A Dissertation Submitted in Partial Fulfillment of the Requirements for the Award of the
Degree of Master of Public Administration of the 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.