| The role of the auxiliary in the implementation of Tanzania's health services since independence in 1961 is examined. The importance of this role was enhanced by the enunciation of the Arusha Declaration in 1967. Fundamental to this declaration, which put Tanzania on the path of socialist development, was the objective of self-reliance in all sectors. Recognizing that self-reliance in the health sector could not possibly be realized through a system that proclaimed the registered doctor as its primary medical practitioner, Tanzania sought to step up production of already-existing auxiliary cadres:assistant medical officer (AMO), medical assistant (MA), and rural medical aid (RMA). Through upgrading courses that follow a prescribed number of years employment, it is now possible for an RMA to become an MA, an MA to become an AMO, an registered doctor. The present health development plan envisions a network of 300 rural health centres and 2 300 rural dispensaries at a ratio of one rural health centre to 50 000 population, and one rural dispensary to 6000 population by 1980. Both centres and dispensaries will be staffed and directed by auxiliary cadres (MAs, RMAs, etc.). A table illustrates recent changes in the output of health personnel, with the distribution in favour of the MAs and the RMAs. Finally, it is pointed out that because so much leadership responsibility is expected of the medical auxiliary, and because his working situation keeps him isolated from other members of his profession, the importance of providing him with possibilities for continuing education cannot be overemphasized. |