Implementation of service agreement under public private partnership at cardinal Rugambwa mission hospital, Ilala municipality, Tanzania

Abstract

ABSTRACT Background: Access to essential health services is an important aspect of development. Due to population increase and technological advancement, governments could no longer cater for services needed. The only solution was to involve Private sector through Public private partnerships (PPPs) in provision of the services. In 2007Tanzania made a generic Service Agreement (SA) to govern PPPs in health sector. However, since its establishment in Tanzania less is known on the implementation of SA in the provision health services. Main Objective: To evaluate the implementation of SA at Cardinal Rugambwa Mission Hospital (CRMH), Ilala Municipality. The study had six specific objectives: to assess the acceptability of Service Agreement, deployment of government Human Resources for Health (HRH)to (CRMH), to assess the government’s financial support to CRMH, to explore the health services provision by CRMH, to assess how government monitors the implementation of SA and to explore other factors affecting the implementation of SA. Methods: The exploratory Cross section study design using qualitative method in data collection was used. Qualitative and quantitative data were collected by using in depth interview guide and documentary review respectively. Data collection was done in July 2019. Purposive sampling was used to select participants. The sample size was based on the principle of saturation level of the information. The thematic analysis was used for qualitative data. Quantitative data was descriptively analyzed using frequencies tables. Results: The acceptance of SA in CRMH, Ilala Municipality is high and done as agreed. However, some challenges were recorded such as:-partial fulfillment of financial commitment, inadequacy deployment of HRH to CRMH by Government. Supportive supervision is mainly used by the government in monitoring of the SA. Other factors affecting implementation of SA in Ilala Municipality are:- existence of guidelines and policies and donor dependency. Conclusion: The implementation of SA between Ilala Municipal Council and CRMH is implemented as agreed, with few challenges affecting implementation of SA. These include: delays of fund and inadequacy deployment of HRH as agreed to CRMH by Government. Recommendations: The government and other stakeholders should find reliable sources of fund for the implementation of SA, reliable means of transportation and adhere to the SA.