Background Achieving equity in healthcare services has been a global priority. According to the literature, a slew of initiatives aimed at increasing household equity in healthcare financing have exacerbated the problem, making it hard for most developing countries to understand the real cause of the problem. Method The non-experimental research design has been used to explore the Tanzania Panel Survey (NPS) data 2019/2020, to investigate equity differential in household healthcare financing in Tanzania by the use of conventional instrumental variable methods of Two-stage and Three-stage least square methods Results Despite the global agenda of universal health coverage, this paper reveals that 86 percent of Tanzania lacks health insurance with a high degree of inequitable distribution of health facilities as 71.54 percent of the population is in rural areas, yet these areas have poor health systems compared to urban ones. These disparities increase pressure on household healthcare financing and widen the inequity and equality gaps simultaneously. Additionally, a household's income, education, health care waivers, out-of-pocket expenditure, and user fees have been found to have a significant impact on household equity in healthcare financing. Conclusion To reverse the situation and increase equity in household healthcare financing in most developing countries, this paper suggests that an adequate pooling system should be used to allow more people to be covered by medical prepayment programs, and the donor-funded programs in developing countries should focus on health sector infrastructure development and not the capacity building.
Efforts to promote equity in healthcare involve implementing policies and programs that address the root causes of healthcare disparities and promote equal access to care. One such program is the public social healthcare protection schemes. However, like many other developing countries, Tanzania has low health insurance coverage, hindering its efforts to achieve universal health coverage. This study examines the role of equity in public social healthcare protection and its effects on household healthcare financing in Tanzania. The study used secondary data collected from the National Bureau of Statistics' National Panel Survey 2020/21 and stratified households based on their place of residence (rural vs. urban). Moreover, the logit regression model, ordered logit, and the endogenous switching regression model were used to provide counterfactual estimates without selection bias and endogeneity problems. The results showed greater variations in social health protection across rural and urban households, increasing disparities in health outcomes between these areas. Rural residents are the most vulnerable groups. Furthermore, education, income, and direct healthcare costs significantly influence equity in healthcare financing and the ability of households to benefit from public social healthcare protection schemes. To achieve equity in healthcare in rural and urban areas, developing countries need to increase investment in health sector by reducing the cost of healthcare, which will significantly reduce household healthcare financing. Furthermore, the study recommends that social health protection is an essential strategy for improving fair access to quality healthcare by removing differences across households and promoting equality in utilizing healthcare services.
Purpose Tanzania has implemented policies that aim at improving health sector performance as well as the general health status of citizens. Establishment of community insurance fund, increase government budget allocation in health sector, establishment of institutions for critical and special diseases like Tanzania Ocean road cancer institute, Muhimbili Orthopaedic Institute and many other that aim at improving sector efficiency. These efforts and policies had a direct impact on improving the health sector and achieving Sustainable Development Goals (SDGs). Despite these improvement efforts, the health sector continues to face enormous challenges. Among the major challenges identified is the level of inefficiencies in healthcare delivery. It is for this reason; this paper examines the scale efficiency level in Tanzania’s public hospitals. Methods Using data from the Ministry of Health, this paper employs the Input based Data Envelopment Analysis (DEA) to examine Tanzania’s public hospital efficiency levels. DEA has been applied because it can handle multiple inputs and output that can have different units simultaneously. Results Findings showed that the average scale efficiency was 78.6%.and 72.9%for regional and district hospitals respectively. Additionally, 43.8% of the regional referral hospitals attained the most productive scale size compared to 21.05% in district hospitals. Conclusion The study concludes that there is dire need for the ministry of health to consider resource reallocation across public hospitals. Periodic re-estimation of efficiency levels coupled with increased health care input injection is of urgent need.
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