The Tanzanian health sector reform

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Periodical article

Title:	The Tanzanian health sector reform
Authors:	Pichette, Pierre Mtasiwa, Deo
Year:	2001
Periodical:	L'Afrique orientale
Pages:	203-274
Language:	English
Geographic term:	Tanzania
Subjects:	health policy public health rural areas
Abstract:	In October 1995, the Ministry of Health in Tanzania developed a Plan of Action for Health Sector Reform (HSR) for the years 1996-1999, which was finally issued in May 1996. The present paper discusses experiences with the implementation of the HSR in Dar-es-Salaam, against the background of the situation of the public health delivery system, and the structural changes that took place as a result of reforms in regional and local government. It considers the vision that lay behind the Plan of Action, its major objectives, its implementation mechanisms as well as its assumptions and risks as identified by the Tanzanian Ministry of Health authorities in 1995-1996, and also looks at the constraints and problems involved. The focus is mainly on HSR implementation in the public sector, but the authors also consider how the public sector fulfilled its mandate to coordinate and supervise the private sector. The authors advocate the replacement of the classical epidemiological approach generally used in the development of health programmes by a more systemic/organizational approach, and discuss this approach in detail in the light of their experience in Dar-es-Salaam. Bibliogr. [ASC Leiden abstract]