equity implications of health sector user fees in tanzania

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Joint NGOs. 2004. NGO Comments for the 2004 Joint Health Sector Review and Poverty Reduction Strategy Review. Kipp, W., Kamugisha, J., Jacobs, P., Burnham, G. & T. Rubaale. 2001. ‘User fees, health staff incentives, and service utilization in Kabarole District, Uganda’. In: Bulletin of the World Health Organisation 79(1):1032-1037. Kivumbi, G.W. & F. Kintu. 2002. ‘Exemptions and waivers from cost sharing: ineffective safety nets in decentralized districts in Uganda’. In: Health Policy and Planning 17(Suppl 1): 64–71. Koivusalo, M. and E. Ollila. 1997. Making a Healthy World. Agencies, Actors & Policies in International Health. Zed Books Ltd., London. Kremer, M. 2002. Issues Paper ‘Evidence from a Study of Vouchers for Private Schooling in Colombia’. Planned paper for American Economic Review. Kurowski, Ch., e.a. 2003. Human Resources for Health; Requirements and availability in the context of scaling-up priority interventions in low-income countries; case studies from Tanzania and Chad. . Laterveer, L. 2003. Pro-poor Health Policies in Poverty Reduction Strategies: How health research can help understand and address health system challenges for the poor. Paper prepared for the parallel session on Poverty and Health Research at the Global Forum for Health Research, Geneva. Laterveer, L., Niessen, L.W. and S. Yazbeck. 2003. ‘Pro-poor health policies in poverty reduction strategies’. In: Health Policy and Planning 18(2): 138-145. Mackintosh, M. and P. Tibandebage. 2001. The market shaping of capabilities in low income contexts and some implications for social policy: liberalised health care in Tanzania. Paper to be presented at the Conference on Justice and Poverty: Examining Sen’s Capability Approach, Von Hugel Institute, Cambridge, 5-7 June 2001. Mackintosh, M. and P. Tibandebage. 2003. The Market Shaping of Capabilities: Charging, Trust and Abuse in Health Care Transactions. Malale, M.J. 2002. Making Services Work for the Poor People. Modes of Financing: The Tanzanian Experience. Ministry of Education and Culture. Maliyamkono, T.L. and L. Ogbu. 1999. Cost sharing in Health and Education. Eastern and Southern African Universities Research Programme (ESAURP). Mamdani, M. and M. Bangser. 2004. Poor Peoples’ Experiences of Health Services in Tanzania: A Literature Review. Women’s Dignity Project. Mbugua, J.K., Bloom, G. and M. Segall. 1995. Impact of User Charges on Vulnerable Groups: The Case of Kibwezi in Rural Kenya. AMREF and University of Sussex. Mbuji, P.K, Ilomo P.A. and A.L. Nswila. 1996. Implementation of Health Services User Fees in Tanzania: An Evaluation of Progress and Potential Impact. Ministry of Health (Tanzania) Cost Sharing Implementation Unit. Ministry of Finance. 2002. Tanzania Assistance Strategy. Ministry of Health. 1997. Kamati ya Utekelezaji Utaratibu wa Wananchi Kuchangia Huduma za Afya: Mwongozo wa Utekelezaji wa Sera ya Wananchi Kuchangia Gharama za Afya katika Hospitali. Dar es Salaam, Tanzania. Ministry of Health. 1999. Evaluation of Cost Sharing Programme Implementation (Health Services User Fees) in the Public Hospitals in Tanzania. Cost Sharing Programme, Dar es Salaam, Tanzania. Equity Implications of Health Sector User Fees in Tanzania 44
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Page 1 and 2:
C R Y S T A L EQUITY IMPLICATIONS O
Page 3 and 4:
TABLE OF CONTENT ABBREVIATIONS ....
Page 5 and 6: ABBREVIATIONS AIDS Acquired Immune
Page 7 and 8: EXECUTIVE SUMMARY 1. Background Ear
Page 9 and 10: Tanzania has opted for a system of
Page 11 and 12: ACKNOWLEDGEMENT Many resource perso
Page 13 and 14: I INTRODUCTION 1.1 Background to th
Page 15 and 16: II LITERATURE REVIEW 2.1 Introducti
Page 17 and 18: have been highlighted in Technical
Page 19 and 20: met with donor support. After the a
Page 21 and 22: III POVERTY AND HEALTH IN TANZANIA
Page 23 and 24: diseases, (3) reducing malnutrition
Page 25 and 26: VI HEALTH SECTOR STRATEGIES TANZANI
Page 27 and 28: Pro-poor observations Tanzania has
Page 29 and 30: V COST SHARING STRATEGIES TANZANIA
Page 31 and 32: eported income proportion for the h
Page 33 and 34: VI IMPACT OF USER FEES IN TANZANIA
Page 35 and 36: An indication of actual charges and
Page 37 and 38: Table 6.3: Critical observations re
Page 39 and 40: All in all, there is limited eviden
Page 41 and 42: User fee policy Stakeholders mostly
Page 43 and 44: persons suggested to design a polic
Page 45 and 46: eneficiaries such as identity numbe
Page 47 and 48: VII CONCLUSIONS Poverty and health
Page 49 and 50: Importance of the public PHC facili
Page 51 and 52: � In the absence of effective per
Page 53 and 54: LIST OF CONSULTED DOCUMENTS 50 Year
Page 55: Gilson, L. 1997. ‘The Lessons of
Page 59 and 60: Schwerzel, P. 2001. Evaluation Repo
Page 61 and 62: World Bank. 2000. Poverty Reduction
Page 63: TECHNICAL PAPER
Page 66 and 67: 2. Groups with most regressive outc
Page 68 and 69: Although the primary purpose is to
Page 70 and 71: Technical Paper 6
Page 72 and 73: Health Sector Reforms: Strategic Pl
Page 76 and 77: Elements of the Community Health Fu
Page 78 and 79: stems from the rapid increase in de
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 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 and 126:
ANNEX 6 RESOURCE PERSONS Name of Re
Page 127 and 128:
ANNEX 7 ITINERARIES 1. Itinerary Pa
Page 129 and 130:
03-04-2004 � Continued desk study
Page 131:
ANNEX 8 MAP OF TANZANIA Equity Impl
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