A Dissertation Submitted in Partial Fulfillment of the Requirements for Award of the Degree of Master of Accounting and Finance (MSc A&F) of Mzumbe University
The study investigated factors causing low revenue collection from health service cost sharing in municipal councils in Tanzania. Kinondoni Municipal Council in Dar es Salaam was taken as the case study. The study population involved patients from different health service provision points which are operated by Kinondoni Municipal council. The health service provision points include hospitals, health centre and dispensaries. The locus population for this study was Mwananyamala and Sinza hospitals, Magomeni heatlth centre and Kimara and Mbezi dispensaries. The study sample constituted 141 patients which were obtained through purposive and convenience sampling design. Data were collected using questionnaires, interviews and observation. Secondary data was collected using documentary sources. The study findings reveals that common factors for low revenue collections through cost sharing are: lack of adequate sensitization of people on the importance of cost sharing in health service provision, fraud done by council employees and recruitment of personnel to carry out the task of revenue collections who are not professional accountants. Other factors include low income among citizens, poor control systems within the council and the act of employees entrusted with running of the programme to waive cost sharing charges for some people who are not eligible for the same. The study concluded that the perceptions of patients towards cost – sharing is positive, it is further concluded that various factors contribute towards low collections of revenue through cost sharing. The study recommends that deliberate efforts be taken to rectify the situation by setting aside adequate resources for sensitization campaign progrmmes, recruiting the right personnel to carry out the collection task, improve control systems to curb fraud, abstain waives. Should the above recommendation be taken on board, revenue collections from health service provision cost sharing will increase.