Tanzania Health Sector Public Expenditure Review 2020

Piatti-Fünfkirchen, Moritz; Ally, Mariam

doi:10.1596/34620

Cited by 11 publications

(11 citation statements)

References 3 publications

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“…Similarly, donor funding was seen by some interviewees as key to the successful implementation of any plan; thus, if donors exit a country or withdraw funding, a huge financial resource disappears, which will make implementation even more difficult. A 2020 report from the World Bank suggested that Tanzania’s spend on health is insufficient to allow everyone to access quality health services, and that per capita spend on health was 28.5 USD in 2017, an increase from 23.6 USD in 2010 [ 23 ]. The report also found that the health sector is over-reliant on donors, with the government providing approximately 40% of the total spend on public health [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Framing the Drivers of Antimicrobial Resistance in Tanzania

et al. 2021

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Despite global awareness of the key factors surrounding antimicrobial resistance (AMR), designing and implementing policies to address the critical issues around the drivers of AMR remains complex to put into practice. We identified prevalent narratives and framing used by epistemological communities involved in the response to AMR in Tanzania, interrogated how this framing may inform policymaking, and identified interventions that could be tailored to the groups believed responsible for AMR. We interviewed 114 key informants from three districts and analysed transcripts line by line. Our results suggest that many different groups help drive the spread of AMR in Tanzania and need to be involved in any effective response. Human health is currently perceived as driving the response, while other domains lag behind in their efforts. For AMR programmes to be successful, all sectors need to be involved, including civil society groups, community representatives, and those working in communities (e.g., primary care physicians). However, current plans and programmes largely fail to include these viewpoints. The perceived presence of political will in Tanzania is a significant step towards such a response. Any strategies to tackle AMR need to be tailored to the context-specific realities, taking into account constraints, beliefs, and power dynamics within countries.

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Section: Discussionmentioning

confidence: 99%

Framing the Drivers of Antimicrobial Resistance in Tanzania

et al. 2021

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Section: Methodsmentioning

confidence: 99%

“…PlanRep is a planning and reporting database used by local government authorities during planning and reporting, facility budget is governed by previous financial year annual revenue collection as budget sealing cut off point from central government to local government and partly is driven by consideration of population size of respective health facilities. 53 , 54…”

Section: Methodsmentioning

confidence: 99%

“…47,52 The DHFF system acts as a bridge between central government (Ministry of Finance and Planning) and local government authorities the primary health facilities in which funds are directly transferred from the Ministry of Finance and planning to frontline primary health facilities. 53 The shift aimed to increase service delivery efficiency by reducing leakages and enhancing predictability and timeliness of funds received at primary health facilities. 41,54 PlanRep is a planning and reporting database used by local government authorities during planning and reporting, facility budget is governed by previous financial year annual revenue collection as budget sealing cut off point from central government to local government and partly is driven by consideration of population size of respective health facilities.…”

Section: Research Settingmentioning

confidence: 99%

“…41,54 PlanRep is a planning and reporting database used by local government authorities during planning and reporting, facility budget is governed by previous financial year annual revenue collection as budget sealing cut off point from central government to local government and partly is driven by consideration of population size of respective health facilities. 53,54 In the four-year lifespan of the DHFF in Pangani, there has not been a thorough assessment of its impact on maternal health services. 47 This study attempts to make such an evaluation, and we consider that the implementation of the DHFF is timely to improve the quality of and access to maternal health services.…”

Section: Research Settingmentioning

confidence: 99%

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Evaluation of the Direct Health Facility Financing Program in Improving Maternal Health Services in Pangani District, Tanzania

Tukay¹,

Pasape²,

Tani³

et al. 2021

IJWH

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Background: Maternal morbidity and mortality remain significant public health concerns globally, with Tanzania reporting 398 deaths per 100,000 live births annually. While national level data provide some insights into the issue, a focus on sub-national levels is required because of differences in contexts such as rural-urban disparities in maternal mortality. This study examined Direct Health Facility Financing (DHFF) and its effects on the quality of maternal health services in Pangani, a rural district in Tanzania. Methods: This study was conducted in Pangani district of Tanga region in Tanzania. The study used both qualitative and quantitative methods, including 16 in-depth interviews with the council health management teams, facility in charges, maternity nurse in charge, and 5 focus group discussions with community health governing committee members. The number of deliveries that occurred in health facilities, as well as medical supplies, equipment, and reagents purchased by the facilities, were compared using descriptive statistics before and after the DHFF implementation. Results: Direct disbursement of funds from the central government through the Ministry of Finance and Planning to the primary health facilities reduced delays in procurement, improved community outreach services, and improved community leaders' engagements. Deliveries occurring at health facilities increased by 33.6% (p < 0.001) one year after the HDFF implementation. Various medicines, delivery kits, and some reagents increased significantly (p < 0.05). However, the lack of computers and poor internet connectivity, an insufficient supply of medical equipment and unstable stock of the Medical Stores Department increased the difficulty of obtaining the missed items from the selected prime vendor. Conclusion:Overall, this study shows a positive impact of the DHFF on maternal health service delivery in Pangani district. Specifically, an increase in the number of medical supplies, equipment, and reagents necessary to provide maternal health services contributed to the observed increase in facility deliveries by 33.6%. Moreover, the system minimizes unnecessary delays in the procurement processes of required drugs, supplies, and other facility reagents. To maximize the impact of the HDFF system, lack of computers, unstable internet, limited knowledge of the staff about the system, and inadequate health workforce should be addressed. Therefore, strengthening the DHFF system and staff training in-service and on the job is essential for smooth implementation.

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Health financing and public financial management during the Covid‐19 pandemic: Evidence from Pakistan as low‐income country

Khan

Nazir

Afzal

et al. 2023

Health Planning & Management

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Purpose This article aims to explore the areas of misalignment between the public financial management (PFM) and health financing during the COVID‐19 pandemic in Pakistan. Originality/Value To the best of our knowledge, it is the first study on South Asian countries to adopt a framework and bring forward the dominant themes that cause the misalignment between PFM and health financing. The timing of the research was excellent as the world was facing the biggest health challenge in the form of COVID‐19 which has put pressure on the PFM and has seriously hampered health service delivery. Therefore, the findings of the study are helpful for the ministry of health to draft policies to improve health allocations and move towards Universal Health Coverage. Design/Methodology/Approach In‐depth semi‐structured interviews of 15 participants were used to explore the areas of misalignment between PFM and health financing. Based on qualitative data, thematic content analysis has been carried out. Findings The findings of the study can be divided into five clusters and their explanations. First overall budget allocation has an impact on the health sector budget. For example, the budget for priority health interventions is not reflected in the budget allocation process. Further, the budget is classified by inputs rather than disease and finally, the budget is not released by the health priorities. The second cluster was the devolution of health to provinces which is unfinished agenda. Under this cluster fiscal decentralisation has been found to cause problems for the provinces as they have not provided fiscal autonomy to spend the money and there is a lack of coordination between the federal and provincial authorities. The third cluster was donor funding, and it was observed that it is not aligned with the government policies and priorities. Forth cluster was procurement and it was discovered that it is a lengthy process and caused delays in procuring the essential health equipment. The fifth cluster was an organisational culture that is not conducive to the health sector. Under this cluster, the attitude, knowledge, and practices of departments responsible for the health sector require complete revamping.

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Tanzania Health Sector Public Expenditure Review 2020

Cited by 11 publications

References 3 publications

Framing the Drivers of Antimicrobial Resistance in Tanzania

Framing the Drivers of Antimicrobial Resistance in Tanzania

Evaluation of the Direct Health Facility Financing Program in Improving Maternal Health Services in Pangani District, Tanzania

Health financing and public financial management during the Covid‐19 pandemic: Evidence from Pakistan as low‐income country

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