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PRIMARY HEALTH CARE: THE PROMISE AND THE CHALLENGE
The Alma-Ata Declaration of 1978 proclaimed Primary Health Care as the means for achieving Health for All. According to the declaration, a primary health care (PHC) strategy entails universal health coverage, patient-centered approaches and demand-driven health policies.
In the aftermath of this declaration, many countries began formulating national policies for implementing effective, cost-efficient primary health care strategies. Tanzania began implementing PHC from before the Alma-Ata Declaration through its existing network of multisectoral PHC committees at national, regional, district, ward and village levels. The Alma-Ata declaration provided a renewed sense of the importance and potential of PHC. In Tanzania, the emphasis on Health Education and Community Involvement as essential mechanisms to improve health is a highly valued element of PHC.
The promise of PHC was the potential to reach health for all in health systems with limited resources. Much of this promise has been achieved: Tanzania has high rates of childhood immunization, under-five mortality rates have decreased continuously in recent years, malaria prevalence is dropping in many parts of the country. However, much work remains to be done. Maternal mortality remains high, and many preventive behaviors are practiced by only a minority of the population. A major constraint is the quality of care in peripheral health facilities. Shortages of trained personnel, shortages of essential medications and irregular supervision all make it difficult to improve the quality of care at this level. The Primary Health Care Institute works to strengthen PHC at the peripheral level in order to achieve health for all even in the most remote corners of Tanzania.
HISTORY OF THE PRIMARY HEALTH CARE INSTITUTE (PHCI)
The vision for a Primary Health Care Institute in Tanzania dates back to 1974. The intention was to create a facility that would teach future health leaders and promote preventive health services in the country.
It was not until 1989, however, that the Ministry of Health and Social Welfare officially implemented a national PHC strategy that led to the creation of PHCI. The aim of the Institute- then, and today- was to enhance a district-level capacity to operationalize the Ministry’s PHC strategy. Specifically, the Institute was charged with contributing to the training, research and management of health services to support the health sector, other sectors and the community at large.
In 1990, the WHO outlined the role of the institute. PHCI was designated as a “Zonal Continuing Education Centre” for the Southern Highlands regions, which today include Ruvuma and Iringa. The institute is charged with coordinating all health trainings carried out by stakeholders in the zone including health training institutions, NGOs and FBOs. PHCI is meant to serve as a multi-purpose institution that can share resources, create closer relations among management teams and enhance integration of on-the-job training and national programmes.
The institute offers both short and long courses, seminars, specialized trainings and various certifications. Training and management are sectors where PHCI excels. We are regional leaders in this regard, having trained thousands of health professionals throughout the country to promote and oversee health interventions.
Operational research is integral to the mission of PHCI, and includes both monitoring and evaluation of existing or proposed training programs, and systematic assessment of different approaches health care provision and community participation in health. Operational research is an arena in which we are committed to further expanding the scope of our activities.. We view systematic research as a crucial element to identifying and assessing gaps in knowledge and practice. By engaging more fully in research activities, we believe we could provide even better services to our students and to the communities that they serve.
In 2005 , the National Council for Technical Education (NACTE) granted PHCI Full Accreditation at National Technical Award (NTA) level 6 in Health Promotion. This permits PHCI to issue those who successfully complete the program a Diploma in Health Promotion.
Today, PHCI is in the process of developing competence-based, modularized and demand-driven curriculum for NTA levels 4, 5, 7 and 8.