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Provision and Access of Health Care Services in the Urban Health Care Market in Tanzania

Kida, T. (2012) Provision and Access of Health Care Services in the Urban Health Care Market in Tanzania. Economic and Social Research Foundation (ESRF). ISBN 978-9987-610-72-3

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Abstract

This article summarizes the findings of a research project that provides evidence of existence of segmentation in provision and access of health care services in the urban health care market in Tanzania. It argues on the basis of field data that segmentation arises from of the influence of demand and supply in the health care market in an environment of widespread poverty. The implication is that segmentation of health care delivery into a two-tier system weakens the whole process of provision and access to health care, especially for the urban poor. It results on one hand to a relatively better quality upper tier of care for those who can afford it and, on the other, a lower tier of inexpensive health care services of generally inadequate and /or doubtful quality mainly to cater for the poor. Furthermore, the evidence in this article provides some support for a model of market segmentation involving two-way causation in which high incidence of poverty interacts with the health care system in a process of cumulative causation. The deregulation and liberalization of the health sector adopted in Tanzania from early 1990‘s has brought about a dramatic shift in the system of health care delivery, from nearly exclusively ‗free‘ public provisioning towards its extensive commercialization that includes the liberalization of private health care provision. The prevalence of commercialized health care, in this sense fee based, requiring out- of- pocket payment in all sectors, in the context of widespread poverty, raises concern about access by the poor to health care services. Therefore, contrary to policy intentions, this article argues that the urban poor frequently find themselves excluded not only from (decent) private health care, but also from access to decent public health care, given the current subsidy structure, its use within an extensively fee-based (commercialized) health system – in both public and private sectors – in the prevalence of widespread poverty.

Item Type: Book
Keywords: Health Care;Health Service Delivery and Access;Health Financing;poverty;Health Seeking Behaviour;Tanzania
Subjects: Health Systems > Service delivery & access
Health Systems > Health financing & economics
Divisions: Other
Depositing User: Mr Joseph Madata
Date Deposited: 05 Feb 2013 08:41
Last Modified: 05 Feb 2013 08:41
URI: http://ihi.eprints.org/id/eprint/1092

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