Ministry of Health, Community Development, Gender, Elderly and Children, P.O.Box.743, Dodoma, Tanzania.
Regional Medical Officer, Morogoro Regional Secretariat, P.O.Box 650, Morogoro, Tanzania.
BMC Public Health. 2022 Jan 29;22(1):200. doi: 10.1186/s12889-022-12520-6.
Development Assistance for Health (DAH) represents an important source of health financing in many low and middle-income countries. However, there are few accounts on how priorities funded through DAH are integrated with district health priorities. This study is aimed at understanding the operational challenges of engaging development partners in district health planning in Tanzania.
This explanatory mixed-methods study was conducted in Kinondoni and Bahi districts, representing urban and rural settings of the country. Data collection took place between November and December 2015. The quantitative tools (mapping checklist, district questionnaire and Development partners (DPs) questionnaire) mapped the DPs and their activities and gauged the strength of DP engagement in district health planning. The qualitative tool, a semi-structured in-depth interview guide administered to 20 key informants (the council health planning team members and the development partners) explained the barriers and facilitators of engagement. Descriptive and thematic analysis was utilized for quantitative and qualitative data analysis respectively.
Eighty-six per cent (85%) of the development partners delivering aid in the studied districts were Non-Governmental Organizations. Twenty percent (20%) of the interventions were HIV/AIDS interventions. We found that only four (4) representing 25 % (25%) DPs had an MOU with the District Council, 56 % (56%) had submitted their plans in writing to be integrated into the 2014/15 CCHP. Six (6) representing 38 % (38%) respondents had received at least one document (guidelines, policies and other planning tools) from the district for them to use in developing their organization activity plans. Eighty-seven point 5 % (87.5%) from Bahi had partial or substantial participation, in the planning process while sixty-two point 5 % (62.5%) from Kinondoni had not participated at all (zero participation). The operational challenges to engagements included differences in planning cycles between the government and donors, uncertainties in funding from the prime donors, lack of transparency, limited skills of district planning teams, technical practicalities on planning tools and processes, inadequate knowledge on planning guidelines among DPs and, poor donor coordination at the district level.
We found low engagement of Development Partners in planning. To be resolved are operational challenges related to differences in planning cycles, articulations and communication of local priorities, donor coordination, and technical skills on planning and stakeholder engagement.
在许多中低收入国家，发展援助是卫生筹资的一个重要来源。然而，关于通过发展援助资助的优先事项如何与地区卫生优先事项相结合，却鲜有报道。本研究旨在了解坦桑尼亚让发展伙伴参与地区卫生规划所面临的运营挑战。
本解释性混合方法研究在金多尼和巴希区进行，这两个区代表了该国的城市和农村地区。数据收集于 2015 年 11 月至 12 月之间进行。定量工具（映射清单、地区问卷和发展伙伴问卷）绘制了发展伙伴及其活动的地图，并衡量了发展伙伴参与地区卫生规划的力度。定性工具是对 20 名关键信息提供者（理事会卫生规划团队成员和发展伙伴）进行的半结构化深入访谈指南，解释了参与的障碍和促进因素。分别对定量和定性数据进行描述性和主题分析。
在研究地区提供援助的 86%（85%）的发展伙伴为非政府组织。20%（20%）的干预措施为艾滋病毒/艾滋病干预措施。我们发现，只有 4 个（4 个）代表 25%（25%）的发展伙伴与区理事会签署了谅解备忘录，56%（56%）以书面形式提交了计划，以纳入 2014/15 年 CCHP。6 个（6 个）代表 38%（38%）的受访者收到了区提供的至少一份文件（准则、政策和其他规划工具），供他们用于制定组织活动计划。巴希区有 87.5%（87.5%）的人部分或充分参与了规划过程，而金多尼区有 62.5%（62.5%）的人根本没有参与（零参与）。参与方面的运营挑战包括政府和捐助者之间规划周期的差异、主要捐助者资金的不确定性、缺乏透明度、区规划团队技能有限、规划工具和流程的技术实际问题、捐助者对规划准则的了解不足以及区一级捐助者协调不力。
我们发现发展伙伴参与规划的程度较低。需要解决的是与规划周期、地方优先事项的表达和沟通、捐助者协调以及规划和利益攸关方参与方面的技术技能相关的运营挑战。
