Health sector of Rukwa regiona is still underdeveloped and it is characterized by high rates of morbidity and mortality due to inadequate resources. Table 16 below shows the number and ownership of health facilities in the region

Table 16 - Number and ownership of health facilities (2006)

In consideration to the population of the region, the number of health facilities serves the population in ratios shown in Table 17 below.

Table 17 - Facilities to population ratio indicators

Common Diseases

The common diseases which cause higher morbidity and mortality rates includes: Malaria, Diarrhea, ARI, HIV/AIDS/STI, Tuberculosis, Anaemia, Meningitis etc. The maternal mortality rate is 187/100,000, infant mortality rate is 87/1000, the under five mortality rate is 175/1000 and maternal mortality rate is 199/100,000. Severe malnutrition is 155 percent.

Health Staff

The region has acute shortage of trained staff. This big shortage is attributed to stigma which existed for many years in Rukwa Region. The Doctor Population ratio is 1:162,500; while the Nurse Population ratio is 1:20,000 (National Average - Doctor 1:25,000 and Nurse 1:6,000). Table 18 below shows the status of the health staff in the region.

Table 18 - Trained health staff cadre situation in Rukwa Region

The Life expectancy according to 2002 census was 55 years. However, in recent years this has been reduced to 45 years due to HIV/AIDS pandemic. .

The health sector is seriously under funded despite the fact that it is a priority sector in the Poverty Reduction Strategy, and despite the fact that a health population is a basic ingredient of economic growth, lack of funds, however, is not the only cause of the weak health system. Under skilled and de-motivated personnel, deficiencies in quality of care, weak and confusing management systems, lack of information provided to health consumers, and lack of access by the very poor to treatment characterizes much of the current situation.

These factors, and more, have resulted in an health care system that requires not only massive investment of funds but also a renewed commitment and vision among all actors - government, policy makes, donors, non – governmental organisation, faith based organisation, heath worker themselves and others to generate fundamental change.

The main sources of fund for health sector is mainly from the government and Health basket funds which is inadequate to support and sustain health services.

Proposals for the following projects are being prepared (with estimated costs in bracket):

•  Malaria project (641 Mio)

•  Comprehensive Eye care project (250 Mio)

•  Infrastructure Rehabilitation (1,900 Mio)

•  Dental out reach programme (260 Mio)

To address the shortage of health staff, the Catholic mission is assisting in establishment of a nursing college in Nkasi and the Government is reviving the Mpanda clinical officers college. However, there is insufficient funds to finalise these programs.

Another initiative being promoted is establishment of a special fund by the region to be used to attract people to work in Rukwa (by paying them extra allowances to meet their basic needs).

HIV/AIDS

HIV/AIDS infection in the region has been rising steadily since 1994. On the whole the region's number of AIDS cases diagnosed rose from 323 cases in 1995 to 807 in 2000. This represents a 150 percent increase for both sexes. Women cases rose by 165 percent while those of men rose by 136 percent. The districts with the most risk was Sumbawanga Municipal were the increase in male cases was 356 percent while those of females increased by 417 percent giving a total for the two sexes of 386 percent. Nkasi district, on other hand was safest by showing declined of 1 percent for both sexes (Regional Social economic profile, 2003).

Current Status 0f HIV/AIDS Care and Treatment

• Cumulative AIDS cases for the past 20 years since the first report AIDS case in 1986 amount to over 9,000
• Due to under reporting, it is estimated that only one case in five cases is reported. This means that a cumulative total of 40,000 cases are likely to have occurred up to December, 2005
• The overall prevalence HIV infection among blood donors was 18.1 percent (in 2005 a total of 3931 donated blood and out of them 713 were positive). Mpanda district with 23 percent, Nkasi district with 18 percent and Sumbawanga municipal was 10.2 percent prevalence. In 2006/07 the overall prevalence is around 9 – 10 percent
• The overall prevalence of syphilis in ANC was 5.7 percent. Nkasi District had the highest prevalence of 12.6 percent. The lowest was Mpanda district with prevalence of 3.3 percent and Sumbawanga Municipal had 4.0 percent as well as Sumbawanga districts was 8.5 percent
• In 2005 a total of 15,000 Episodes of STI were reported. The common reported STD syndromes were GDS, GUD, PID and UTI
• Major determinants of HIV/AIDS in Rukwa Region includes, wife inheritance, alcoholism, polygamy, early marriage, illiteracy, unsafe traditional healers practice, mobile population groups and poverty especially among girls and women

Table 19 - Cumulative HIV/AIDS Cases from 1986 to 2005 by districts

Opportunity

8Sufficient number for curative and preventive centres at Regional, divisional, Ward and village levels.

Obstacles

•  Lack of funds for equipping, modernising and maintaining the health facilities;

•  Lack of curative and preventive experts at all levels;

•  Shortage of working tools such as ambulance etc.;

•  Shortage of accommodation for doctors at regional and district levels.