Abstract
Background
Access to essential health services is an important aspect of development. Due to the population increase and technological advancement, governments could no longer cater for the services needed. One of the solutions was to involve private sector through Public Private Partnerships (PPPs) in provision of the services. In 2007 Tanzania made a generic Service Agreement (SA) to govern PPPs in health sector. However, since its establishment, less is known on opportunities and challenges of implementing SA in the provision of health services in Tanzania. Therefore, the focus of this study was to assess the opportunities and challenges of implementing SA in Tanzania using a case of SA between the Cardinal Rugambwa Mission Hospital (CRMH) and the Ilala Municipality in Dar es Salaam.
Methods
The study employed a case study design using qualitative method of data collection. Data were collected by using in depth interview guide. Purposive sampling was used to select participants. The sample size was based on the principle of saturation level of the information collected. Data were analyzed using a thematic analysis approach.
Results
The opportunities of implementing SA in CRMH, Ilala Municipality include: the existence of guidelines and policies, Patients receive some health Services free of charges, availability of some services at reduced prices, presence of SA review meetings, good coordination, availability of supervision, training and mentorship opportunities, presence of political support, trust of the hospital by suppliers and trust between government and the hospital. The identified challenges in implementing SA include: - partial fulfillment of financial commitment, inadequacy deployment of HRH to CRMH by government, lack of transport for supervision and donor dependence.
Conclusion
There are a number of available opportunities for partnering between the private sector and the government in the delivery of health services. However, for the PPP to achieve its desired objective of improving access to health services particularly to most vulnerable population such as women and children, there is a need for the two parties (private and public) to address the identified challenges such as partial fulfillment of financial commitment and inadequacy deployment of HRH from the government to the private health facilities as per SA.