Public Private Partnership Project and its Effectiveness in Improving Health Service Delivery in Tanzania: A Case of Temeke Regional Hospital
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Mzumbe University
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A Dissertation Submitted in Partial Fulfilment of the Requirements for Award
of Degree of Master in Public Administration (MPA) of
Mzumbe University
This study investigated the effectiveness of Public-Private Partnership in improving the delivery of health services. Specific objectives were to assess the contribution of PPP arrangements to improving service delivery, evaluate the effectiveness of PPP in enhancing service delivery, and determine the challenges facing the implementation of PPP at Temeke Regional Hospital. Data were collected from 195 respondents including 192 users who filled in a questionnaire and three PPP managers who were interviewed. User respondents were selected conveniently while interviewees were selected purposefully. The analysis was guided by a conceptual framework combining the assumptions of the Game Theory and Normative - Positive Theory. The findings revealed that PPP had contributed significantly to improved service delivery. Overall, 88.6% against 11.4% agreed that PPP had contributed to improved service delivery. However, the proportions differed across selected and assessed aspects of improvement with the highest in the accessibility (76.69%) followed by availability (71.76%), agency and control over service decisions (68.51%), and finally in the reliability of the service (64.05). However, perceptions of improvement declined with a focus on individual attributes of effective PPP arrangements such as access to doctors in the absence of prior appointment. Medicine availability and improved customer care were most associated with PPP arrangements. Despite the improvements, challenges were noted on the power relationship and trust between the government, hospital, and private providers which affect collaboration in setting and implementing planned goals. Among others, the study recommends for a joint strategy for improving the working relationship between the government, hospital management, and private providers. The arrangement will enhance the contribution of private providers in both planning and ensuring strategic investment for improving and sustaining the adequacy of service delivery infrastructure in the hospital. A sector-wide study to establish the milestones in the initiation and implementation of PPP initiatives is recommended.
This study investigated the effectiveness of Public-Private Partnership in improving the delivery of health services. Specific objectives were to assess the contribution of PPP arrangements to improving service delivery, evaluate the effectiveness of PPP in enhancing service delivery, and determine the challenges facing the implementation of PPP at Temeke Regional Hospital. Data were collected from 195 respondents including 192 users who filled in a questionnaire and three PPP managers who were interviewed. User respondents were selected conveniently while interviewees were selected purposefully. The analysis was guided by a conceptual framework combining the assumptions of the Game Theory and Normative - Positive Theory. The findings revealed that PPP had contributed significantly to improved service delivery. Overall, 88.6% against 11.4% agreed that PPP had contributed to improved service delivery. However, the proportions differed across selected and assessed aspects of improvement with the highest in the accessibility (76.69%) followed by availability (71.76%), agency and control over service decisions (68.51%), and finally in the reliability of the service (64.05). However, perceptions of improvement declined with a focus on individual attributes of effective PPP arrangements such as access to doctors in the absence of prior appointment. Medicine availability and improved customer care were most associated with PPP arrangements. Despite the improvements, challenges were noted on the power relationship and trust between the government, hospital, and private providers which affect collaboration in setting and implementing planned goals. Among others, the study recommends for a joint strategy for improving the working relationship between the government, hospital management, and private providers. The arrangement will enhance the contribution of private providers in both planning and ensuring strategic investment for improving and sustaining the adequacy of service delivery infrastructure in the hospital. A sector-wide study to establish the milestones in the initiation and implementation of PPP initiatives is recommended.
Keywords
Public-Private Partnership, delivery of health services