On 5 July 2007, the World Bank Board of Executive Directors approved an additional International Development Association (IDA) credit of US$60 million for the Government of Tanzania to support the second phase of the Health Sector Development Project. The additional funds will support Tanzania’s Second Health Sector Strategic Plan (HSSP) for an additional two years: 2007-2009. Through this project there will be increased funds for more efficient delivery of essential health services and staffing at district level.
Resource allocation and health financing
Tanzania: World Bank approves additional funds for health development
Shalita S, Maro-Mzobora I: The World Bank, 5 July 2007
Tanzanian MPs Call for Universal Health Insurance
Tanzania Daily News: 10 May 2013
Members of Parliament have called for health insurance coverage for all Tanzanians, noting that the government should find ways of making the National Health Insurance Fund (NHIF) accessible to every Tanzanian, regardless of whether they are in the formal sector or not. Debating budget estimates for the Ministry of Health and Social Welfare, the legislators decried weaknesses in the current distribution system of drugs and medical equipment and the scarcity of health workers, and claimed that enrolling all people in the NHIF would support wider access to quality health services, particularly for mothers and children.
Tanzanian Prime Minister calls on regional leaders to increase health spending to 15% of national budgets
The Partnership for Maternal, Newborn and Child Health: 17 April 2007
More than 300 delegates gathered at the first-ever assembly of The Partnership for Maternal, Newborn and Child Health. Hosted by the Government of Tanzania, the Partner's Forum (17-20 April 2007) declared that action is urgently required, if high rates of unjust deaths of mothers, babies and children in poor countries are to be reversed.
Taskforce report calls on G8 to support its recommendations on innovative financing
Taskforce on Innovative International Financing for Health Systems: 2009
The Taskforce's proposals aim to meet a US$10 billion funding gap through a number of means including the expansion of a mandatory solidarity levy on airline tickets, the increased use of the International Financing Facility for Immunisation and the strengthening in capacity of government in their health sector. Following the success of a series of meetings and consultations in Doha, London, Johannesburg, Abuja and Paris over the past seven months the Taskforce has finalised its recommendations on innovative international financing for health systems, which it calls on the participants of the G8 summit to support. The intention is spur world leaders on to strengthen the urgency for a combined effort to tackle the issue of providing adequate health systems for developing countries and increase vital aid flows. Strong political backing for each of the initiatives recommended is critically important. Successful implementation of these recommendations requires purposeful engagement with civil society, both in donor countries and recipient countries.
Taskforce Working Group 1 Technical Report: Constraints to scaling up and costs
Taskforce on Innovative International Financing for Health Systems, 5 June 2009
This report calculates that, if financial commitments are met, there is on average, across all countries, no financing gap in 2015. However, donors and recipient governments are currently far from delivering on agreed targets, and the economic recession is making this more difficult. If current relationships of health spending to GDP remain unchanged, the financing gap is will be US$28–37 billion in 2015. If commitments are met, for sub-Saharan Africa (SSA), there will be a funding gap of US$3–5 billion. In the no-change scenario, the funding gap for SSA is predicted by 2015 is US$26–24 billion. Financing arrangements must ensure sustainable and equitable domestic financing structures, predictable external finance, improved risk pooling over time, and effective purchasing of priority services. Service delivery arrangements should reflect the most cost-effective ways of providing services that are accessible, responsive to users, and equitable, taking advantage of both public and private providers where appropriate.
Taskforce Working Group 2 Technical Report: Raising and channeling funds
Taskforce on Innovative International Financing for Health Systems, 3 June 2009
Depending on decisions taken by politicians and parliamentarians, a large part of the additional US$36–45 billion needed in 2015 could be available in an entirely predictable and sustained manner. Most of the gap will need to be filled by domestic resources contributed by national governments and citizens. But even if governments in low-income countries give more priority to health, they will still be unable to meet the required costs of scaling up health systems and providing free essential health services. If low-income countries are to reach the health millennium development goals, international funding will have to complement domestic health resources. Development partners are strongly urged to fulfil the commitments they have already made. Innovative development finance is the way forward, with non-traditional applications of official development assistance (ODA), joint public-private (or private) mechanisms and flows that support fund-raising, engage partners as stakeholders and deliver financial solutions to development problems on the ground.
Tax Experiments in Developing Countries: A Critical Review and Reflections on Feasibility
Mascagni G: CDI Practice Paper 11, March 2015
This CDI Practice Paper provides a critical assessment of the literature on tax experiments to date. It examines the main conceptual, methodological and data-related challenges, and provides practical reflections on how to move forward in low- and middle-income countries where this type of research is still underdeveloped. It offers a guide for practitioners on the main challenges in quantitative research on tax compliance and on the methods used tackle them, which may be of interest for evaluation research more generally.
Tax us if you can: Why Africa should stand up for tax justice
Tax Justice Network, January 2011
Bad governance and the persistence of tax avoidance allow billions of dollars of profit to be siphoned out of Africa, untaxed, every year, according to this report. For the past 25 years, tax revenues in most African countries have missed even the low target of 15% of gross domestic product, far less than rich countries’ average of 35%. Tax Justice Network (TJN) notes that 80% of Africa’s exports consist of primary commodities and, while African governments depend heavily on the resource rents from these commodities, many commodities are exempt from taxation. Multinational companies operating in African economies, including those of least-developed countries, are granted massive tax exemptions by under-resourced, inept or corrupt tax officials, according to TJN, and they enjoy tax holidays and deferments, extremely low royalty payments and cheap access to natural resources. For example, estimates in the report indicate that Kenya’s government only manages to collect 35% of the corporate income tax required by national law. The cumulative stock of illicit financial flows from Africa is estimated at US$854 billion between 1970 and 2008, or more than US$30 billion each year. Because borders are one of the few effective tax collection points, tariffs are rigorously enforced, which holds back regional economic integration, TJN argues. TJN argues further that some African countries have become tax havens for corporations exporting resources, including mineral resources, from the region.
Taxing the ill - How user fees are blocking universal health coverage
Médecins Sans Frontières: Belgium, December 2017
Direct payments by patients at the point of health care delivery, commonly known as user fees, lead to low utilisation of or exclusion from available health care services and impoverish households. Vulnerable groups are particularly affected. Over the past decade, many countries transitioned away from their user fee policies in favour of health care free at point of care for all or for specific population groups, such as pregnant women, children, and people with certain illnesses. Médecins Sans Frontières teams report in this paper witnessing evidence which starkly contrasts the discourse around UHC. Instead of improved access to care, they report a trend towards the reintroduction of user fees and other direct payments within national health financing strategies. They also report a lack of commitment and support to implement free care policies that secure access and sufficient coverage for the population’s health needs. The authors argue that if the global health community is serious about making UHC a reality and ‘leave no one behind’, removal of user fees for essential medicines and services must be tackled as a priority.
Technical efficiency of district hospitals: Evidence from Namibia using Data Envelopment Analysis
Zere E, Mbeeli T, Shangula K, Mandlhate C, Mutirua K, Tjivambi B and Kapenambili W: Cost Effectiveness and Resource Allocation 2006, 4:5
In most countries of the sub-Saharan Africa, health care needs have been increasing due to emerging and re-emerging health problems. However, the supply of health care resources to address the problems has been continuously declining, thus jeopardizing the progress towards achieving the health-related Millennium Development Goals. Namibia is no exception to this. It is therefore necessary to quantify the level of technical inefficiency in the countries so as to alert policy makers of the potential resource gains to the health system if the hospitals that absorb a lion's share of the available resources are technically efficient.