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Pay for Performance in Maternal Health in Tanzania: Perceptions, Expectations and Experiences in Mvomero district

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dc.contributor.author Chimhutu, Victor
dc.date.accessioned 2011-12-19T12:43:31Z
dc.date.available 2011-12-19T12:43:31Z
dc.date.issued 2011-05-30
dc.date.submitted 2011-05-30 en
dc.identifier.uri http://hdl.handle.net/1956/5311
dc.description.abstract In 2008, Tanzania was one of the 11 countries responsible for 65% of all maternal deaths in the world. The Ministry of Health and Social Welfare of Tanzania in 2008 acknowledged lack of commendable progress in reducing maternal deaths. At the heart of the lack of progress are challenges in human resources for health, including poor motivation among health workers. In 2009, the Government of Tanzania decided to introduce P4P in mother, newborn and child health (MNCH), in order to bring down the MMR and accelerate progress towards Millennium Development Goals 5&4 addressing mother and child health. Pay for performance links incentives with performance and assumes that better health worker performance improves acceptability, utilisation and quality of health services. The study explores how service provision and the use of incentives in maternal health is perceived by health practitioners and community members The study was carried out in Mvomero district in Tanzania, at 5 health facilities. The study's approach was qualitative. Twelve in-depth interviews were conducted with health workers and 3 focus group discussions were also conducted with community members. A number of perceived barriers to the access of health services were reported. The barriers existed on both the provider and the user side. By and large, provider side factors seemed to play a major role in the low-utilisation of health services and of these, supply shortages were the mostly cited impediment to the provision of health services. Health workers reported dissatisfaction and demotivation with the current working conditions citing mainly the perceived unfair remuneration system and supply shortages as major factors. Mixed views to the use of incentives in health care were reported. There were some concerns that P4P might undermine the quality of health services by promoting unethical behaviours such cheating, emphasis on quantity against quality or prioritisation of rewarded services. On the other hand P4P was perceived to have the potential of increasing health worker motivation, cooperation and teamwork at facility level. The study concluded that in view of health workers and community members' perceptions and experiences related to incentives and service provision, steps should be taken to ensure that the conditions for successful implementation should be in place before the P4P programme is scaled up. This involves ensuring the availability of basic equipments, staff and routines at facility level. en
dc.format.extent 1630479 bytes en
dc.format.mimetype application/pdf en
dc.language.iso eng en
dc.publisher The University of Bergen en
dc.rights Copyright the author. All rights reserved en
dc.title Pay for Performance in Maternal Health in Tanzania: Perceptions, Expectations and Experiences in Mvomero district en
dc.type Master thesis en
dc.type.degree Master i Master of Philosophy in Gender and Development en
dc.type.course GAD350 en
dc.subject.nsi VDP::Social science: 200::Women's and gender studies: 370 en
dc.rightsHolder The author en
dc.subject.archivecode Mastergrad en
dc.subject.nus 739999 en
dc.type.program MAPS-GAD en


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