Community level health facilities are seen as efficient means to expand health care in most developing countries. Small clinics provide services planned in accordance with local needs and appropriately address concerns specifically in that community. Tanzania, like many developing countries, use this pyramidal health system in which primary care clinics are available in the local settings, a bigger health facility for referrals, then general hospitals in urban areas. This health structure is intended to provide medical care to as many rural areas as possible. However, in Tanzania, dispensaries available for the locals are bypassed more often than actually used. Patients choose to pay more to seek better medical treatment in higher-level hospitals that are usually based in cities. This trend is not only visible in Tanzania but also in other developing countries as well. Low-income countries usually lack the monetary and human resources to provide the health care that the population needs. I see this problem rooting from three things 1) international brain drain, 2) lack of motivation among health care workers, and 3) low quality of primary care facilities provided by the government.
Brain drain presents a very devastating effect on low-income countries. Considering the inadequate number of trained health professionals, brain drain leaves most countries very limited access to quality health care providers. Shortages in doctors and nurses are familiar sites in most dispensaries and health centers. Instead of the expected 24-hour health service, populations in rural areas are left with closed facilities due to the lack of health providers. Due to this, individuals seeking for medical care bypass these dispensaries to find facilities staffed by more knowledgeable and more experienced physicians whom they can trust. Also, part of the problem is the low motivation of health workers in these facilities. They are not only compensated poorly but they also face everyday risk of contracting diseases. Furthermore, because they are less motivated, most of the health workers lack the responsiveness to the patients needs. All these are important aspects of health system that affect the quality of care being given to the patients. Because most of the facilities provided by the government are poorly equipped both in technological and human resources, patients in these rural areas are doubtful of the kind of treatment and service that they will receive.
In the health care business, patients are seen more as passive consumers. As a frequent consumer of medical care, I am definitely not and I think majority of the world’s population are not as well. It is a common misconception that most people are not aware of the differences in health services available to them. In reality, individuals are concern about the quality of medical care they need. I think governments should start realizing that quality is necessary in providing health care service even in developing nations. Quantity does not answer the problem in better health care if the quality does not level the demand of the patients. Quality is very important to individuals seeking medical help. When an individual seek help, it comes with it a certain level of trust that medical professionals are able to treat and help the patient’s specific health concerns. The current trend in Tanzania and in the rest of the developing world, serves as a manifestation of failing primary care in the community level. Establishing health facilities within the community should provide a much focused care among the population. If these facilities fail, so is the trust of individuals who depend on their government to look after their overall well being.