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DOI: 10.1055/s-2000-12586
Nachhaltigkeit und Armutsrelevanz: ein unversöhnlicher Widerspruch?
Das Beispiel der Evang. Luth. Kirche in TansaniaPublication History
Publication Date:
31 December 2000 (online)

Zusammenfassung
Das Gesundheitswesen in Entwicklungsländern steht im Spannungsfeld zwischen zwei Zielen: Nachhaltigkeit und Zugänglichkeit. Eine mehrmonatige Untersuchung der Krankenhäuser der Evang. Lutherischen Kirche in Tansania (ELCT) zeigte jedoch, dass die überwiegende Mehrheit dieser Institutionen weder eine Überlebenschance hat, noch einen maßgeblichen Beitrag zur Gesundheitsversorgung der Armen leistet. Aufbauend auf dieser Untersuchung werden einige Maßnahmen diskutiert, um das kirchliche Gesundheitswesen in Entwicklungsländern gemäß den Zielen der Nachhaltigkeit und Zugänglichkeit zu transformieren. Es zeigt sich jedoch, dass es nicht genügen wird, die technische Effizienz bestehender Krankenhäuser zu erhöhen. Eine komplette Umstrukturierung im Sinne des Primary Health Care erscheint derzeit als der einzige Weg, um dem kirchlichen Gesundheitswesen in diesen Ländern das Überleben und vielen Patienten eine adäquate Gesundheitsversorgung zu garantieren.
Sustainability and Affortability: A Conflict that Cannot Be Resolved? - Exemplified by the Situation of the Lutheran Church in Tanzania
Public Health systems in developing countries are in a field of tension between two poles: sustainability and accessibility. A several months check on hospitals run by the Lutheran Church in Tanzania led us to conclude, however, that the great majority of these institutions have neither a survival chance nor have they made any substantial contribution to the status of public health care for the poor. Basing on the results of this check we discuss a few measures to transform church-run public health systems in developing countries in accordance with the goals of sustainability and accessibility. It is, however, evident that it will not be enough just to increase the technical efficiency of existing hospitals. What is needed - and this seems indeed to be the only feasible way - is to effect a complete reorganisation in the sense of Primary Health Care. It is only then that church-run Public Health Care may survive in these countries and that provision of adequate health care can be ensured for many patients.
Key words
Sustainability - Africa - Tanzania - Public Health
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Prof. Dr. Steffen Fleßa
Evang. Fachhochschule Nürnberg
Fachbereich Pflegemanagement
Bärenschanzstraße 4
90429 Nürnberg