Hospital side hustles: Funding conundrums and perverse incentives in Tanzania's publicly-funded health sector

Marten, Meredith G.; Sullivan, Noelle

doi:10.1016/j.socscimed.2019.112662

Cited by 10 publications

(9 citation statements)

References 27 publications

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“…In Africa, some literature has found that user fees reduced the level of equity not only in healthcare financing but also in healthcare utilization among households in African countries such as Burkina Faso, Burundi, Ghana, Tanzania, and Kenya [ 26 ]. Unlike in West Africa where studies report that the introduction of user fees contributed to the improvement of the health services and narrowed inequity [ 27 ]. Since, user fees have different results in different countries, precautionary measures have to be taken regularly to ensure it would not affect citizens' healthcare utilization and worsen the situation.…”

Section: Discussion Of Findingsmentioning

confidence: 99%

“…Therefore, this controversy, discloses important information for the health systems in developing countries that inequity in healthcare finance and access to services is not just due to user costs, but the alternative finance options aimed at lowering total out-of-pocket expenses are critical to increasing equity in healthcare financing [ 27 ]. Health insurance coverage has been significantly found to influence equity improvement among households [ 3 ].…”

Section: Discussion Of Findingsmentioning

confidence: 99%

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Analysis on the equity differential on household healthcare financing in developing countries: empirical evidence from Tanzania, East Africa

2022

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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.

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Section: Discussion Of Findingsmentioning

confidence: 99%

Section: Discussion Of Findingsmentioning

confidence: 99%

Analysis on the equity differential on household healthcare financing in developing countries: empirical evidence from Tanzania, East Africa

2022

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“…Public sector health facilities in SSA suffer from understaffing, poor infrastructure, geographical maldistribution, and an inappropriate skill mix [ 12 ]. Austerity measures imposed by some international donors, and reduced public health expenditure in many SSA countries, have led to underfinancing, under-resourcing, and donor dependency, compromising the health sectors’ ability to provide effective and equitable healthcare [ 13 , 14 ]. A shift to strengthened, climate-resilient, migration-inclusive health systems may better anticipate, prevent, prepare for, monitor, and manage changing health needs [ 4 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Family Physician Perceptions of Climate Change, Migration, Health, and Healthcare in Sub-Saharan Africa: An Exploratory Study

Scheerens

Bekaert

Ray

et al. 2021

IJERPH

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Although family physicians (FPs) are community-oriented primary care generalists and should be the entry point for the population’s interaction with the health system, they are underrepresented in research on the climate change, migration, and health(care) nexus (hereafter referred to as the nexus). Similarly, FPs can provide valuable insights into building capacity through integrating health-determining sectors for climate-resilient and migration-inclusive health systems, especially in Sub-Saharan Africa (SSA). Here, we explore FPs’ perceptions on the nexus in SSA and on intersectoral capacity building. Three focus groups conducted during the 2019 WONCA-Africa conference in Uganda were transcribed verbatim and analyzed using an inductive thematic approach. Participants’ perceived interactions related to (1) migration and climate change, (2) migration for better health and healthcare, (3) health impacts of climate change and the role of healthcare, and (4) health impacts of migration and the role of healthcare were studied. We coined these complex and reinforcing interactions as continuous feedback loops intertwined with socio-economic, institutional, and demographic context. Participants identified five intersectoral capacity-building opportunities on micro, meso, macro, and supra (international) levels: multi-dimensional and multi-layered governance structures; improving FP training and primary healthcare working conditions; health advocacy in primary healthcare; collaboration between the health sector and civil society; and more responsibilities for high-income countries. This exploratory study presents a unique and novel perspective on the nexus in SSA which contributes to interdisciplinary research agendas and FP policy responses on national, regional, and global levels.

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“…Projectification has been studied in varied contexts, such as entrepreneurship (Auschra et al, 2019;Li et al, 2020), public sector organizations (Godenhjelm et al, 2015), conservation of traditional rural biotopes (Cwikla and Jalocha, 2015;Raatikainen, 2018), health care (Glasdam et al, 2015;Marten and Sullivan, 2020;Penkler et al, 2020), pharmaceutical companies (Biedenbach, 2011), media broadcast (Clegg and Burdon, 2021) and in performing arts (Lindgren and Packendorff, 2007). From a geographic perspective, studies also examined the regional influences of projectification in European (Dornisch, 2002;Mukhtar-Landgren and Fred, 2019;Schoper et al, 2018) and in African countries (Bardosh, 2015;Marten and Sullivan, 2020) and as a crucial element to promote and coordinate collective innovation strategies in high-growth emerging countries (Clegg and Burdon, 2021;Midler, 2019a).…”

Section: Literature Review 21 the Phenomenon Of Projectificationmentioning

confidence: 99%

From the wall of the industry to the soul of society: a review and multi-level analysis on projectification

Fregolente

Neto

Ribeiro

et al. 2022

IJMPB

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PurposeThe growing presence of projectification is affecting more than its cradle, the industry, characterizing it as a broader phenomenon than initially envisioned. This study aims to provide a literature review on the concept.Design/methodology/approachThe sampling process includes articles from two databases, Web of Science and Scopus, and a backward snowballing sampling through the references, entailing the analysis of 103 documents. The publications were analyzed applying bibliometric, content and semantic analyses both manually and with the assistance of VOSViewer, Bibliometrix, NVivo11 and Tropes v.8.FindingsThe results identified 55 definitions of projectification. The study synthesizes them in five levels of analysis to capture their main distinctive aspects, as follows: (1) Private Organizations; (2) Public Sector; (3) Academy; (4) Individuals (work and private life); and (5) Society. The paper concludes by depicting factors as general effects, negative effects, tensions, funding and knowledge, embedded within each level of analysis.Originality/valueThis work sheds light on the evolution of projectification concept, presents a multilevel analysis of its consequences and brings forward the related topics, which still require further investigation.

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Hospital side hustles: Funding conundrums and perverse incentives in Tanzania's publicly-funded health sector

Cited by 10 publications

References 27 publications

Analysis on the equity differential on household healthcare financing in developing countries: empirical evidence from Tanzania, East Africa

Analysis on the equity differential on household healthcare financing in developing countries: empirical evidence from Tanzania, East Africa

Family Physician Perceptions of Climate Change, Migration, Health, and Healthcare in Sub-Saharan Africa: An Exploratory Study

From the wall of the industry to the soul of society: a review and multi-level analysis on projectification

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