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While interest in social disparities in health within affluent nations has been growing, discussion of equity in health with regard to low- and middle-income countries has generally focused on north-south and between-country differences, rather than on gaps between social groups within the countries where most of the world's population lives. This paper… (More)
This article discusses how to increase the effectiveness of district health systems, with particular reference to the setting of priorities and targets, the realization of various forms of joint action, and the improvement of management and other skills.
Although WHO and many countries are intensifying their efforts to improve the performance of district health systems, a lot remains to be done. The district is the most peripheral fully-organized unit of local government. As it is small enough for health staff to observe and understand major problems and developments, the district offers great opportunities… (More)
Since its independence, Tanzania has consistently followed a socialist policy with a strong emphasis on the development of the rural areas and on an equal distribution of goods and services. In the health field, this policy has taken the form of establishing a network of rural health centers, training auxiliaries, and involving the communities through mass… (More)
Health sector reforms are now being implemented in many developing and developed countries. Concerns have been raised about the effects of these reforms on the objectives of improving health and on the quality, efficiency, equity and sustainability of health services. Although considerable understanding of the impact of some types of reforms has been… (More)