Abstract:

Good and satisfactory health services are a major public health problem in poor countries like Tanzania. Most communities in these countries are affected because they have no means of accessing important health education concerning their health as well as lacking good health services. Sadly enough some patients die even before reaching to the health facilities or before getting health services after reaching the health facilities or before getting health services after reaching the health facilities due to lack of enough well trained medical personnel, lack of medical equipment’s and medications. Therefore, these shortcomings encouraged me to go at Tabora regional referral hospital (Kitete) and spend most of time in the department of internal medicine during my elective/attachment period to learn more about different diseases and their management which I believe it will be helpful to my community in the future.

My goals is this medical attachment were to learn management of common newborn conditions at Kitete regional hospital, cooperates fully with my seniors and share what I have learnt from my seniors at CUHAS-Bugando.

Learning the disease theoretically is an important step, but participating in the care of patients has clearly helped me to understand the newborn conditions and their management. There are different newborn conditions being reported at Kitete regional hospital. The most important things I learned especially at the clinic were how to diagnose different diseases through history taking and physical examination, and the importance of the rational drug prescription.

The most practical works which I did and learnt include; how to perform major and service ward round with my seniors, and the management of the newborn condition in the wards. Taking vital signs to all newborns admitted in the ward every morning before ward round, collection of specimens from the sick newborns, insert intravenous lines, ordering investigations for different disease conditions, well as importance of good manners in the management of patients

During this elective I observed several challenges in the care of sick newborns, which include absence of neonatal ward, inadequacy of basic working tools/instrument in management of sick newborns, blood smear for malaria parasites (they depend entirely on MRDT due to lack of equipment’s for confirmation of malaria, culture and sensitivity can’t be performed so patients were treated clinically most of the time, lack of drug to the extent that some of the patient had to go and buy some of the prescribed drugs from outside because they were out of stock in the hospital, inadequate number of well-trained medical personnel.

So I learned how to manage the patients empirically in resource limited settings like Kitete as well as counselling in order to avoid complications of diseases which may cause death of patients.

In Summary, government, non-government organizations (NGOs) and individual participation are needed in raising the standard of health services provision by building health centers in remote areas, providing drugs, tools and instruments which are needed in the management of patients. Government should support and encourage medical practitioners to go to the remote areas and other medical centers so as to cover the need of medical services needed by the communities. Proper counseling and encouraging patients on adherence to medications are very important in the management and prevention of complications of diseases.