equity implications of health sector user fees in tanzania

Health Sector Reforms: Strategic Plan
The Plan of Work (POW) 1999-2002 provides an overview of the eight strategies for the Health Sector
Reforms. The numbers of the different strategies are relevant for referential purposes in the sense that
under these headings extensive policy documents, reports and studies have been published that
provide in-depth information about the specific elements of the strategies.
Table TP 4: Strategies in Plan of Work (POW) Health Sector Reforms 1999-2002
Strategies Focus of Strategies
Strategy 1 Improve access, quality and efficiency of District Health Services
� Address organisation, management, accountability and financial management
� Address accountability of providers to the councils through the Council Health
Boards
� Address provision of services, referral system, provision of essential clinical and
public health packages of services, inter-sectoral collaboration, provision of essential
medical and non-medical supplies and community involvement
� Address cost-effective health packages
Strategy 2 Reorient Secondary and Tertiary Services
� Address institutional management
� Address linkages with not-for-profit hospitals
� Address privatising some elements of hospital care not contained in the essential
health package
Strategy 3 Improve the capacity of the Central Ministry of Health
� Address key management and administration issues, policy development,
reorganisation of the MOH, integration of vertical programmes
� Address necessary legislation in view of HSR, advocacy for HSR
� Development of effective communication system in implementing health sector
reforms
Strategy 4 Human Resource Development
� Focus on capacity building, formal in-service training and technical assistance
� Reduction of unqualified and unproductive health workers
Strategy 5 Strengthen Central Support Systems
� Address personnel management, drugs and supplies management, management of
medical equipment, management of physical infrastructure, transport management
and communications
� Address liberalisation of drug procurement
Strategy 6 Increase Health Care Financing
� Address financing health care through MOH and Ministry of Local Government
� Address development of alternative cost-effective and sustainable health care
financing, National health insurance, community health funds, donor funding and
development of different options for funding
Strategy 7 Promote Public/Private Mix
� Address development and promotion of private practice participation, contracting out
services, revise legislation and the role of different professional associations
Strategy 8 Redefine Ministry of Health and donor relation ships
� Address donor co-ordination, sector wide approach and review of progress by MOH
and donors in joint funding of health
Source: Danida HSPS II May 1999
Technical Paper 8