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Analytical summary - Health system outcomes

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The advance of HIV/AIS pandemic and re-emergence of TB has not only overstretched the capacity of the established Primary Healthcare (PHC) structures and institutions making them susceptible in terms of ability to cope and produce positive results. This has also brought in the challenge of vertical programming of health services. A negative trend in PHC indicators has been observed in the country since the mid-90.

This trend is likely to continue until a negative trend is observed in terms of HIV/AIDS, TB and non-communicable diseases. HIV and TB have diverted both human and financial resources away from other PHC interventions which were adequately supported before.

The country has been faced with significant epidemiological transition from water-borne and sanitation related morbidities and mortalities to lifestyle related morbidities and mortalities. Lifestyle related diseases, related NCD’s and communicable diseases such as HIV and AIDS and TB have put a heavy strain on healthcare services. Clearly, there are more sick people in the country of late than any other time before.

The interplay within communicable diseases such as HIV/TB co-infection and between communicable diseases and non-communicable diseases such as diabetes and some cancers have equally worsened the situation. The reality now is that the country is dealing with a population cohort suffering from incurable illnesses such as HIV and AIDS, MDR/XDR TB, Diabetes, Hypertension and cancers. While treatment approaches as means for diseases control may seem to relieve short term suffering, this approach faces long term sustainability.