In 2001, the total per capita expenditure on health care was Intl $26 (4.4% of GDP).47 Among the countries of Africa, this figure falls within a spending range of Intl $652 in South Africa (8.6% of GDP) and Intl $12 in the Democratic Republic of Congo (3.5% of GDP). At 2.0% the smallest spending as a percentage of GDP is in Equatorial Guinea (Tables 9 and 10).
Tables 9 and 10 Total health expenditure (Intl $) per capita and as a percentage of GDP: countries of Africa, 2001
Table 9
Health expenditure (Intl $) per capita: Africa
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Table 10
Health expenditure (Intl $) as a percentage of GDP: Africa
|
Country
|
Per capita
|
South Africa |
652 |
Tunisia |
463 |
Botswana |
381 |
Namibia |
342 |
Libya |
239 |
Morocco |
199 |
Gabon |
197 |
Algeria |
169 |
Swaziland |
167 |
Egypt |
153 |
Zimbabwe |
142 |
Côte d'Ivoire |
127 |
Liberia |
127 |
Kenya |
114 |
Equatorial Guinea |
106 |
Lesotho |
101 |
Djibouti |
90 |
Gambia |
78 |
Angola |
70 |
Senegal |
63 |
Guinea |
61 |
Ghana |
60 |
Central African Republic |
58 |
Uganda |
57 |
Zambia |
52 |
Mozambique |
47 |
Mauritania |
45 |
Togo |
45 |
Rwanda |
44 |
Cameroon |
42 |
Sudan |
39 |
Malawi |
39 |
Benin |
39 |
Guinea-Bissau |
37 |
Eritrea |
36 |
Nigeria |
31 |
Mali |
30 |
Burkina Faso |
27 |
Sierra Leone |
26 |
Utd Rep of Tanzania |
26 |
Congo |
22 |
Niger |
22 |
Burundi |
19 |
Chad |
17 |
Ethiopia |
14 |
Dem Rep of the Congo |
12 |
Somalia |
|
|
Country
|
%
GPD
|
South Africa |
8.6 |
Kenya |
7.8 |
Malawi |
7.8 |
Namibia |
7.0 |
Djibouti |
7.0 |
Botswana |
6.6 |
Tunisia |
6.4 |
Gambia |
6.4 |
Zimbabwe |
6.2 |
Côte d'Ivoire |
6.2 |
Mozambique |
5.9 |
Uganda |
5.9 |
Guinea-Bissau |
5.9 |
Zambia |
5.7 |
Eritrea |
5.7 |
Lesotho |
5.5 |
Rwanda |
5.5 |
Morocco |
5.1 |
Senegal |
4.8 |
Ghana |
4.7 |
Sudan |
4.5 |
Central African Republic |
4.5 |
Utd Rep of Tanzania |
4.4 |
Angola |
4.4 |
Benin |
4.4 |
Mali |
4.3 |
Sierra Leone |
4.3 |
Liberia |
4.3 |
Algeria |
4.1 |
Egypt |
3.9 |
Niger |
3.7 |
Ethiopia |
3.6 |
Mauritania |
3.6 |
Burundi |
3.6 |
Gabon |
3.6 |
Guinea |
3.5 |
Dem Rep of the Congo |
3.5 |
Nigeria |
3.4 |
Cameroon |
3.3 |
Swaziland |
3.3 |
Burkina Faso |
3.0 |
Libya |
2.9 |
Togo |
2.8 |
Chad |
2.6 |
Somalia |
2.6 |
Congo |
2.1 |
Equatorial Guinea |
2.0 |
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The WHO overall health system performance score places Tanzania 156/191 countries. This composite measure of overall health system attainment48 is based on a country’s goals relating to health, responsiveness, and fairness in financing. The measure varies widely across countries and is highly correlated with general levels of human development as captured in the human development index .
WHO recognises the following strengths and opportunities in Tanzania:49
home based care is integrated in the health system
- existing palliative care team at ORCI
- palliative care provided at district level by some NGOs
- support of MOH, district health management and NGOs
- government provides funds for palliative care treatments
Concerns centre on:
- training of home based care providers
- availability of manuals on home based care
- link between hospital based services and home based services
- only medical doctors have license to prescribe opioid drugs
- radiotherapy is only available at ORCI
In Tanzania, there is some concern that the needs of cancer patients are overshadowed by the needs of people living with AIDS.
Currently, the AIDS Control Programme is in the process of establishing national policies for home based care, but this lacks several components of palliative care. There is a cancer registry but no developed National Cancer Control programme.
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