Challenges in health service delivery under public-private partnership in Tanzania:  Stakeholders’ views from Dar es Salaam Region

Abstract

Background: Public-private partnership in the health sector was introduced to improve the delivery of health services in Tanzania. Contrary, the anticipated outcomes have not been fully realised. This study aimed at investigating challenges encountered in the implementation of public-private partnership institutional arrangements in health service delivery in Kinondoni Municipality, Dar es Salaam, Tanzania.Methods: A qualitative case study design was used, where in-depth interviews with stakeholders were held and document reviews conducted. Fourteen (n=14) participants engaged in this study. Eight (n=8) and six (n=6) of the fourteen participants were from the public and private sector respectively. Thematic approach was used to analyse data and ethical principles were upheld in the research process.Results: Findings revealed that although public-private partnerships are hailed for supplementing the government’s efforts in the provision of health services, institutional arrangements for the smooth provision of these services is lacking. Several challenges encumber smooth provision of health services and these include inadequate resources, ineffective monitoring and evaluation, as well as insufficient consultations between partners.Conclusion: Challenges facing institutional arrangements for public-private partnerships may either be influenced by inadequate legal and policy framework, or ineffective implementation practices. Therefore, strengthening of public-private partnerships is recommended to improve implementation mechanisms and practices such as adherence to partnership agreements and compliance to the policies, laws and regulations.