The effects of reforms on management of public hospitals in Tanzania

This thesis has documented the effects of hospital reforms in regional hospital settings. The overall objective was to find out the effects of reforms on management of Public hospitals in Tanzania. The study employed a descriptive qualitative study design using in-depth interviews and focus group discussions to collect primary data from information rich cases that were purposefully sampled from four regional hospitals, Regional Secretariats, Ministry of Health and Social Welfare (MOHSW), Prime Minister’s Office Regional Administration and Local Government (PMORALG) and Donors; and has used document review to collect secondary data. Data have been analysed qualitatively using Qualitative System Research Non-numerical version 6 (QSR N6) Software for qualitative data analysis. The key findings indicate hospital reforms have brought mixed effects to regional hospitals; the old tripartite management of regional hospitals was replaced by team management structures (Hospital Management Teams (HMTs) and Hospital Boards) and there are improvements in hospital management performance. The study further shows that in the process of hospital reforms, no law to reform was enacted; MOHSW has decentralized by centralization of authority to Regional Administrative Secretary and Regional Medical Officer and assumed the implementation of hospital reform policy would go as planned, but was not. The reforms freed regional hospitals from MOHSW bureaucracy but tied them to those of RAS. The study recommends that the hospital reform be reviewed; there should be established a law to guide the reforms, and further devolution of management authority should be brought down to regional HMTs and Hospital Boards.