Wananchi wengi wanatumia vituo vya afya vya serikali
na husubiri chini ya saa moja kumuona daktari
Wakati huo huo, wananchi 7 kati ya 10 wanasema changamoto
ipo katika upatikaji wa dawa na vifaa tiba
30 Agosti 2017, Dar es Salaam: Wananchi wanapopata majeraha ama kuugua, 6 kati ya 10 (61%) huenda katika kituo cha afya cha serikali. Kiwango hiki kimeongezeka kutoka 45% mwaka 2014 na kubaki hivyo hivyo tangu mwaka 2016. Kwa kiasi kikubwa hii imesababishwa na kupungua kwa watu wanaojitibu wenyewe kwa kwenda kwenye maduka ya dawa (9%), maduka ya kawaida kupata dawa (7%), wasiofanya chochote (1%) au wanaotafuta aina nyingine za matibabu (5%). Takwimu zilizokusanywa toka mwaka 2014 zinaonesha kupungua kwa matumizi ya njia hizo. Idadi ya wananchi wanaotumia vituo binafsi, vya kanisa ama vya mashirika yasiyo ya kiserikali haijabadilika katika kipindi hiki (16% mwaka 2017).
Pamoja na ongezeko la idadi ya wagonjwa, utaratibu wa wananchi kusubiri kwa saa moja ama chini ya hapo ili kumuona daktari haujabadilika toka mwaka 2014. Wananchi 7 kati ya 10 (70%) walisubiri kwa saa moja ama chini ya hapo mwaka 2014 ukilinganisha na wananchi 3 kati ya 4 (76%) mwaka 2017. Hata hivyo, wagonjwa husubiri kwa saa moja ama chini ya hapo katika vituo binafsi, vya kanisa ama vya mashirika yasiyo ya kiserikali (88% walisubiri kwa muda huu) ukilinganisha na vituo vya serikali (74% walisubiri kwa saa moja ama chini ya hapo).
Matokeo haya yametolewa na Twaweza katika utafiti wake uitwao Afya kwanza! Wasemavyo wananchi kuhusu huduma za afya. Muhtasari unatokana na takwimu za Sauti za Wananchi, utafiti wa kwanza barani Afrika, wenye uwakilishi wa kitaifa unaotumia simu za mikononi. Matokeo haya yanatokana na takwimu zilizokusanywa kutoka kwa wahojiwa 1,801 kutoka maeneo mbalimbali ya Tanzania Bara (Zanzibar haihusiki kwenye utafiti huu) mwezi Mei 2017.
Wananchi wengi wanaridhishwa na usafi katika vituo vya afya. Wananchi wanaosema hili bado ni tatizo wamepungua kutoka 29% mwaka 2015 hadi 9% mwaka 2017 na 42% walilalamikia kiwango cha kuheshimiwa na kujaliwa na wahudumu mwaka 2015 ukilinganisha na 26% mwaka 2017.
Pamoja na maboresho haya, wananchi wanaendelea kukumbana na changamoto kubwa wakati wakipata huduma za afya. Wananchi watatu kati ya kumi ambao walimsindikiza mtu hospitali mwaka uliopita (29%) walikuta wagonjwa wawili ama zaidi wakichangia vitanda na magodoro. Kuna mabadiliko kutoka mwaka 2016 ambapo karibu wananchi 4 kati ya 10 (36%) walishuhudia wagonjwa wakichangia vitanda/magodoro.
Inatia mashaka zaidi linapokuja suala la upatikanaji wa dawa na vifaa tiba. Toka mwaka 2015, kumekuwa na ongezeko la wananchi waliokutana na upungufu wa dawa/vifaa tiba mara ya mwisho walipoenda katika kituo cha afya cha serikali. Vilevile, kuna ongezeko la wananchi ambao wanalalamikia muda wa kusubiri, kutoka 53% mwaka 2015 hadi 63% mwaka 2017.
Linapokuja suala la upatikanaji wa madaktari na gharama za huduma, idadi ya wananchi waliokuwa wanalalamikia masuala haya walipungua kati ya mwaka 2015 na 2016, lakini idadi imeongezeka tena mwaka 2017.
· Ukosefu wa madaktari lilikuwa ni tatizo kwa 43% mwaka 2015, likashuka mpaka 18% mwaka 2016 na kupanda mpaka 29% mwaka 2017.
· Gharama za huduma ilikuwa ni tatizo kwa wananchi 34% mwaka 2015, 19% mwaka 2016 na 28% mwaka 2017.
Twaweza pia iliwauliza wananchi iwapo sera ya serikali inatekelezwa kwa uzoefu wao,
· Watoto wenye umri chini ya miaka mitano, wazee na wajawazito wanapaswa kupata matibabu bure katika vituo vya afya vya serikali. Tangu mwaka 2016 kumekuwa na ongezeko dogo la idadi ya watu kutoka kwenye makundi hayo wanaopata huduma za matibabu bila malipo lakini wengi wao wanalazimishwa kulipa. Miongoni mwa wananchi waliowasindikiza watoto, wajawazito na wazee, 35% walilazimika kulipia matibabu ya mtoto, 28% ya wajawazito na 37% ya wazee.
· Pamoja na kauli za serikali na wananchi 84% kuwa waathirika wa ajali, ugomvi au majeraha watibiwe kabla ya kupata kibali kutoka polisi, wananchi 6 kati ya 10 waliowasindikiza waathirika hao ili kupata matibabu walitakiwa kupata kibali cha polisi kabla ya kupata matibabu.
· Bima, hususani kupitia Mfuko wa Afya ya Jamii ulioboreshwa, ni mkakati mkubwa wa serikali wa kupanua upatikanaji wa huduma za afya. Kati ya mwaka 2014 na 2017 idadi ya watu wenye bima ya afya imeongezeka kutoka 21% hadi 27%. Kwa ujumla, 13% ya wananchi wanasema ni wanachama wa Mfuko wa Afya ya Jamii (ulioboreshwa). Kwa kiwango cha ongezeko la sasa, Tanzania huenda ikafikia kiwango cha kimataifa cha wananchi wake kufikiwa na bima ya afya ndani ya miaka 40 ijayo.
Mkurugenzi Mtendaji wa Twaweza Aidan Eyakuze, anasema: “Tunaweza kuyafurahia baadhi ya matokeo haya. Wananchi wanatumia zaidi vituo vya afya vya serikali na baadhi ya masuala katika utoaji wa huduma za afya yameboreshwa. Lakini tatizo la dawa na vifaa tiba, sambamba na uchache wa watendaji wa afya, bado ni tatizo kubwa.”
“Jambo lingine linalotia mashaka,” anaendelea “ni namna ambavyo sera ya serikali inapuuzwa na watoa huduma za afya. Kwani pamoja na kauli kali za serikali na kampeni za kuelimisha umma, huduma bure ya afya haitolewi ipasavyo kwa makundi ya wananchi wanaostahili huduma bure. Lazima tuendelee kufuatilia na kukumbushana kuwa utamaduni wa uwajibikaji ni kiungo muhimu sana kwa maendeleo ya sekta yetu ya afya.”
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Kwa taarifa zaidi wasiliana na:
Risha Chande, Mshauri Mwandamizi wa Mawasiliano, Twaweza
Maelezo kwa Wahariri
- Muhtasari huu na takwimu zake zinapatikana kupitia www.twaweza.org, auwww.twaweza.org/sauti
- Twaweza inafanya kazi ya kupima uwezo wa watoto kujifunza, wananchi kuwa na utayari wa kuleta mabadiliko na serikali kuwa wazi na sikivu zaidi katika nchi za Tanzania, Kenya na Uganda. Twaweza ina programu, wafanyakazi na ofisi katika nchi zote tatu, na mfumo unaoheshimika kimataifa wa kujifunza, ufuatiliaji na tathmini. Programu zetu muhimu ni pamoja na Uwezo, ambayo ni tathmini kubwa ya kila mwaka ya wananchi barani Afrika inayopima viwango vya watoto vya kujifunza kwenye maelfu ya kaya na Sauti za Wananchi, utafiti wa kwanza barani Afrika wenye uwakilishi wa kitaifa unaofanyika kwa njia ya simu za mkononi. Pia tunashiriki katika masuala ya umma na sera kupitia ubia wetu na taasisi mbalimbali pamoja na vyombo vya habari. Vile vile Twaweza inashiriki na kuratibu jitihada za kimataifa zinazoshughulikia masuala ya uwazi, uwajibikaji na Ushirikishwaji kama vile mkakati wa kimataifa wa kuendesha shughuli za serikari kwa uwazi (OGP).
- Tovuti: www.twaweza.org Facebook: Twaweza Tanzania Twita: @Twaweza_NiSisi
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More citizens are using public health facilities and
waiting for less than an hour to see a doctor
At the same time, 7 out of 10 say that the lack of medicines and supplies is a challenge
30 August 2017, Dar es Salaam: When injured or ill, 6 out of 10 citizens (61%) seek treatment at a government health facility. This proportion has risen from 45% in 2014 although it has stayed steady since 2016. This is in large part due to a drop in people diagnosing or treating themselves by going to a pharmacy (9%), a grocery store for medicine (7%), doing nothing (1%) or seeking other forms of treatment (5%). Data collected since 2014 show a declining use of these alternatives. Citizens using private, church or NGO facilities has remained steady over this period (16% in 2017).
Despite an increasing number of patients, the trend since 2014 has been of more and more citizens waiting for an hour or less to be seen by the doctor. Seven out of ten citizens (70%) waited for an hour or less in 2014 compared to 3 out of 4 (76%) in 2017. However patients are more likely to wait for an hour or less at private/church/NGO facilities (88% waited for this time) than in government ones (74% waited for an hour or less).
These findings were released by Twaweza in a research brief titled Health check: Citizens diagnose health sector challenges. The brief is based on data from Sauti za Wananchi, Africa’s first nationally representative high-frequency mobile phone survey. The findings are based on data collected from 1,801 respondents across Mainland Tanzania (Zanzibar is not covered in these results) in May 2017.
More and more citizens are also satisfied with the cleanliness of facilities (those reporting this as an issue dropped from 29% in 2015 to 9% in 2017) and the level of respect and attention they receive from staff (42% complained about this in 2015 compared to 26% in 2017).
Despite these improvements, citizens continue to experience major challenges in accessing health services. Three out of ten citizens who accompanied someone to hospital in the past year (29%) found two or more patients sharing beds or mattresses. This is an improvement from 2016 when close to four out of ten (36%) witnessed bed/mattress sharing.
The trend is more worrying when it comes to accessing medicines and other supplies. Since 2015, there has been a steady increase of citizens reporting that they encountered shortages during their last visit (in the previous three months) to a government health facility. Similarly, increasing numbers of citizens are also complaining about waiting times, up from 53% in 2015 to 63% in 2017.
When it comes to the availability of doctors and the cost of services, progress is mixed. There was a sharp drop in citizens complaining about these issues between 2015 and 2016, but in 2017 the numbers are again rising.
- Absent doctors was an issue for 43% in 2015, falling to 18% in 2016 and climbing back up to 29% in 2017
- The cost of services was a problem for 34% of citizens in 2015, 19% in 2016 and 28% in 2017
Twaweza also asked citizens whether, in their experience, government policy is being practiced.
- Children under five, the elderly and pregnant women are entitled to free treatment in government health facilities. Since 2016 there have been small increases in the number of people in these groups who receive these services for free but a high portion are still forced to pay. Among citizens who accompanied members of these groups to a health facility, 35% were forced to pay for a child under five, 28% were asked to pay for a pregnant woman and 37% had elderly patients who also had to pay.
- Despite government pronouncements and massive public support (84%) for the victims of accidents, fights or other injuries to be treated before obtaining police clearance, 6 out of 10 citizens who accompanied victims to seek treatment were required to get police clearance before being treated.
- Insurance, particularly through the Improved Community Health Fund, is a major strategy for the government to expand access to health services. Between 2014 and 2017 the share of people with health insurance rose from 21% to 27%. In total, 13% of citizens report being members of the (Improved) Community Health Fund. At the current rate of increase, Tanzania will achieve universal health insurance coverage in roughly 40 years, around 2055
Aidan Eyakuze, Executive Director of Twaweza, said: “We can celebrate some of these findings. Citizens are using public facilities more and some aspects of health service delivery have improved. But problems with medicines and supplies, along with human resources challenges, remain serious.”
“Perhaps even more worrying,” he continued “is the extent to which government policy is being ignored by health service providers. Despite strong ministerial pronouncements and public education campaigns, fee free health services are not always being provided to the most needy citizens. We must continue to watch and remind each other that a strong culture of accountability is an essential ingredient for our health sector to progress.”
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For more information:
Risha Chande, Senior Communications Advisor, Twaweza
e: rchande@twaweza.org | t: (+255) (0) 656 657 559
Notes to Editors
· This brief and the data contained can be accessed at www.twaweza.org, orwww.twaweza.org/sauti
· Twaweza works on enabling children to learn, citizens to exercise agency and governments to be more open and responsive in Tanzania, Kenya and Uganda. We have programs, staff and offices across all three countries, and a globally respected practice of learning, monitoring and evaluation. Our flagship programs include Uwezo, Africa’s largest annual citizen assessment to assess children’s learning levels across hundreds of thousands of households, and Sauti za Wananchi, Africa’s first nationally representative mobile phone survey. We undertake effective public and policy engagement, through powerful media partnerships and global leadership of initiatives such as the Open Government Partnership
· You can follow Twaweza’s work