| The Group Occupational Health Service Association, the first of its kind in Africa, was set up in 1967 in Dar es Salaam, Tanzania, to provide employees of participating firms with better medical attention than was provided by existing public and private services. Since then, 10 of the association's 65 firms have acquired their own dispensaries and staff who are supervised by doctors visiting daily or weekly; the other 55 have been split into contiguous groups of 5-10 factories, each served by a male auxiliary health worker. Each group is visited two to three times weekly by a doctor but patients needing a doctor more urgently are sent to meet him at some other point in his rounds. The association staff' is presently composed of three doctors, 13 auxiliaries (rural medical aides, nurses, and nursing assistants), and five support personnel. The association supervises another 12 health workers in the direct employment of the larger member firms. The author concludes that such a service is likely to be welcomed where public and private services are deficient, but that initial finance, a good programme, and a base of operations such as a university department of community medicine must be provided. He adds that the direct service approach is likely to have a deeper and more rapid influence on occupational health standards than any advisory unit. |