WUNRN
Consider Gender Dimensions of Issues
Presented.
Tanzania - Older People’s Right To Health
Ms Teresa Minja,
Paper prepared for the panel discussion: The right to health: in
conversation with older people, 2nd August 2011, Second
Working Session of the Open-ended Working Group on Ageing, 1 – 4 August 2011
Introduction
The Universal
Declaration of Human Rights (1948), Article 25(1) states that “Everyone has the
right to a standard of living adequate for the health and wellbeing of himself
and that of his family, including food, clothing, housing, medical care and
necessary social services…”
There are now more than 11.4 million Tanzanian’s
living below the basic needs poverty line, and a substantial proportion of
these are older people. Today 4.66 % of
The intergenerational poverty cycle is
exacerbated by HIV/AIDS, which has resulted in older people caring for their
sick and dying children and their grandchildren. In
In
This paper will discuss the
extent to which the right to health is accessible and available to older people
in
Accessibility
· In the National Strategy for Growth and Reduction of Poverty (NSGRP) I it was planned that the furthest health facility would not be more than 5 km from any household. This has not been achieved. Due to the poor infrastructure, especially in the rural areas many older people are unable to accesses health services. We hope this target may be achieved in NSGRP II.
· Due to poor infrastructure, lack of reliable transport and acute poverty, a substantial number of older people cannot afford to pay their fare to get to hospital even though some arrangement would have been made for them to receive free medication. Worse still, the main diseases facing older people require attention of a fully qualified medical doctor at either a district or regional hospital. Unfortunately these hospitals are very far from where the majority of older people live. The implementation of the Government’s intention for a mobile/ outreach service has not started in any district although it was ordered by the Prime Minister in 2010. We also expect an improved network of health facilities so that older people do not have to walk long distances to get health services.
· There
is also the problem of identity. In
· In
· Older
People in
·
Privately owned health facilities cover 40% of all medical services in
Availability
· Currently, older people are visiting health facilities but the drugs they need are not available. Statements like “there are no medicines for old people” or “we only have medicines for your grandchildren” or “how much longer do you want to live” are still common in some areas.
· In many parts of the country, drugs for the diseases that affect people in advanced age are not given priority when health facilities are placing drug orders from the Medical Store Department. As a result it is very difficult to find such drugs especially in the dispensaries and health centers and district hospitals. This is unfair. Tere is a need for sensitizing health personnel to include such drugs on their priority list.
· There is also inefficiency in the system for ordering drugs and other hospital equipment from Medical Stores Department. Hospitals, health centers and dispensaries complain of their orders not being met by the Medical Stores Department. In my view, prescribed medicines have to be purchased from drug shops in the event that the MSD cannot deliver them in time.
·
Because free medication is not available in most cases, older people
have to buy the medicines prescribed privately. In
· Countrywide, there is a shortage of trained health personnel, doctors, nurses and health workers, especially in age-related illnesses. Although the Government has ordered that special rooms be allocated for treating older people, the implementation of this directive has faced many challenges some of them are as follows:
1. Acute shortage of medicine
2. Shortage of staff
3. Lack of medical staff with geriatric knowledge, particularly in rural areas
4. Reluctance of some medical staff to allow older people to access Medication without paying money
5. Lack of fare to travel to hospital to access services
6. Low priority for the drugs related to diseases that affect people at advanced age.
Recommendations for Action
1. Our National Aging Policy (NAP 2003) provides for free health services to older people over 60 years of age. But since this is just a policy, it does not oblige health care providers to give free treatment to older people. The Government is yet to enact a law that will enforce implementation of the National Aging Policy. Age care organizations in the country are requesting the Government to speed up the process of enacting such a law.
2. As stated earlier, older people were not aware of their health rights, few were visiting health facilities. Currently older people are becoming more and more aware of their health rights and going to hospital for treatment. It is therefore very discouraging to note that there is still an acute shortage of the drugs they need. In this context older people are requesting to be represented on the MSD Board to ensure adequate age-related drugs are stocked and supplied to health facilities. Older people should also be represented on all health committees at wards and district council levels.
3. The Government should train more staff in geriatric care, and assure that referral hospitals have specialists in geriatric care.
4. There is a need for the Government to increase the
budget allocated to the health sector to 15% as per the
Conclusion
In
I appreciate this conference because it puts older people’s health agenda in the open.