equity implications of health sector user fees in tanzania

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48. Ms. Mfunjo, Hilda � Nurse Midwive St. Theresia Kajunguti Dispensary 49. Mr. Mosha, Leocardia � Client in TADEPA Clinic Bukoba Regional Hospital 50. Mr. Muchunguzi, Ceasar � Social Welfare Officer Bukoba Regional Hospital 51. Mr. Mukakendage � Orphan in PARTAGE VP 15 Bukoba Rural District 52. Ms. Mulisa, Bernadeta � Nurse Officer in TADEPA Clinic Bukoba Regional Hospital 53. Mr. Mushobozi, Yusto � Client in TADEPA Clinic Bukoba Regional Hospital 54. Mr. Mutalemwa, Anthony � Project Coordinator CHAWATA 55. Ms. Mwadasiro, Mariam � Librarian with REPOA 56. Mr. Mwaimu � Planner MOEC 57. Mr. Mwesiga, Medard � Orphan in PARTAGE VP 15 Bukoba Rural District 58. Dr. Njau, Faustine � Head, Health Sector Reform Secretariat, Department of Policy and Planning, Ministry of Health 59. Mr. Nyika, Konde � Person with a disability 60. Mr. Nyamwihura, Elias � Coordinator of Kagera Orphans Trust Fund 61. Mr. Nyamwhihura � Guardian in PARTAGE VP 15 Bukoba Rural District 62. Ms. Okwany, Auma � Lecturer in Rural Development, Environment and Population Studies, Institute of Social Studies, The Netherlands 63. Ms. Omari, Mariam � Client in TADEPA Clinic Bukoba Regional Hospital 64. Mr. Paschal, Petro � Orphan in PARTAGE VP 14 Ruhano Ishozi Bukoba Rural District 65. Mr. Rajabu, Rashid � Client in TADEPA Clinic Bukoba Regional Hospital 66. Mr. Reid, Graham � Tanzania Essential Health Intervention Project 67. Mr. Ruhakingira, Anatoly � Project Coordinator PARTAGE (curative services) 68. Ms. Rugakingira, Gelda � Person with a disability 69. Mr. Rugarabamu, Willibord � Diocesan Health Coordinator, Bukoba Catholic Diocese 70. Mr. Ruhumuliza � Orphan in PARTAGE VP 15 Bukoba Rural District 71. Ms. Rushoke, Elly � Orphan in PARTAGE VP 14 Ruhano Ishozi Bukoba Rural District 72. Sr. Rwakalema, Mecktilda � Nurse Midwife In Charge St. Theresia Kajunguti Dispensary 73. Ms. Rwamahe, Specioza � Resource Person Medecins du Monde 74. Mr. Rwamdeke, Sylidion � Person with a disability 75. Mr. Mike Rowson � Medact, Director 76. Mr. Sagday, Servus � Senior Officer Poverty Eradication Unit Vice President’s Office 77. Dr. Schleimann, Finn � Regional Technical Health Advisor DANIDA 78. Ms. Ellen Verheul � Wemos 79. Ms. Wilberd, Joyce � Matron in VP 14 Ruhano Ishozi Bukoba Rural District Equity Implications of Health Sector User Fees in Tanzania XXIV
ANNEX 7 ITINERARIES 1. Itinerary Patricia Schwerzel Date Itinerary Patricia Schwerzel 03-03-2004 � Preparation for REPOA Assignment 04-03-2004 � Preparation for REPOA Assignment � Communication with REPOA and team of consultants 08-03-2004 � Preparation of Data Matrix 09-03-2004 � Preparation of Data Matrix � Categorizing of available documents 11-03-2004 � Traveling from Bukoba to Dar es Salaam � Meeting with REPOA Coordinator for assignment � Assessment of documents in REPOA library � Meeting with team member to prepare the assignment 12-03-2004 � Meeting with Resource Person in GTZ Office � Meeting with R&AWG to discuss the TOR � Meeting with team member to develop tools for data collection 13-03-2004 � Assessment and selection of documents in REPOA Library � Copying of essential documents 14-03-2004 � Document study � Preparation of debriefing for team of consultants 15-03-2004 � Assessments and selection of documents in REPOA Library � Copying of essential documents � Meeting with resource person R&AWG/Women Dignity Programme 16-03-2004 � Traveling from Dar es Salaam to Bukoba � Meeting with assistant for data collection in Kagera Region 17-03-2004 � Preparation of Inception Report for REPOA � Preparation of Guide for data collection in Dar es Salaam and Kagera � Preparation of Table of Content � Follow-up communication with team of consultants 05-04-2004 � Follow-up with team of consultants � Debriefing with assistant regarding data collection in Kagera � Desk study 06-04-2004 � Meeting with NGO Partage in Bukoba regarding user fee practises � Visit to dispensary in Kajunguti regarding user fee practises � Visit private clinic in Bukoba regarding user fee practises 07-04-2004 � Visit to project areas of NGO Partage in Ishozi and Bwanjai for a FGD with orphans and guardians � Visit to Kashozi Health Center regarding user fee practises 08-04-2004 � Meeting with ELCT resource person regarding user fee practises � Meeting with health workers of NGO TADEPA and HIV positive clients who receive support from TADEPA � Meeting with resource person from ELCT coordinated Community Health Fund � Meeting with HUYAWA resource persons regarding the position/exclusion of street children � Meeting with EDI Research Director regarding findings of CWIQ survey in Kagera 09-04-2004 � Meeting with Social Welfare Officer regarding exemption and waiver practises in Bukoba Regional Hospital � Meeting with assistant regarding findings of data collection in Kagera 13-04-2004 to 19- � Desk study on relevant documents to assess what additional information is 04-2004 required 20-04-2004 � Assessments of documents received by team of consultants and indication of additional information that is required 21-04-2004 to 12- 05-2004 � Preparation, writing and editing of draft report for REPOA 25-04-2004 � Meeting with team member in the Netherlands to discuss draft final report 31-05-2004 to 09- 06-2004 � Preparation, writing and editing of draft report for REPOA Equity Implications of Health Sector User Fees in Tanzania XXV
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C R Y S T A L EQUITY IMPLICATIONS O
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TABLE OF CONTENT ABBREVIATIONS ....
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ABBREVIATIONS AIDS Acquired Immune
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EXECUTIVE SUMMARY 1. Background Ear
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Tanzania has opted for a system of
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ACKNOWLEDGEMENT Many resource perso
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I INTRODUCTION 1.1 Background to th
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II LITERATURE REVIEW 2.1 Introducti
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have been highlighted in Technical
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met with donor support. After the a
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III POVERTY AND HEALTH IN TANZANIA
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diseases, (3) reducing malnutrition
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VI HEALTH SECTOR STRATEGIES TANZANI
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Pro-poor observations Tanzania has
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V COST SHARING STRATEGIES TANZANIA
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eported income proportion for the h
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VI IMPACT OF USER FEES IN TANZANIA
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An indication of actual charges and
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Table 6.3: Critical observations re
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All in all, there is limited eviden
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User fee policy Stakeholders mostly
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persons suggested to design a polic
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eneficiaries such as identity numbe
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VII CONCLUSIONS Poverty and health
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Importance of the public PHC facili
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� In the absence of effective per
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LIST OF CONSULTED DOCUMENTS 50 Year
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Gilson, L. 1997. ‘The Lessons of
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Ministry of Health. 2003. Assessmen
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Schwerzel, P. 2001. Evaluation Repo
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World Bank. 2000. Poverty Reduction
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TECHNICAL PAPER
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2. Groups with most regressive outc
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Although the primary purpose is to
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Technical Paper 6
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Health Sector Reforms: Strategic Pl
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Technical Paper 10
Page 76 and 77: Elements of the Community Health Fu
Page 78 and 79: stems from the rapid increase in de
Page 80 and 81: Technical Paper 16
Page 82 and 83: Type of service Clarifications Refe
Page 84 and 85: Charges in the public and private h
Page 86 and 87: � Implementation of fees at the l
Page 88 and 89: - Enhance the accessibility of serv
Page 90 and 91: Technical Paper 26
Page 92 and 93: Critical factors that hamper access
Page 94 and 95: An exploratory study 11 in Kagera R
Page 96 and 97: Table TP 15 Views of 4 orphans towa
Page 98 and 99: this way the health centre prevents
Page 100 and 101: dispensaries. That is where most of
Page 103 and 104: ANNEX 1 TERMS OF REFERENCE Equity I
Page 105 and 106: � Access to services for the poor
Page 107 and 108: ANNEX 2 DATA MATRIX FOR CATEGORISAT
Page 109 and 110: (These are the key questions in the
Page 111 and 112: ANNEX 3 GUIDELINES FOR DATA COLLECT
Page 113 and 114: � Can you mention negative experi
Page 115 and 116: � Which groups are exempted from
Page 117 and 118: ANNEX 4 TOOL FOR ANALYSIS OF POVERT
Page 119 and 120: c.3 User fees 19. Does the strategy
Page 121 and 122: ANNEX 5 TANZANIA COUNTRY PROFILE 1.
Page 123 and 124: 2. Tanzania Millennium Goals Countr
Page 125: ANNEX 6 RESOURCE PERSONS Name of Re
Page 129 and 130: 03-04-2004 � Continued desk study
Page 131: ANNEX 8 MAP OF TANZANIA Equity Impl
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