Public-Private Partnership Supported Health Facilities and Progress towards Attainment of Universal Health Coverage in Kilimanjaro, Tanzania

Abstract

Background 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. Methods 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. Results 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. Conclusion 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.