/1,000 population
• Sex ratio at birth: 1.03 males/ 1 female
23. UNEMPLOYMENT & POVERTY
• Unemployment Age 15-24
• total: 8.8%
• male: 7.4%
• female: 10.1%
• 33.4% of population living in poverty (2007)
27. HEALTH STATUS
• Life expectancy, infant mortality, immunization rate,
major age-specific mortality & morbidity, major
cause-specific mortality & morbidity
28. LIFE EXPECTANCY
• Total Life Expectancy: 53.14 years
• male: 51.62 years
• female: 54.7 years
• Total Infant Mortality: 46.5 deaths/1,000 live births
• Males: 48.5 deaths/1,000 live births
• Females: 44.4 deaths/1,000 live births
• Malaria
29. IMMUNIZATIONS
• 1-year-old children immunized against:
• Tuberculosis
• Diphtheria, Pertussis, and Tetanus
• Polio
• Measles
• Hepatitus B
• Haemophilus Influenzae B
2
31. PUBLIC HEALTH AND TECHNOLOGY
• Clean, safe water and sanitation in schools and health
facilities is declining
• Transportation
• access to health care
• health care system (e.g. national insurance or out of
pocket payment)
• Housing
32. TANZANIAN TRAINING CENTER FOR
INTERNATIONAL HEALTH
• Located in Ifakara in the
Morogoro region
• Mission: To provide quality
training facilities and
services for the
strengthening of human
resources development in
Tanzania and international
health sector.
33. TTCIH CONTINUED
• Courses offered:
• Assistant medical officer
• Clinical officer refresher
• Integrated Management of Childhood Illnesses
• Swiss TPH Advanced Studies in International Health
• Averting maternal health and disability (external course offered in
Columbia)
• Disaster medicine and health crisis management (external course
offered in Athens)
• Malaria Course
34. GLOBAL SERVICE CORPS
• Offered to health professionals, pre-med and medical
students and others interested in health care
• Requires a nine-week minimum commitment and can
be extended to three months or more
• International Health Program placements consist of two
components
• The first segment of the volunteer assignment is
approximately three weeks, comprised of a week-
long cultural orientation and technical training
followed by participation in HIV/AIDS prevention
and nutrition community training workshops.
• The second phase of the volunteer placement
(minimum six weeks) includes participation in a
computer-based capacity-building project in
conjunction with shadowing health professionals in
local hospitals
35. TANZANIAN FIELD EPIDEMIOLOGY AND
LABORATORY TRAINING PROGRAM
• Two-year Masters of Science
course (MSc) program in
Applied Epidemiology and
Public Health Laboratory
• 46 TFELTP trainees have been
enrolled
• 21 trainees have already
graduated
• The program has grown from
28 participants in 2008 to 56 in
2011
39. GOVERNMENTS ROLE IN HEALTHCARE
• At the early stages of the independence in 1961, there were:
• 22 health centers
• 875 small, meagerly staffed and equipped dispensaries operated by local authorities.
• The average number of people served by each dispensary was 11 700.
• There were about 100 hospitals
• 40 of them run by voluntary agencies, such as churches.
• The physicians, working in the country numbered 415, only 12 of whom were
Tanzanians, and there were 380 rural medical aides.
• Total number of nurses was 1400.
• The present national healthcare system includes:
• 8500 village health posts,
• 3000 MCH clinics,
• 2644 dispensaries,
• 260 health centers,
• 98 district hospitals,
• 17 regional hospitals,
• 4 referral hospitals.
• The government health units often face a shortage of trained manpower,
inadequate facilities and drugs, and low staff motivation.
• Private health facilities are being established in increasing numbers,
especially in urban areas.
40. ECONOMIC STATUS
• Status of country (developed, developing, under-
developed)
• Resources for improving the nations’ health
41. TANZANIA’S ECONOMICS
• Underdeveloped
• Low Income Level
• Limited financial and human resources
• Tanzania Global Health Initiative Strategy 2010-2015
43. WHAT IS MEDA?
• Mennonite Economic Development
Associates (MEDA)
• Non-profit, non-governmental organization
(NGO) that is locally registered in Tanzania
since 1986.
• Our main purpose is to alleviate poverty
through sustainable economic
development.
• MEDA’s Mission
44. MEDA AND MALARIA
• The Tanzania National Voucher Scheme (TNVS)
• It is popularly known by its Swahili program name Hati
Punguzo in Tanzania
• TNVS makes Insecticide Treated Mosquito Nets (ITNs) widely
available to pregnant women and infants in Tanzania
through vouchers that subsidize the cost of nets at
appointed TNVS retailers throughout the country.
• The voucher system targets sustainability and accessibility
by facilitating the distribution of ITNs through a public-
private partnership of clinics, wholesalers, retailers and the
net manufacturer.
• The top-up amount to be paid by the beneficiary at the
retail shop is fixed at 500 Tanzanian Shillings ($0.35 USD).
47. RESPONSE TO CHOLERA OUTBREAKS
• Cholera is one of the major causes of
morbidity and mortality in Africa
• Within 20 days of detecting the Cholera
outbreak in 2009 there was already 588
cases reported and 16 deaths
• Ministry of Health and Social Welfare turned
to the Tanzania Field Epidemiology and
Laboratory Training Program
48. HIV PREVENTION
Click picture to
play video…
http://www.youtube.com/watch?v=EyWeCASsOUQ&playnext=1&list=PL87B964CE4CF0A
98C&feature=results_video
53. SOURCES CONTINUED…
• "Embassy of the United States Dar Es Salaam,
Tanzania." Success Stories. N.p., n.d. Web. 04 Jan.
2013.
• Tanzanian Training Center for International Health. N.p.,
n.d. Web. 04 Jan. 2013.
• "Tanzania FELTP." Tanzania FELTP. N.p., n.d. Web. 04
Jan. 2013.
Editor's Notes
Dr. Steven Reynolds a doctor who works in Uganda quoted, “The more tools you have in the toolbox, the better prepared and useful you’ll be.” This directly relates to studying international health. If you don’t discover important factors leading to the improvement of health, health will never have the necessities for improvement.
Tanzaniais located in East Africa. This country is divided into 30 regions. Tanzania is has tropical climate ranging in temperatures from 59-90 degrees during it’s cold and hot seasons. Hot season extends from November to February and cold season is from May to August. Tanzania has two different rain seasons. The first one is called uni-modal, which occurs from December to April and the second is called bi-modal, which occurs from October to December and March to May. This country has plains along the coast, central plateaus, and highland areas in the north and south.
Diseases associated in Tanzania are malaria, pneumonia, diarrhea, and AIDS.
Malaria is the leading cause of death in children who survive the neonatal period. This disease is serious and could be deadly. It is contracted through the bite of a mosquito that is infected with the parasite. Incubation period can last from 1 to 3 weeks.
The following are the signs and symptoms of malaria. Malaria symptoms will occur 7-9 days after being bitten by the mosquito.
Malaria can cause many side effects in left untreated. Above are some of the more prone. Jaundice or yellowing of the skin due to the attack on the liver. Anemia which is low red blood cells and iron, kidney failure, coma and death.
If you have a mild case of malaria, oral medications can be used. If severe, IV medications are required. Depending on what strain of malaria you contract will determine what medication you receive. The above medications are some examples.
Pneumonia kills more children than any other disease according to the WHO and is the second biggest killer in Tanzania. Increasing childhood vaccinations such as the HIB, should decreasedeaths by two-thirds.
It sounds like 3 easy ways to promote the use of immunizations, right? In poor countries it is not easy to come by these. Tanzania is working with a company called Unicef to achieve this goal.
Prevention is the key to decreasing the spread of disease. Here are some ways to decrease pneumonia.
Above are the signs and symptoms for pneumonia.
Diarrheal diseases are the leading cause of morbidity and mortality in low income countries in children. In Children less than 5 years, there is 10.6 per 1000 kids that die from it.
Above are some causes of diarrheal diseases.
Shigellosis is a bacteria gastroenteritis transmitted by a fecal-oral route. Symptoms include watery diarrhea, cramping, abdominal pain and fever. Typhoid fever is contracted through contaminated foods or water caused by bacteria. Signs and symptoms include fever, headache, weakness, fatigue, sore throat, cough, rash and diarrhea. If untreated you can become extremely ill and contagious.
For low income countries to manage diarrheal diseases, oral rehydration therapy, immunizations, and education is recommended. The rule to ORT is 1 cup of solution for 1 cup of stool lost. Challenges are faced when poorer countries do not own measuring cups or know math to know if they are measuring appropriately. Another challenge is sitting all day with your sick child spoon feeding them fluids. Teaching families proper sterilization techniques, sanitation, nutrition, and handwashing are a few ways to improve this.
Ages 25 years to 49 years is the highest age category in Tanzania of the AIDs population. Woman have a higher prevalence than males to contract Aids. This epidemic has stabilized in Tanzania. Their greatest challenge is receiving quality healthcare in their country. A second challenge is poverty. They can not afford medications to treat the virus or birth control to practice safe sex.
Religion in Tanzania has been divided equally between Christianity, Muslim and Indigenous (believing in another power) beliefs. Religion is a very sensitive subject in this country and statistics have not been updated sicnce the 1960’s.
Traditional healers are an important part of Tanzania’s society but is limited and impressionistic. Most do not practice the same way. The government is against use of healers due to possibility of poor practice. Culture in Tanzania has a major influences on health. Because promiscuity, homosexuality, female circumcision, medicinal “blood letting” and enema rituals, and sharing of instruments are practiced, HIV/AIDS are contracted easily. Tanzania is a huge banana growing country. Parasites are transmitted through poor agronomic techniques contributing to diarrheal infections. Development of proper sanitation of planting material, fallowing or rotation of nematode-infested fields with non-host crops before replanting bananas, and alternative control systems for the subsistence farmer are needed.
Christmas is practiced as we do in the United States in the Christian faith. They decorate with lights, candles and celebrate with a midnight Christian mass. Eid-il-fitr is a Muslim holiday based on the date of the new moon. This holiday includes a 2 day fasting and praying. They wear new clothes and give to charities. Navratri and Diwali is the indian holiday that involves dancing during the nine night of prayer. each one following a day devoted to one of the nine forms in which Hindus believe the divine mother goddess appears. For nine nights a lamp is kept lit and prayers are offered for the protection of health and prosperity.
Malaria leading cause of deaths in infantsLife Expectancy has increased in recent decadesInfant mortality has decreased in recent decades
The Government of the United Republic of Tanzania is a unitary republic based on multiparty parliamentary democracy. The President of the United Republic is the Head of State, the Head of Government; and the Commander-in-Chief of the Armed Forces. The government is made up of President, Vice President Prime Minister and Cabinet Ministers.
Tanzania public health's goals is to address public heath at the public’s levels. They hope to use the truth of science to benefit everyone. It assess communities at risk and monitors them, policies to promote health, prevent disease, provide cost effective quality care and evaluate further needs. It currently shifted away from eradicating disease, surveillance, screening, sanitation efforts, and treatment to social and environmental determinants as well as risks from people across the borders. They are preparing for global pnademics, health effects of trade, bio-terrism, and hazordous materials from other countries. Four prinicples are Prevention, direct involvement with the communities and promotion of healthy lifestyle, prevention option that gives the widest gain, and new methods to continue promoting healthy lifestyles.
Many volunteer programs such as Global Services Corps and The Tanzania Public Health Association exist. These groups focus on deploying volunteers to Tanzania to assist with healthcare needs. Being that Tanzania is a country wioth poor healthcare, groups like these are needed to assist in educating the people of Tanzania. The CDC has worked with the people of Tanzania since 2001 to address HIV, malaria and other health threats. They have provided finances, strengthening of healthcare infrastructure, education, counseling and treatments of disease.
The ultimate goal of Tanzania’s government is to promote the highest level of health by all people living in Tanzania. Due to the people of Tanzania being poor, uneducated with little resources, this goal is still hard to obtain. With the help of other nations hopefully one day there will be a difference in the health of Tanzania. As you can see with the information above the healthcare in Tanzania has changed drastically for the better over the years, yet there is still room for major improvement. Especially working on improving the shortage of trained manpower, inadequate facilites and drugs, and low staff motivation.
Relies a lot on foreign aidTanzania Global Health Initiative Strategy 2010-2015was created by the collaboration of the Governments of Tanzania and the United States to improve health care for Tanzanians
Meda works with both government and the private sector to help accomplish our goals.Meda’smission is to bring hope, opportunity and economic well-being to rural and urban communities of Tanzania by building the capacity of the economically active poor and linking them to production, marketing and financial infrastructure
In Tanzania, malaria is responsible for more than one-third of deaths among children under the age of 5 years and for up to one-fifth of deaths among pregnant women. Malaria also consumes an estimated 3.4% of national resources per year (GDP) making malaria a major contributor to the continuing cycle of poverty and stifled economic performance in Tanzania. It is not only a health, but also a major development and economic issue. Sadly, malaria is both preventable and treatable.Initiative under the Tanzanian Ministry of Health and Social Welfare and the National Malaria Control Program effort to boost coverage rates among the most vulnerable groups, pregnant women and infants, in Tanzania.
