Research On Medical System Reform Of The Tanzania Mainland In1985-2005

Tanzania’s full name is The United Republic of Tanzania China mainland (The United Republic of Tanzania), by The Tanganyika and Zanzibar was established on April26,1964, and officially called The mainland Tanzania on October24. On the administrative division, the country is divided into two parts of Tanganyika and Zanzibar. The authors explore the medical system reform of mainland mainly refers to the mainland Tanzania-Tanganyika region.From that day on independent mainland Tanzania has experienced different stages of political development, each stage of development in different political purpose, direction, and the people’s health as a starting point. Since independence the medical development can be divided into three main iconic development stages, respectively by three presidential health policy reform during his tenure of office as the center of gravity is a comparative study, understand each stage in medical development tendency, achievements and problems.The first phase of Nyerere during his tenure (1961-1985), after independence in1912until1972. This stage national independence need to take the new medical policy. The principles of primary health care in1961-1967has been introduced, put forward the development of health care services. The period1967-1976is the route of "socialism", has been followed in The Arusha Declaration set out a new medical policy statement. Began to implement the primary health care plan, the key lies in self-reliance and rural development. The Arusha Declaration, however, in the form of the socialist political harm, the primary health care plan is still not reach the expected goal. It can’t meet the needs of local and threat to established health care system. Reform policy in1977-1985in solving rural resource allocation are unfair. Because the central government economic ability is weak and realize regional medical service need funds. The reform of the lesson includes maintaining political stability to accelerate enlarge the coverage of rural medical service, medical commission need fusion region medical services; At the same time local governments need to enough resources to provide medical services. Also need to increase the medical expenses. At the same time, real wages fell during the reform, which leads to the lack of morale.The second phase of Mwinyi during his tenure (1985-1995), facing the problems in the legacy of Nyerere period, mainland Tanzania unable to support the development of local medical enterprise, Mwinyi’s presidency would accept the international monetary fund and the bank loan conditions, the implementation of structural adjustment policies, health spending cuts, worsening the medical career development, lead to the phenomenon of the poor medical care, then corruption phenomenon, and circulation economic development. After taking charge mechanism, namely the cost-sharing system. By the government, public institutions and individuals to share medical costs, no longer implement the free medical care. Although alleviate the medical trouble, but the absence of money making mainland Tanzania over-reliance on foreign aid, and ordinary people and no money to pay for medical expenses, which hindered the process of medical enterprise.The third part is the Mkapa (1995-2005), while in office, Mkapa is aware of the great problems of the charging mechanism, so the pay mechanism under the implementation of the "exemption", but the exemption is difficult to determine, the last also failed to implement. Due to the introduction of payment mechanisms and other cost recovery policies intended to bring new money for system, allowing more mainland Tanzania residents involved in the save the healthcare system. But people for service quality is low and the mechanism of charge are bitter said. Similarly, the support of the international community is also shrinking, mainland Tanzania in the90s medical prospects become very bleak, and appeared the situation of "aid fatigue". The implementation of the strategy of poverty alleviation in the20th century relaxed the mainland Tanzania broken health care system, benefit from the poverty reduction strategy, but poverty is a difficult task, joint all countries in the world can only slowly. In the21st century, the decentralization of policy implementation, support the rise of various medical institutions, the formation of a medical situation of the decentralization of power, go hand in hand. In1999, the mainland Tanzania government set the policies of health interventions, department actual aims to change the roles and tasks, management mode and financing mode, create a higher efficiency and higher utility system. Although these interventions is also against the disease, improve human health is an important part of, but money is not everything, need more effective drugs and vaccines. Medical system’s efficiency is the key point of the medical funds into earnings, improve the level of people’s health task is very difficult.The fourth part is the summary stage. From the Mwinyi President’s and the Mkapa President’s health system reform policy, we can analysis the two presidential tenure system of health care reform and the existing shortcomings, play a guide role for the health care system development direction.