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Intervening to address constraints through health sector reforms in Tanzania: some gains and the unfinished business
Author(s) -
Munishi Gaspar Kilala
Publication year - 2003
Publication title -
journal of international development
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.533
H-Index - 66
eISSN - 1099-1328
pISSN - 0954-1748
DOI - 10.1002/jid.969
Subject(s) - prepayment of loan , tanzania , health sector , business , community health , economics , public economics , quality (philosophy) , health services , economic growth , finance , health care , socioeconomics , environmental health , medicine , population , philosophy , epistemology
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.