Factors influencing implementation of the community health fund in tanzania
Factors influencing implementation of the community health fund in tanzania
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DOI：
10.1093/heapol/czm001
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发表时间：
2007-03-01
影响因子：
3.2
通讯作者：
Gilson, Lucy
中科院分区：
文献类型：
--
作者：
Kamuzora, Peter;Gilson, Lucy
尽管预付款计划在国际上被誉为解决低收入国家医疗保健融资问题的一部分，但文献也提出了此类计划的问题。本文报告了一项研究的结果，该研究调查了影响坦桑尼亚健康预付计划（社区健康基金）入学率低的因素。该论文认为，地区管理者对解释入学率低的因素有直接影响，并在其他研究中发现（无法支付会员费、护理质量低、对计划管理者缺乏信任以及未能理解投保的理由）。反过来，地区经理的行为似乎至少部分是对该政策实施方式的回应。为了更好地实现预付计划的目标，重要的是要关注政策实施者，他们有能力在政策实施过程中重塑政策，并对政策结果产生影响。
Although prepayment schemes are being hailed internationally as part of a solution to health care financing problems in low-income countries, literature has raised problems with such schemes. This paper reports the findings of a study that examined the factors influencing low enrolment in Tanzania's health prepayment schemes (Community Health Fund). The paper argues that district managers had a direct influence over the factors explaining low enrolment and identified in other studies (inability to pay membership contributions, low quality of care, lack of trust in scheme managers and failure to see the rationale to insure). District managers' actions appeared, in turn, to be at least partly a response to the manner of this policy's implementation. In order better to achieve the objectives of prepayment schemes, it is important to focus attention on policy implementers, who are capable of re-shaping policy during its implementation, with consequences for policy outcomes.