Factors Influencing Implementation of the Community Health Fund in Tanzania
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Date
2006
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Abstract
Although prepayment schemes are being hailed internationally as part of a
solution to health care financing problems in low-income countries, literature
has raised problems with such schemes. This paper reports the findings of a
study that examined the factors influencing low enrolment in Tanzania’s health
prepayment schemes (Community Health Fund). The paper argues that district
managers had a direct influence over the factors explaining low enrolment and
identified in other studies (inability to pay membership contributions, low
quality of care, lack of trust in scheme managers and failure to see the rationale
to insure). District managers’ actions appeared, in turn, to be at least partly
a response to the manner of this policy’s implementation. In order better to
achieve the objectives of prepayment schemes, it is important to focus attention
on policy implementers, who are capable of re-shaping policy during
its implementation, with consequences for policy outcomes.
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Keywords
Tanzania, Policy analysis, Prepayment schemes, Implementation, Street-level bureaucrats
Citation
Kamuzora, P. and Gilson, L., 2007. Factors influencing implementation of the Community Health Fund in Tanzania. Health policy and planning, 22(2), pp.95-102.