Browsing by Author "Bakari, Aisha Idd"

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    Health care delivery in tanzania: assessment of the implementation of waiver fee policy among elderly people in Bagamoyo district, Tanzania
    (University of Dar es Salaam, 2012) Bakari, Aisha Idd
    Tanzania, like other African countries, has been implementing user fee policy in its health sector since 1990s. Accompanying user fee, mechanisms were designed that exempted the elderly from paying user charges. While studies on the implementation of exemption policies in Tanzania exist, to the best of our knowledge, no study has systematically documented the implementation of waiver fee policy for elderly. Drawing from the implementation theories, the study documents the implementation of the waiver policy for elderly people in Bagamoyo district in Tanzania. Specifically, the study assesses processes, awareness, attitudes and challenges of implementing waiver policy in the area. Semi-structured interviews were conducted with the local government leaders, health workers and the knowledgeable elderly people. Purposive and snow bow sampling techniques were used to select the respondents. The result indicates that despite long period of the implementation of the waiver policy majority of the elderly people in Bagamoyo district were not aware of the policy. Also, some waivers were granted to people other than the targeted elderly groups. In addition, lack of clear guidelines, fear of loss of revenues by health workers, and weak enforcement mechanisms made policy implementers at the facility and village levels to implement the waiver policy in their own way. In order to better achieve the policy objectives, there must be simple guidelines that are clearly communicated to health care providers, village leaders, and beneficiaries. Resources must be dedicated for educating the beneficiaries, village leaders and health staff on the waiver policies. Furthermore, it is important to recognize policy implementers as active participants who are capable of changing the way a policy is implemented and in the process even redefine the objectives of the policy.