Kimario Kanti, Kayunze Kim, Muhanga Mikidadi
Department of Development and Strategic Studies, College of Social Science and Humanities, Sokoine University of Agriculture, Morogoro, Tanzania, United Republic of.
Community Development and Gender, Moshi Co-operative University, Moshi, Kilimanjaro, Tanzania, United Republic of.
Rwanda J Med Health Sci. 2022 Jun 8;5(2):216-232. doi: 10.4314/rjmhs.v5i2.10. eCollection 2022 Jun.
Public-Private-Partnership-supported health facilities have been operational in Tanzania, and specifically, in Kilimanjaro since 1990s. This study provides a snapshot of the contribution of PPP-supported health facilities' operations towards attainment of Universal Health Coverage (UHC) in Kilimanjaro region.
Adopting a cross-sectional research design, samples of 384 households and 30 health facilities were selected through a multi-stage and purposive sampling approaches, respectively. Questionnaires and key informant interviews (KIIs) were administered (June 2020 - February 2021). Using IBM-SPSS v.23, chi-square was used to compare PPP-supported and government health facilities' service delivery quality and affordability. Content analysis was done on KIIs.
With PPP-support unweighted mean index score for service availability (SA) was 46.59% and 29.14% without PPP-supported health facilities. With PPP-support, the GSR index score was 87% while it was 82% without PPP-support. This implies, with PPP-support, progress towards UHC attainment can be accelerated. There was no significant association between accessing services in PPP-supported or government health facilities by perceived service delivery quality and service affordability.
PPP-supported and government health facilities co-existence is essential at hastening the progress towards UHC in the study area. The government should strengthen policies and regulations to promote more PPPs in improving health facilities' operations.
自20世纪90年代以来，公私伙伴关系支持的卫生设施在坦桑尼亚投入运营，特别是在乞力马扎罗地区。本研究简要介绍了公私伙伴关系支持的卫生设施运营对乞力马扎罗地区实现全民健康覆盖（UHC）的贡献。
采用横断面研究设计，分别通过多阶段抽样和目的抽样方法选取了384户家庭和30个卫生设施作为样本。于2020年6月至2021年2月期间进行问卷调查和关键信息人访谈（KIIs）。使用IBM-SPSS v.23软件，采用卡方检验比较公私伙伴关系支持的卫生设施和政府卫生设施的服务提供质量和可负担性。对关键信息人访谈进行了内容分析。
在公私伙伴关系的支持下，服务可及性（SA）的未加权平均指数得分在有公私伙伴关系支持的卫生设施中为46.59%，在没有公私伙伴关系支持的卫生设施中为29.14%。在公私伙伴关系的支持下，GSR指数得分是87%，而在没有公私伙伴关系支持的情况下为82%。这意味着，在公私伙伴关系的支持下，可以加快实现全民健康覆盖的进程。在公私伙伴关系支持的或政府卫生设施中获取服务，与感知的服务提供质量和服务可负担性之间没有显著关联。
公私伙伴关系支持的卫生设施与政府卫生设施并存对于加快研究地区实现全民健康覆盖的进程至关重要。政府应加强政策和法规，以促进更多公私伙伴关系来改善卫生设施的运营。
