Assessment of public–private partnership policyimplementation in Tanzania: a case study of Ilula designated district hospital

The purpose of this study was to assess how Public-Private Partnership Policy (PPP) has been implemented in Ilula Designated District Hospital (DDH). Specifically, the study sought to explore implementers’ understanding of the PPP policy, find out how PPP policy has been implemented through the DDH model and the challenges encountered. The study employed both the qualitative and quantitative approach under descriptive research design guide in data collection and analysis. The study used a total of 63 respondents in the categories including health practitioners and key informants. The study used interviews guide, questionnaires, focus group discussions and document review as tools for data collection. The study has revealed that implementers at Ilula designated hospital understand PPP policy objectives and its main elements partially. It was further revealed that PPP policy was not disseminated to all key implementers and stakeholders and, above all, no capacity training and orientation was provided at the outset of the project. The findings further show that the policy has been implemented based on a Memorandum of Understanding (MoU), Comprehensive Council Health Planning Guideline (CCHP), and instructions given by the district and the Ministry of Health and Social Welfare (MoHSW).Results also show that somehow all parties fulfill their duties and responsibilities. And that the government paid all the salaries of qualified workers and other charges such as financial resources while the church provided buildings. Additionally, insufficient funds to support effective policy implementation, delay and lack of drugs and medical supplies from the Medical Store Department (MSD) and the absence of a PPP focal person to spearhead all PPP intervention at the district/council were the major challenges faced by Ilula DDH in executing PPP policy. The study concludes that, despite of the challenges and shortfalls observed, Ilula DDH has achieved major PPP policy implementation goals and objectives by providing several health care services to special groups (children below five years, pregnant women, and those above sixty years) free. The study recommends that the government through MOHSW should disseminate widely the PPP Policy and guidelines to the Local Government Authority’s (LGA’s) and the DDH in order to fully understand the policy and implement the policy effectively. It should conduct special targeted seminars and training on PPP involving implementers both at the district and facility level. The government, through the MOHSW, should employ a PPP focal person to oversee PPP policy implementation i.e. provide guidelines and sensitize/advocate for policy implementation, conduct special skills building training/seminars/workshops, and provide clear guidance on roles and responsibilities of the focal person.