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Intervening to address constraints through health sector reforms in Tanzania: some gains and the unfinished business

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  • Gaspar Kilala Munishi

    (University of Dar es Salaam, Dar es Salaam, Tanzania)

Abstract

This paper describes two projects designed to address health sector constraints. The Community Health Fund attempts to create a community-owned and community-managed prepayment scheme. Although membership growth has been disappointing, substantial funds have been mobilized and the scheme replicated in nine additional districts. The Dar Urban Health Project aimed to improve various dimensions of health service quality, and provides a model which can be replicated elsewhere. The two cases concentrated largely on relaxing constraints related to the availability of inputs, while leaving unresolved macro-level general infrastructural and policy-related constraints. This omission partly explains the limited gains in relaxing constraints at the input level. Copyright © 2003 John Wiley & Sons, Ltd.

Suggested Citation

  • Gaspar Kilala Munishi, 2003. "Intervening to address constraints through health sector reforms in Tanzania: some gains and the unfinished business," Journal of International Development, John Wiley & Sons, Ltd., vol. 15(1), pages 115-131.
    • Handle: RePEc:wly:jintdv:v:15:y:2003:i:1:p:115-131
    DOI: 10.1002/jid.969
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    References listed on IDEAS

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    1. Gilson, Lucy & Alilio, Martin & Heggenhougen, Kris, 1994. "Community satisfaction with primary health care services: An evaluation undertaken in the Morogoro region of Tanzania," Social Science & Medicine, Elsevier, vol. 39(6), pages 767-780, September.
    2. World Bank, 1993. "World Development Report 1993," World Bank Publications - Books, The World Bank Group, number 5976.
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    Cited by:

    1. M. Kent Ranson & Kara Hanson & Valeria Oliveira-Cruz & Anne Mills, 2003. "Constraints to expanding access to health interventions: an empirical analysis and country typology," Journal of International Development, John Wiley & Sons, Ltd., vol. 15(1), pages 15-39.
    2. repec:unu:wpaper:wp2012-69 is not listed on IDEAS
    3. Arnab Acharya & Melisa Martínez-Álvarez, 2012. "Aid Effectiveness in the Health Sector," WIDER Working Paper Series wp-2012-069, World Institute for Development Economic Research (UNU-WIDER).
    4. Valeria Oliveira-Cruz & Christoph Kurowski & Anne Mills, 2003. "Delivery of priority health services: searching for synergies within the vertical versus horizontal debate," Journal of International Development, John Wiley & Sons, Ltd., vol. 15(1), pages 67-86.
    5. Zacharia S. Masanyiwa & Anke Niehof & Catrien J. A. M. Termeer, 2015. "A gendered users′ perspective on decentralized primary health services in rural Tanzania," International Journal of Health Planning and Management, Wiley Blackwell, vol. 30(3), pages 285-306, July.
    6. Kara Hanson & M. Kent Ranson & Valeria Oliveira-Cruz & Anne Mills, 2003. "Expanding access to priority health interventions: a framework for understanding the constraints to scaling-up," Journal of International Development, John Wiley & Sons, Ltd., vol. 15(1), pages 1-14.
    7. Acharya, Arnab & Martínez-Álvarez, Melisa, 2012. "Aid Effectiveness in the Health Sector," WIDER Working Paper Series 069, World Institute for Development Economic Research (UNU-WIDER).

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