Factors associated with cost sharing for the users of government health facilities in Tanzania: The case study of Dar es Salaam city municipal hospitals

Shabani, Ally Khamisi (2008) Factors associated with cost sharing for the users of government health facilities in Tanzania: The case study of Dar es Salaam city municipal hospitals. Masters thesis, The Open University of Tanzania.

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Abstract

This research describes the factors associated with the cost sharing system in government health facilities. Cost sharing has been in operation in Tanzania since 1993. studies from Tanzania and other African countries show that free services offered were not of good quality (Mwabu and Wang'ombe, 1995; MoH, 1994; Stanton and Clemence, 1989; The aim of introducing cost sharing in Tanzania aimed at improving quality of health services and reduce the government budget for the health sector, to improve equity and accessibility to health care services also to promote the efficient use of public health care facilities (MoH, 1994). Studies done in some countries like Kenya, Guinea, Ecuador, Indonesia including Tanzania found some constrain on the effective implementation of cost sharing these include; poor design of the cost sharing system, inadequate capacity for implementation and financial management of the cost sharing system, weak supporting system like inadequate drug supply systems, poor management information systems, lack of supervision and the contextual constraints like public lack of experience in paying for services and political constraints. Most of these factors have affected the improvement of the quality of health care services (Gilson, 1997). The general objective of this study is the assessment of the factors associated with cost sharing on the users of the government health facilities. The study was carried out in Dar es Salaam City Council by incorporating the three Municipal Council Hospitals. The study population of this study was the users of the Dar es salaam City Council Municipal Hospitals. Mwananyamala hospital, Amana Hospital and. Temeke Hospital were included in the study from Kinondoni, Ilala and Temeke Municipal council respectively. Study type was a cross-sectional. Data collection was done through qualitative and quantitative techniques, adopting structured and semistructured interview approach. The study sampled patients at the exit of the health facilities, and staffs of the health facilities. The study gives recommendations on areas of improvement such as; informing community and health workers the amount of money received and its expenditure, the health workers should be motivated by giving them incentives and a better referral system be improved to prevent overcrowding of patients at the hospitals.

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