Implementation of an insecticide-treated net subsidy scheme under a public-private partnership for malaria control in Tanzania - challenges in implementation

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dc.contributor.authorNjau, Rithaen_ZA
dc.contributor.authorde Savigny, Donen_ZA
dc.contributor.authorGilson, Lucyen_ZA
dc.contributor.authorMwageni, Eleutheren_ZA
dc.contributor.authorMosha, Franklinen_ZA
dc.date.accessioned2015-11-04T12:01:14Z
dc.date.available2015-11-04T12:01:14Z
dc.date.issued2009en_ZA
dc.description.abstractBACKGROUND: In the past decade there has been increasing visibility of malaria control efforts at the national and international levels. The factors that have enhanced this scenario are the availability of proven interventions such as artemisinin-based combination therapy, the wide scale use of insecticide-treated nets (ITNs) and a renewed emphasis in indoor residual house-spraying. Concurrently, there has been a window of opportunity of financial commitments from organizations such as the Global Fund for HIV/AIDS, Tuberculosis and Malaria (GFATM), the President's Malaria Initiative and the World Bank Booster programme. METHODS: The case study uses the health policy analysis framework to analyse the implementation of a public-private partnership approach embarked upon by the government of Tanzania in malaria control - 'The Tanzania National Voucher Scheme'- and in this synthesis, emphasis is on the challenges faced by the scheme during the pre-implementation (2001 - 2004) and implementation phases (2004 - 2005). Qualitative research tools used include: document review, interview with key informants, stakeholder's analysis, force-field analysis, time line of events, policy characteristic analysis and focus group discussions. The study is also complemented by a cross-sectional survey, which was conducted at the Rufiji Health Demographic Surveillance Site, where a cohort of women of child-bearing age were followed up regarding access and use of ITNs. RESULTS: The major challenges observed include: the re-introduction of taxes on mosquito nets and related products, procurement and tendering procedures in the implementation of the GFATM, and organizational arrangements and free delivery of mosquito nets through a Presidential initiative. CONCLUSION: The lessons gleaned from this synthesis include: (a) the consistency of the stakeholders with a common vision, was an important strength in overcoming obstacles, (b) senior politicians often steered the policy agenda when the policy in question was a 'crisis event', the stakes and the visibility were high, (c) national stakeholders in policy making have an advantage in strengthening alliances with international organizations, where the latter can become extremely influential in solving bottlenecks as the need arises, and (d) conflict can be turned into an opportunity, for example the Presidential initiative has inadvertently provided Tanzania with important lessons in the organization of 'catch-up' campaigns.en_ZA
dc.identifier.apacitationNjau, R., de Savigny, D., Gilson, L., Mwageni, E., & Mosha, F. (2009). Implementation of an insecticide-treated net subsidy scheme under a public-private partnership for malaria control in Tanzania - challenges in implementation. <i>Malaria Journal</i>, http://hdl.handle.net/11427/14691en_ZA
dc.identifier.chicagocitationNjau, Ritha, Don de Savigny, Lucy Gilson, Eleuther Mwageni, and Franklin Mosha "Implementation of an insecticide-treated net subsidy scheme under a public-private partnership for malaria control in Tanzania - challenges in implementation." <i>Malaria Journal</i> (2009) http://hdl.handle.net/11427/14691en_ZA
dc.identifier.citationNjau, R. J., de Savigny, D., Gilson, L., Mwageni, E., & Mosha, F. W. (2009). Implementation of an insecticide-treated net subsidy scheme under a public-private partnership for malaria control in Tanzania–challenges in implementation. Malar J, 8(1), 201.en_ZA
dc.identifier.ris TY - Journal Article AU - Njau, Ritha AU - de Savigny, Don AU - Gilson, Lucy AU - Mwageni, Eleuther AU - Mosha, Franklin AB - BACKGROUND: In the past decade there has been increasing visibility of malaria control efforts at the national and international levels. The factors that have enhanced this scenario are the availability of proven interventions such as artemisinin-based combination therapy, the wide scale use of insecticide-treated nets (ITNs) and a renewed emphasis in indoor residual house-spraying. Concurrently, there has been a window of opportunity of financial commitments from organizations such as the Global Fund for HIV/AIDS, Tuberculosis and Malaria (GFATM), the President's Malaria Initiative and the World Bank Booster programme. METHODS: The case study uses the health policy analysis framework to analyse the implementation of a public-private partnership approach embarked upon by the government of Tanzania in malaria control - 'The Tanzania National Voucher Scheme'- and in this synthesis, emphasis is on the challenges faced by the scheme during the pre-implementation (2001 - 2004) and implementation phases (2004 - 2005). Qualitative research tools used include: document review, interview with key informants, stakeholder's analysis, force-field analysis, time line of events, policy characteristic analysis and focus group discussions. The study is also complemented by a cross-sectional survey, which was conducted at the Rufiji Health Demographic Surveillance Site, where a cohort of women of child-bearing age were followed up regarding access and use of ITNs. RESULTS: The major challenges observed include: the re-introduction of taxes on mosquito nets and related products, procurement and tendering procedures in the implementation of the GFATM, and organizational arrangements and free delivery of mosquito nets through a Presidential initiative. CONCLUSION: The lessons gleaned from this synthesis include: (a) the consistency of the stakeholders with a common vision, was an important strength in overcoming obstacles, (b) senior politicians often steered the policy agenda when the policy in question was a 'crisis event', the stakes and the visibility were high, (c) national stakeholders in policy making have an advantage in strengthening alliances with international organizations, where the latter can become extremely influential in solving bottlenecks as the need arises, and (d) conflict can be turned into an opportunity, for example the Presidential initiative has inadvertently provided Tanzania with important lessons in the organization of 'catch-up' campaigns. DA - 2009 DB - OpenUCT DO - 10.1186/1475-2875-8-201 DP - University of Cape Town J1 - Malaria Journal LK - https://open.uct.ac.za PB - University of Cape Town PY - 2009 T1 - Implementation of an insecticide-treated net subsidy scheme under a public-private partnership for malaria control in Tanzania - challenges in implementation TI - Implementation of an insecticide-treated net subsidy scheme under a public-private partnership for malaria control in Tanzania - challenges in implementation UR - http://hdl.handle.net/11427/14691 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14691
dc.identifier.urihttp://dx.doi.org/10.1186/1475-2875-8-201
dc.identifier.vancouvercitationNjau R, de Savigny D, Gilson L, Mwageni E, Mosha F. Implementation of an insecticide-treated net subsidy scheme under a public-private partnership for malaria control in Tanzania - challenges in implementation. Malaria Journal. 2009; http://hdl.handle.net/11427/14691.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDepartment of Public Health and Family Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2009 Njau et al; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceMalaria Journalen_ZA
dc.source.urihttp://www.malariajournal.com/en_ZA
dc.subject.otherMalariaen_ZA
dc.subject.otherPreventative strategiesen_ZA
dc.titleImplementation of an insecticide-treated net subsidy scheme under a public-private partnership for malaria control in Tanzania - challenges in implementationen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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