Wednesday, 25 January 2012 22:48
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The Citizen Reporters
Dar es Salaam. There’s no let-up in the battle of wits between the government and striking doctors, which the former is anxious to end, but the latter are determined to escalate if their demands are not met.Prime Minister Mizengo Pinda told senior journalists and editors in Dar es Salaam yesterday that he had instructed his subordinates to arrange a meeting at which he would have discussion with representatives of the doctors and resolve the issue.
But, at a separate venue in the city, the chairman of the caretaker committee under the auspices of the Medical Association of Tanzania, Dr Ulimboka Stephen, said they would write a letter to the Premier, whose message would be that they would not resume working until their problems were solved.
Speaking at the Don Bosco centre – the rallying point of the embattled medics ‑ Dr Stephen said: “We have resolved to continue with the strike… we are asking our colleagues across the country to join us, because the outcome will benefit all of us and the general public at large.”
He rejected the proposal that the doctors outline their grievances to an emissary of the Prime Minister – a senior police officer – who would subsequently give him a feedback.
Dr Stephen was emphatic that they wanted a direct audience with the PM, because executives at the ministerial level with whom they had engaged had failed to solve their problems.
At the press conference, Mr Pinda said he was deeply disturbed because the issue was taking too long to resolve, at the expense of suffering patients. He appealed to doctors to attend to patients as efforts were being made to resolve their problems.
“I am still hoping that I will meet with them before I leave for Dodoma on Saturday for the National Assembly session,” said the Prime Minister, who explained that a meeting that had been scheduled for Monday aborted because their representatives did not turn up.
He said the government had delayed payment of November and December 2011 allowances amounting to about Sh800 million to doctors, because the priority was to pay salaries. He conceded, however, that a mistake was done: “The government should have communicated with the doctors and told them the real situation,” said Mr Pinda, adding: “My meeting with them will enable me to know what had exactly transpired.” In a another development, retired specialists who have been recalled on special contracts, were organising a meeting with the Muhimbili National Hospital (MNH) management in a bid to review their job description.
They lamented that they are overwhelmed by the worsening situation.
One of them, who spoke on condition of anonymity, complained: “We cannot work like this; it is unprofessional as two doctors, whether specialists or not, cannot attend 150 patients. Report for duty every day, do theatre jobs and later do ward rounds, is extremely burdensome.”
Reached for comment, the MNH Public Relations Officer, Mr Aminieli Aligaesha, was mum, merely claiming that the hospital directors were holding a mid-week meeting which, among other issues, would come up with a statement on the saga. The doctors are demanding salary increases, improved working conditions and being valued by the government.
Chadema
In his statement, the Chadema Director for Publicity, Mr John Mnyika, who is also Ubungo MP, said the opposition party has been touched by the strike and blamed the government for what is happening.
Mr Mnyika said Chadema has contacted the shadow minister for Health and Social Welfare, Gervas Mbassa, and asked him to support the strike by the medical workers.
Shinyanga
Reports from Shinyanga say doctors continued with their normal routines as they were not informed of the strike. Patients who went to the regional Hospital yesterday said they were attended normally and activities and services at the hospital were uninterrupted.
Mbeya
A total of 75 doctors as well as nurses at Meta maternal hospital in Mbeya moved to support their Dar es Salaam colleagues by boycotting work, save for a few doctors and nurses who were attending to emergency cases.
“If we had enough money we would have gone to private hospitals… the government should immediately deal with this problem,” pleaded Neema Emmanuel, noting that the strike was affecting poor people.
Reported by Lucas Liganga and Alex Bitekeye
Thursday, 26 January 2012
Friday, 20 January 2012
should doctors know how to fight for their rights without jeorpadising health of the citizen?
More that a week now, medical doctors in Tanzania are in unresolved conflict with the government. The saga started when the government reallocated intern doctors working at Muhimbili national hospital ( the biggest hospital in the country) to other other hospitals in the country . This reallocation was seen innappropriate as it was taken as a punishment after the interns boycotted in order that they can be paid their monthly allowances by the Minstry of Health and Social welfare. Since then medical doctors ( genealists and specialists) have joined the intern doctors to fight against this seemingly humiliation to the afflicted inten doctors who were demanding for their basic rights as it was part of their contract that they must be paid monthly. The Medical association of Tanzania, has taken a lead to mobilise doctors across the country to discuss this issue and other doctors welfares that have been neglected by the current government. Different govenment officials including the minster of health have given the government stand on this issue but this has not satisfied the medics and are still on a go-slow in order that their demands are met.Among other things,they are demanding that the government should stop reallocating the intern doctors and meet other doctors welfare such as night call allowances . Pointing to the recent increase of the sitting allowances given to the Members of parliament that has increased from Tsh 70,000 ($44) to 200,000Tshs ($ 126) , medics have questioned the government on why their call allowance have not been increased since early ninetees where they have been paid 10,000 ($6.3)Ths per night call?
While this saga is ongoing, there are posibilities of mobilising all the doctors in the country to strike offering medical services untill their demands are met. This will cost the government and the citizens at lage. Critics are asking why has the matter been allowed to deteriorate to this stage? Is it the medical professionals, the government, the media and by extension the society at large?. Commenting in one of the social media, one senior citizen asked that should the doctors know how to fight for their rights without jeopardising health of the citizens? These questions seems to be difficult but each group has a part to play!
While this saga is ongoing, there are posibilities of mobilising all the doctors in the country to strike offering medical services untill their demands are met. This will cost the government and the citizens at lage. Critics are asking why has the matter been allowed to deteriorate to this stage? Is it the medical professionals, the government, the media and by extension the society at large?. Commenting in one of the social media, one senior citizen asked that should the doctors know how to fight for their rights without jeopardising health of the citizens? These questions seems to be difficult but each group has a part to play!
Sunday, 1 January 2012
The miracle cure ; implications for improvement in care of chronic diseases
In 2011, thousands of people in Tanzania and neighbouring countries flocked to the remote Samunge village in Ngorongoro, Arusha region for a cupful of retired pastor Ambikile Masapile's "miracle cure". Later on, the country experienced a proliferation of herbalists and faith healers who claimed that they can treat chronic illnesses such as HIV/AIDS, Diabetes and cardiovascular diseases. With some imitating the dispensing of cupful of herbal concoctions .This has put the country in dilemma with critics warning that the government risks serious embarrassment for its apparent silent approval of a trend that has sparked medical concerns only to gain political mileage.
For almost a year , he is offering the medication for a mere Sh500 per cupful, the young and old and the low and mighty - drawn from all corners of the nation, the neighbouring countries and beyond - have been trooping to Samunge. Many have braved several nights in the cold in motor vehicles stuck in queues stretching up to 50 kilometres, determined to reach the cleric and receive their dose of the "miracle cure".Although he is no longer popular today, but a significant number of people have received his medicines.
Reflecting on this, one would ask a question as to why these people are flocking to Sumunge rather than going to the health facilities that are scattered through out the country? Does it mean that people have lost hope on the country's health care system? May be these questions might go beyond the national level to the global medical comunity, has the global community lost grip on care of chronic diseases?
Sunday, 11 December 2011
50 YEARS OF INDEPENDENCE IN TANZANIA AND THE ROAD TO UNIVERSAL HEALTH COVERAGE
Tanzania is marking 50th Anniversary since its independence in December this year. During this period Tanzanians need to recapitulate on the progress they have attained in developing systems that will assure sustainable development .Health system development is a fundamental one in the development process as it is widely known that a nation with poor health cannot attain optimal development. Recalling the widely agreed definition of health by the World Health Organization (WHO) which states that "Health is the state of complete physical mental, and social well-being and not merely the absence of disease”, health is thus considered the very center of persons' well being and development. It is today widely acknowledged that health is an important component of the development process in the sense that it can help or hinder national development, and that other forces of development can add to or detract from health. Universal health coverage focuses on access to health care and social protection for all citizens.
In 1961 when Mainland Tanzania gained its independence under the Mwalimu Julius Kambarage Nyerere, the health sector was medically oriented and sidelined promotive, preventive and social protection interventions. Soon after independence, more efforts were invested in improving health and social services. This policy change was beneficial to the majority of Tanzanians who live in rural areas because the services provided in the colonial era were favoring the elites and the well to do in the society who live in urban areas.
With the introduction of the Arusha Declaration in 1967, Tanzania pursued a health policy that aimed at providing equal and free access to health facilities and services to the entire population. This was indeed a bold and revolutionary step and stemmed from Mwalimu Nyerere's basic principle and conviction that improving the health and wellbeing of all Tanzanians was the way forward to sustainable development. Health care provision was reoriented to reach rural and urban communities and include the poor who could not afford the costs of health care. Health services were provided free of charge by the government in all public health facilities, while voluntary agencies charged modest fees. Given the reality that over 80% of the population lived in rural areas; development of the rural health infrastructure was given high priority.
Hospitals were built in each region and there was also a shift on emphasis from curative to preventive services, hence increasing the range of interventions offered to the communities. These measures allowed the majority of Tanzanians to have access to health services and improve the quality of life. For instance, by 1992 about 72% of the population lived within 5 km of a health facility and 93% lived within 10 km. The life expectancy increased from 35 years in 1961 to 53 in 1983 (which latter on fell to below 50 years as a result of AIDS). The Arusha declaration marked the health for all strategy that was later on emphasized by the Global movement towards primary health care as declared by the World Health Organization in Alma Atta in 1978 . Since then, in the health sector there has been only incremental policy changes that are in line with the Alma Atta declaration.
The introduction of user fees arrangements in health care services that were introduced in response to Structural Adjustment Programs in 1990s by the World Bank and IMF, marked the major health sector reforms in the history of Tanzania ( as elsewhere in the developing countries). From the eyes of those who introduced such policies, they considered these reforms to be beautiful and suitable for the developing countries including Tanzania. The aftermath of these policies include been documented elsewhere and include increased inequalities . Other countries like Uganda decided to abolish the user fee policies which are a result of the policies . The situation immediately after independence could be of similar picture, but after the Arusha declaration, the government committed itself to providing free health services in all government health facilities and banned the private practice. This policy being more socialistic and embracing the solidarity ideology had its own weakness but to a large extend, had a potential to achieving universal health coverage especially to the poor rural Tanzanians.
Revisiting the contemporary Tanzania health policy document, there are such issues as exemption and waivers for the poor , but the reality at the ground is that the poorest of the poor do not know that there are such exemptions, and they are either subjected to catastrophic expenditures or denied to access health care when they fall sick. Since, the Arusha declaration is a history, and the policy on user fees is leading to inequalities, it is a high time to advocate for its abolition and/or find the alternative (if the state cannot provide free services to all of its citizens) in order that we move towards universal health coverage, whereby all citizens in the formal and informal sector will have access to quality health care without being exposed to impoverishment as a result of catastrophic health expenditures .
The establishment of social health insurance through National health insurance fund (NHIF) has increased access to health services for the formal sector employees ensuring social protection to this group. This is one of the important achievement in celebrating 50 years of independence, however, establishing it is one thing, and making it functional and really meet its objectives is another thing. The later, needs viable functioning health care system with availability of health facilities that have adequate health care workers and medicines. We have heard of success in some regions that clients with NIHF cards are attended well, but still in some places, when one presents with the NHIF card is not attended on time, much attention is to those who can provide “informal payment” or simply a bribe. This fact has been revealed by many clients who have attended several public hospitals including the National hospital but the steps taken to avert this seems to be unsatisfactory.
Coverage of social health insurance needs to go hand in hand with the quality of services rendered to the beneficiaries and cover employees in the private sector. On the other hand, the informal sector depends on community based health insurance for social protection, there is a need to strengthen the community health fund in the district health system and make it community driven.
In this year, Tanzania celebrates 16 years since establishment of community health fund (CHF) in all districts in Tanzania. The objectives of CHF, as stipulated in the Community Health Fund Act of 2001 include: (i) To mobilize financial resources from the community for provision of health care services to its members; (ii) To provide quality and affordable health care services through sustainable financial mechanism; and (iii) To improve health care services management in the communities through decentralization by empowering the communities in making decisions and by contributing on matters affecting their health.
However, the CHF scheme suffers from low enrollment rates in most of the districts with no viable strategies to increase the enrollment. The challenges are in the availability of medicines in health facilities and lack of trust on the managers of the scheme or simply the community does not see that they own this scheme due to the bureaucratic procedures attached to management of funds and other procedures of the scheme, “is rather a government thing than a community thing”. These are issues that need to be addressed. CHF should be seen by policy makers, practitioners and beneficiaries as a stride forward to universal coverage for all citizens especially the poor. A call for high political will and leadership towards making it a reliable scheme in the Tanzanian district health system is advocated. Importantly, making CHF community driven might be a way forward to its success.
Revisiting the important metrics such as life expectancy, quality of life, mortality and morbidity, one will realize we are in the step further. However, we may be termed as laggards when compared with other developing countries that have the same age. The life expectancy has increased from 35 to 58 years regardless of sex, this is somehow promising. However, what strategies are in place to improve the life expectancy of a Tanzanian to be similar to our fellows in developed countries? This can be a fundamental question that those in policy making should put forward, in that respect every responsible citizen should think of holding the government accountable in order that the life expectancy of the future Tanzanians improves. In Japan for example, in the period of 50 years, the life expectancy at birth have increased from 50 years for men and 54 years for women to 79.6 for men and 86.4 for women. This year Tanzania celebrates its 50th anniversary with the slogan of Tumethubutu, tumeweza na tunazidi kusonga mbele that literally means that despite all challenges we have managed and we are optimistic for the future. Let us expect that in the next 50 years the life expectancy will be like that of developed countries.
When it comes to maternal and child health, there is vast litany in reduction of maternal and child mortality through various political slogans, declarations and commitments, leaders forums, high level consultations, activism and directives in election manifesto since independence, to what results, one might reasonably ask, given the increasing of unavoidable maternal and child mortality. In 1961 the maternal mortality was 451 per 100, live births, in the 70s through 80s it fell below 200 per 100,000 live births but in 90s to date the mortality have increased to more than 400 per 100,000 live births. It may be right for the government to address that there is a remarkable achievement in maternal and child mortality and that we are approaching to achieve the millennium goals. But, do these achievements match with the government investment in maternal and child health? Thanks for the development partners through the Millennium development have used the objective measurements in tracking the progress in such objective measures despite the wider social economic situations.
The MMAM strategy that aims at constructing health facilities in every village seems to be an ambitious and based on the biomedical model, that emphasizes on treatment and sidelines prevention and health promotion components. Fundamental questions that were supposed to be asked by those responsible were to be like this, why do people get sick, how enabling is their environment? Is distance the only reason to make them not access health services? Who are providing services in the health facility they visit?
To be fair, and for reasons that are not hard to understand, agencies, development partners , the government and civil society leaders have found it hard to strengthen the health system that can ensure universal health coverage, but has embarked in operational issues with interests that in a broad sense marginalizes the poor. For example, when you compare the distribution of human resource for health in the country, you find that there are places that had experienced shortage of human resource since independence, and others who have never experienced such a problem, but no viable strategies in place to address this inequality in health service provision. What we see, are the mushrooming organizations that lures human resource for health by promising incentives on deployment to hard to reach areas and later on leave those health workers mainstreamed in the public service that operates in a business as usual with no sensitivity to the inequalities that exist between places. The point here is that there should be public policies that acknowledges these inequalities on health workforce and provides needs according to the environment.
Formidable challenges in strengthening the health system still remain unsolved. Maternal and infant mortality is still unacceptably high. Only mortalities that occur in hospitals that are reported, the rural community is more experienced with unacceptable number of mortalities that happen at community level without even being attended by a dispensary health worker due to affordability and lack of trust on the quality of services provided in our facilities. Less than 50% of Tanzanians are attended by skilled health workers, most of these workers are in urban areas, there is a devastating scarcity of human resource for health in rural areas, and thus, rural areas of Tanzania face human resource for health crisis in umber and motivation. Those with health related degrees are very scarce in rural areas, especially doctors and pharmacists.
Universal health coverage can be realized if there is political will and effective governance, these are the key to health-system reform. Policy makers must prioritize health in their governmental budgets and move health financing for universal coverage to the top of the political agenda.
Therefore, a number of positive as well as negative experiences in the Tanzanian health care system during the 50 years of independence may be used to shape the future health systems that embrace the universal health coverage concept.
In 1961 when Mainland Tanzania gained its independence under the Mwalimu Julius Kambarage Nyerere, the health sector was medically oriented and sidelined promotive, preventive and social protection interventions. Soon after independence, more efforts were invested in improving health and social services. This policy change was beneficial to the majority of Tanzanians who live in rural areas because the services provided in the colonial era were favoring the elites and the well to do in the society who live in urban areas.
With the introduction of the Arusha Declaration in 1967, Tanzania pursued a health policy that aimed at providing equal and free access to health facilities and services to the entire population. This was indeed a bold and revolutionary step and stemmed from Mwalimu Nyerere's basic principle and conviction that improving the health and wellbeing of all Tanzanians was the way forward to sustainable development. Health care provision was reoriented to reach rural and urban communities and include the poor who could not afford the costs of health care. Health services were provided free of charge by the government in all public health facilities, while voluntary agencies charged modest fees. Given the reality that over 80% of the population lived in rural areas; development of the rural health infrastructure was given high priority.
Hospitals were built in each region and there was also a shift on emphasis from curative to preventive services, hence increasing the range of interventions offered to the communities. These measures allowed the majority of Tanzanians to have access to health services and improve the quality of life. For instance, by 1992 about 72% of the population lived within 5 km of a health facility and 93% lived within 10 km. The life expectancy increased from 35 years in 1961 to 53 in 1983 (which latter on fell to below 50 years as a result of AIDS). The Arusha declaration marked the health for all strategy that was later on emphasized by the Global movement towards primary health care as declared by the World Health Organization in Alma Atta in 1978 . Since then, in the health sector there has been only incremental policy changes that are in line with the Alma Atta declaration.
The introduction of user fees arrangements in health care services that were introduced in response to Structural Adjustment Programs in 1990s by the World Bank and IMF, marked the major health sector reforms in the history of Tanzania ( as elsewhere in the developing countries). From the eyes of those who introduced such policies, they considered these reforms to be beautiful and suitable for the developing countries including Tanzania. The aftermath of these policies include been documented elsewhere and include increased inequalities . Other countries like Uganda decided to abolish the user fee policies which are a result of the policies . The situation immediately after independence could be of similar picture, but after the Arusha declaration, the government committed itself to providing free health services in all government health facilities and banned the private practice. This policy being more socialistic and embracing the solidarity ideology had its own weakness but to a large extend, had a potential to achieving universal health coverage especially to the poor rural Tanzanians.
Revisiting the contemporary Tanzania health policy document, there are such issues as exemption and waivers for the poor , but the reality at the ground is that the poorest of the poor do not know that there are such exemptions, and they are either subjected to catastrophic expenditures or denied to access health care when they fall sick. Since, the Arusha declaration is a history, and the policy on user fees is leading to inequalities, it is a high time to advocate for its abolition and/or find the alternative (if the state cannot provide free services to all of its citizens) in order that we move towards universal health coverage, whereby all citizens in the formal and informal sector will have access to quality health care without being exposed to impoverishment as a result of catastrophic health expenditures .
The establishment of social health insurance through National health insurance fund (NHIF) has increased access to health services for the formal sector employees ensuring social protection to this group. This is one of the important achievement in celebrating 50 years of independence, however, establishing it is one thing, and making it functional and really meet its objectives is another thing. The later, needs viable functioning health care system with availability of health facilities that have adequate health care workers and medicines. We have heard of success in some regions that clients with NIHF cards are attended well, but still in some places, when one presents with the NHIF card is not attended on time, much attention is to those who can provide “informal payment” or simply a bribe. This fact has been revealed by many clients who have attended several public hospitals including the National hospital but the steps taken to avert this seems to be unsatisfactory.
Coverage of social health insurance needs to go hand in hand with the quality of services rendered to the beneficiaries and cover employees in the private sector. On the other hand, the informal sector depends on community based health insurance for social protection, there is a need to strengthen the community health fund in the district health system and make it community driven.
In this year, Tanzania celebrates 16 years since establishment of community health fund (CHF) in all districts in Tanzania. The objectives of CHF, as stipulated in the Community Health Fund Act of 2001 include: (i) To mobilize financial resources from the community for provision of health care services to its members; (ii) To provide quality and affordable health care services through sustainable financial mechanism; and (iii) To improve health care services management in the communities through decentralization by empowering the communities in making decisions and by contributing on matters affecting their health.
However, the CHF scheme suffers from low enrollment rates in most of the districts with no viable strategies to increase the enrollment. The challenges are in the availability of medicines in health facilities and lack of trust on the managers of the scheme or simply the community does not see that they own this scheme due to the bureaucratic procedures attached to management of funds and other procedures of the scheme, “is rather a government thing than a community thing”. These are issues that need to be addressed. CHF should be seen by policy makers, practitioners and beneficiaries as a stride forward to universal coverage for all citizens especially the poor. A call for high political will and leadership towards making it a reliable scheme in the Tanzanian district health system is advocated. Importantly, making CHF community driven might be a way forward to its success.
Revisiting the important metrics such as life expectancy, quality of life, mortality and morbidity, one will realize we are in the step further. However, we may be termed as laggards when compared with other developing countries that have the same age. The life expectancy has increased from 35 to 58 years regardless of sex, this is somehow promising. However, what strategies are in place to improve the life expectancy of a Tanzanian to be similar to our fellows in developed countries? This can be a fundamental question that those in policy making should put forward, in that respect every responsible citizen should think of holding the government accountable in order that the life expectancy of the future Tanzanians improves. In Japan for example, in the period of 50 years, the life expectancy at birth have increased from 50 years for men and 54 years for women to 79.6 for men and 86.4 for women. This year Tanzania celebrates its 50th anniversary with the slogan of Tumethubutu, tumeweza na tunazidi kusonga mbele that literally means that despite all challenges we have managed and we are optimistic for the future. Let us expect that in the next 50 years the life expectancy will be like that of developed countries.
When it comes to maternal and child health, there is vast litany in reduction of maternal and child mortality through various political slogans, declarations and commitments, leaders forums, high level consultations, activism and directives in election manifesto since independence, to what results, one might reasonably ask, given the increasing of unavoidable maternal and child mortality. In 1961 the maternal mortality was 451 per 100, live births, in the 70s through 80s it fell below 200 per 100,000 live births but in 90s to date the mortality have increased to more than 400 per 100,000 live births. It may be right for the government to address that there is a remarkable achievement in maternal and child mortality and that we are approaching to achieve the millennium goals. But, do these achievements match with the government investment in maternal and child health? Thanks for the development partners through the Millennium development have used the objective measurements in tracking the progress in such objective measures despite the wider social economic situations.
The MMAM strategy that aims at constructing health facilities in every village seems to be an ambitious and based on the biomedical model, that emphasizes on treatment and sidelines prevention and health promotion components. Fundamental questions that were supposed to be asked by those responsible were to be like this, why do people get sick, how enabling is their environment? Is distance the only reason to make them not access health services? Who are providing services in the health facility they visit?
To be fair, and for reasons that are not hard to understand, agencies, development partners , the government and civil society leaders have found it hard to strengthen the health system that can ensure universal health coverage, but has embarked in operational issues with interests that in a broad sense marginalizes the poor. For example, when you compare the distribution of human resource for health in the country, you find that there are places that had experienced shortage of human resource since independence, and others who have never experienced such a problem, but no viable strategies in place to address this inequality in health service provision. What we see, are the mushrooming organizations that lures human resource for health by promising incentives on deployment to hard to reach areas and later on leave those health workers mainstreamed in the public service that operates in a business as usual with no sensitivity to the inequalities that exist between places. The point here is that there should be public policies that acknowledges these inequalities on health workforce and provides needs according to the environment.
Formidable challenges in strengthening the health system still remain unsolved. Maternal and infant mortality is still unacceptably high. Only mortalities that occur in hospitals that are reported, the rural community is more experienced with unacceptable number of mortalities that happen at community level without even being attended by a dispensary health worker due to affordability and lack of trust on the quality of services provided in our facilities. Less than 50% of Tanzanians are attended by skilled health workers, most of these workers are in urban areas, there is a devastating scarcity of human resource for health in rural areas, and thus, rural areas of Tanzania face human resource for health crisis in umber and motivation. Those with health related degrees are very scarce in rural areas, especially doctors and pharmacists.
Universal health coverage can be realized if there is political will and effective governance, these are the key to health-system reform. Policy makers must prioritize health in their governmental budgets and move health financing for universal coverage to the top of the political agenda.
Therefore, a number of positive as well as negative experiences in the Tanzanian health care system during the 50 years of independence may be used to shape the future health systems that embrace the universal health coverage concept.
Monday, 7 November 2011
News from Newala youth Network
Tuesday, 6 September 2011
international health policies
Let us have a look on what is in the NEWSLETTER : International Health Policies
There are various contraversies in the international health policies pointed out in this newsletter. Emphasis on the need for each country to strengthern its health system in order to mitigate the impact of contraversial global health policies is seen as an important stride .
The issue on AID EFFECTIVENESS supports the need for independency from foreign aids that creates a vicious cycle of poverty.
There are various contraversies in the international health policies pointed out in this newsletter. Emphasis on the need for each country to strengthern its health system in order to mitigate the impact of contraversial global health policies is seen as an important stride .
The issue on AID EFFECTIVENESS supports the need for independency from foreign aids that creates a vicious cycle of poverty.
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