Public Private Partnership in Utilization of Funds in the Health Sector in Tanzania an Analysis of Key Financing Mechanisms

ABSTRACT Purpose As a result of donor apathy, there has been notable decrease in the amount of donor funding to the social sector in recent years. Results of recent studies conducted on the impact of previous donor funding efforts have led to development workers to query if foreign aid works. Noting the importance of the health sector in a country's pathway to development, the purpose of this study is to analyse the key financing mechanisms in the republic of Tanzania with a view to informing the policy makers on the need to design more efficient, equitable and sustainable financing mechanisms. Methodology This study used two main strategies to ensure sufficient collection of secondary and primary data. This included a detailed review of related literature obtained from internet searches, publications and related papers and journals from all over the world but with specific focus on Tanzania. The source of primary data was mainly from interviews with key stakeholders, that is, representatives from donor agencies, leading NGOs, faith based organizations and government departments. Findings. The study notes that public private partnerships in delivery of health services are not new in the republic of Tanzania. The earlier public partnership between the district hospitals and the private not for profit faith based organizations was more focused than the public private partnership between the transnational drug companies and the central government today. Implications. There is need to redefine the objectives of public private partnerships to ensure that partnerships are initiated where they exist in pursuit of a common objective. Policies and legislation are required to ensure where viable partnerships are identified, the ventures are appropriately monitored to ensure the set goals are achieved in an efficient manner

TABLE OF CONTENTS 

TITLE PAGE .................................................................................................................................... ii 

DECLARATION ............................................................................................................................... iii 

APPROVAL. ..................................................................................................................................... iv 

DEDICATION ................................................................................................................................... v 

ACKNOWLEDGMENT ..................................................................................................................... vi 

LIST OF TABLES ............................................................................................................................. viii 

LIST OF ACRONYMS ...................................................................................................................... ix 

ABSTRACT ...................................................................................................................................... x 

CHAPTER ONE ............................................................................................................................... 1 

INTRODUCTION ............................................................................................................................. 1 

1.1 BACKGROUND ............................................................................................................... 1 

1.2 BACKGROUND TO THE STUDY ...................................................................................... 3 

1.3 STATEMENT OF THE PROBLEM .................................................................................... 4 

1.4 RESEARCH QUESTIONS ................................................................................................ 6 

1.5 OBJECTIVES OF THE STUDY ......................................................................................... 6 

1.6 SCOPE OF THE STUDY .................................................................................................. 7 

1.7 SIGNIFICANCE OF THE STUDY ...................................................................................... 8 

1.8 CONCEPTUAL FRAMEWORK ......................................................................................... 9 

1.9 DEFINITION OF KEY CONCEPTS ................................................................................... 9 

CHAPTER TWO .............................................................................................................................. 13 

REVIEW OF RELATED LITERATURE ........................................................................................... 13 

2.1 INTRODUCTION ............................................................................................................. 13 

2.2 THE ROLE OF STAKEHOLDERS IN THE HEALTH SECTOR ............................................ 13 

2.3 FINANCING MECHANISMS IN THE HEALTH SECTOR ......................................................... 33 

2.4 CHALLENGES AND WEAKNESSES IN DONOR FINANCING MECHANISMS .................... 38 

CHAPTER THREE ......................................................................................................................... .43 

RESEARCH METHODOLOGY ....................................................................................................... 43 

3.1 INTRODUCTION ............................................................................................................. 43 

3.2 RESEARCH DESIGN ....................................................................................................... 43 

3.3 STUDY POPULATION ..................................................................................................... 44 

3.4 SAMPLE SIZE ................................................................................................................. 45 

3.5 SELECTION OF RESPONDENTS .................................................................................... 45 

3.6 DATA COLLECTION METHODS ...................................................................................... 46 

3.7 DATA ANALYSIS AND PRESENTATION .......................................................................... 46 

CHAPTER FOUR ............................................................................................................................ 48 

DATA PRESENTATION, ANALYSIS AND INTERPRETATION .................................................... 48 

4.1 INTRODUCTION ............................................................................................................. 48 

4.2. ROLE OF STAKEHOLDERS IN THE HEALTH SECTOR. .................................................. 48 

4.3 FINANCING MECHANISMS IN THE HEAL TH SECTOR .................................................... 61 

CHAPTER FIVE ............................................................................................................................... 67 

SUMMARY, CONCLUSIONS AND RECOMMENDATIONS ...................................................... 67 

5.1 ROLE OF THE VARIOUS STAKEHOLDERS IN THE HEALTH SECTOR ............................ 67 

5.2 FUNDING MECHANISMS: ............................................................................................... 70 

5.3 CONCLUSIONS ............................................................................................................... 71 

5.4 RECOMMEMENDATIONS ............................................................................................... 73 

BIBLIOGRAPHY .................................................................................................................... 76 

APPENDICES .................................................................................................................................. 80 

Research Guide and Questionnaire ................................................................................................ 80