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<p class=MsoNormal><font size=2 color=navy face=Tahoma><span style='font-size:
10.0pt;font-family:Tahoma;color:navy'>Although Decentralization by Devolution
(DbyD) has attempted to put more power in the hands of local communities in <st1:country-region
w:st="on"><st1:place w:st="on">Tanzania</st1:place></st1:country-region>, the
system is not yet effectively functioning. Time and time again examples have
shown that district officials exclude local communities from decision-making
bodies, health boards and committees that are supposed to meet monthly often do
not meet, and local leaders/communities are rarely aware of their rights to be
making decisions under DbyD. The system is a good one but still young –
putting resources may strengthen it but it may also lead to gross misadministration.
Something to think about…<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Tahoma><span style='font-size:
10.0pt;font-family:Tahoma;color:navy'><br>
~Ismat~<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
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<p class=MsoNormal><font size=2 color=navy face=Tahoma><span style='font-size:
10.0pt;font-family:Tahoma;color:navy'>Ismat Dewji Sheriff</span></font><font
color=navy><span style='color:navy'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Tahoma><span style='font-size:
10.0pt;font-family:Tahoma;color:navy'>Health Equity Programme Coordinator</span></font><font
color=navy><span style='color:navy'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Tahoma><span style='font-size:
10.0pt;font-family:Tahoma;color:navy'>CARE <U1:COUNTRY-REGION u2:st="on"><U1:PLACE u2:st="on"><st1:country-region
w:st="on"><st1:place w:st="on">TANZANIA</st1:place></st1:country-region></span></font><o:p></o:p></p>
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<p class=MsoNormal><b><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font size=2
face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'>
pha-exchange-bounces@phm.kabissa.org [mailto:pha-exchange-bounces@phm.kabissa.org]
<b><span style='font-weight:bold'>On Behalf Of </span></b>Beatus K. Leon<br>
<b><span style='font-weight:bold'>Sent:</span></b> Tuesday, March 11, 2008 3:18
PM<br>
<b><span style='font-weight:bold'>To:</span></b> Claudio Schuftan;
pha-exchange@phm.kabissa.org<br>
<b><span style='font-weight:bold'>Subject:</span></b> Re: PHA-Exch> Funding
for primary health care in developing countries</span></font><o:p></o:p></p>
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<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
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<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>This is a brilliant idea! I wouldn't however advocate for the 15% to go
to a central government common fund, but rather to support local communities'
capacity to manage and control issues related to their health. Primary Care in <st1:country-region
w:st="on"><st1:place w:st="on">Tanzania</st1:place></st1:country-region> is
largely decentralized, and this appears to work well, given the vast
geographical size and limitations in transport and communication
infrastructure. Local Communities (through their health committees from village
to district level) participate in the planning and prioritization of their
health care needs, using policy guidelines from the Ministry of Health which
also oversees quality issues. However, the greatest limitation is always
scarcity of resources (human resources, finances, equipment etc). Of all
the limitations, the human resource crisis is currently the most crippling.<o:p></o:p></span></font></p>
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<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> <o:p></o:p></span></font></p>
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<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>The idea in general about supporting the health system is brilliant,
and I'm in full agreement with it. If there is anything I can do to put
more strength in the movement to make 15by2015 a success, I am
ready. <o:p></o:p></span></font></p>
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<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><br>
<br>
Dr Beatus Kiraiya <st1:country-region w:st="on"><st1:place w:st="on">Leon</st1:place></st1:country-region>,<br>
506 <st1:place w:st="on">Carmarthen</st1:place> House,<br>
<st1:PlaceType w:st="on">University</st1:PlaceType> <st1:PlaceType w:st="on">Hospital</st1:PlaceType>
of <st1:country-region w:st="on"><st1:place w:st="on">Wales</st1:place></st1:country-region>,<br>
<st1:PlaceName w:st="on">Heath</st1:PlaceName> <st1:PlaceType w:st="on">Park</st1:PlaceType>,
<st1:City w:st="on"><st1:place w:st="on">Cardiff</st1:place></st1:City>, CF 14
4XW<br>
cellphone: +44 7880 513 215<br>
E-mail: LeonBK@cardiff.ac.uk, beatusleon@yahoo.co.uk.<o:p></o:p></span></font></p>
<p><font size=3 face="Times New Roman"><span style='font-size:12.0pt'> <o:p></o:p></span></font></p>
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<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>Sent from <a
href="http://us.rd.yahoo.com/mailuk/taglines/isp/control/*http:/us.rd.yahoo.com/evt=52419/*http:/uk.docs.yahoo.com/nowyoucan.html"
target="_blank">Yahoo! Mail</a>. <br>
The World 's Favourite Email.<o:p></o:p></span></font></p>
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