Primary Health Care Primary Health Care Schemes water and sanitation maternal and child health disease control essential drugs food and nutrition traditional medicine health education curative care Health Provision Water/Sanitation Education Programmes Food/Traditional Medicines

Health Provision Barefoot Doctors These are local people who are medical auxiliaries having been trained to treat straightforward illnesses and refer more serious problems to hospitals. They operate on a part time basis, the rest of their time being spent on farming. As they are cheap to train more of them can be employed, covering a larger percentage of the population. As they are local they are seen as more approachable and trustworthy by locals and so are more popular than incoming doctors. Medical Centres The creation of village health centres bases upon a trained doctor and “barefoot doctor”, have meant that immunisation programmes have been implemented against localised diseases as well as education programmes. Information on hygiene has meant fewer diseases have been passed on through poor hygiene; family planning clinics have meant that contraception availability and use have increased meaning smaller families; and preventative methods for malaria have helped reduced its impact. The doctor in charge can deal with cases the “barefoot doctor” can’t, but is relieved of less important cases by the “barefoot doctor”. The very worst cases are sent to a regional hospital. Medicines (Preventative & Curative) The immunisation programmes carried out by these centres focused on diseases such as Measles, Polio & TB etc. Statistics show that 6 children die and another 6 become disabled every year due to poor immunisation programmes, despite drugs being relatively cheap. These centres help to reduce this problem particularly as it is easy for them to administer several doses to ensure full immunisation. One of the most effective medicines given out was ORT to combat diarrhoea as it was cheap and easy to use. Better access to medical care is a hugely important part of PHC and can be tackled in the following different ways.

Education Programmes Gender Issues In many poorer countries women receive less education than men, for example in Mali there are 23% less women in education than men. Breaking down these barriers is important as it is the women who bring up and feed the family. To inform them of preventative health measures will help reduce infant mortality rates e.g. use of clean water to prevent infections; variety in diet to boost immune systems; use of family planning to reduce birth rates. Delivery Programmes have been delivered through medical centres either directly in Mothers & Toddler Groups organised by the centre or using barefoot doctors to go into local schools.

Others Food We have aleady discussed the relevance of food to health, see Task 3, but you must be clear that it is an integral part of the Primary Health Care system. Generic Drugs More recently a push to use cheaper drugs has taken place and essentially is the copying of existing western drugs locally. With no profits required, a relaxation of patent rights (due to public pressure) and cheap labour these are vastly cheaper than those in the MEDC’s.

Water & Sanitation We’ve already done this as part of Task 4, but here are the main points again. k

Effectiveness The PHC schemes in Tanzania have been largely successful as any improvement to health care is positive. There were some problems. Just getting started has been a problem though as the country was in so much debt it didn’t have much money to start, though the World Health Organisation did help out. The health centres were unevenly spread out so that in rural areas people still had to travel as far as 10km to get to a clinic. More dense areas had many of clinics. The many AIDS victims of Tanzania have swamped the health system so there is little money available for these clinics.