The efficacy of public- private partnership management in improving quality and accessibility of health care in primary health facilities: the case of Raha Leo primary health facility in urban district Zanzibar

It is generally accepted that, the primary health facilities if well equipped in terms resource both human and financial resource can effectively featuring in the endeavors to improve the health status of the majority of people whom it serves. However, the main question arising out of this optimisms is whether the initiatives employed by the government such as public private partnership management can fulfill the expectation in as sustainable way. The main objective of this study was to investigate effects of the new management partnership in primary health facilities in service delivery by focusing specifically on the two aspects of quality and accessibility using Raha Leo primary health facility that is located at the per-urban district of Zanzibar as case study. To archive the main object, the range of sources with experience of service delivery such as government, private partner, staff and service users were consulted to give their opinion on improvement in the two aspects of quality and accessibility. The findings revealed that, engagement of private partner in the management has largely brought a considerable improvement in service delivery. It specifically lead to increased capital of the facility in improving infrastructures that enables it to effectively respond to the needs of the community members. It also found out that, the charges introduced at the facility in the absence of an effective waiver and exemption system compromises accessibility to health care. Lastly, recommendation have been made on the areas of community involvement capacity building for clinical staff and management as well a on effective ways in administering cost sharing as appropriate measures and/ or mechanisms that could be taken in supporting and improving the performance of primary health facilities in a sustainable way to attain the goal of better for all as stipulated in the national health policy of Zanzibar