17 results on '"Mujinja, Phares G. M."'
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2. Beyond “Late Presentation”: Explaining Delayed Cancer Diagnosis in East Africa
- Author
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Cross, Charlotte, primary, Mokua, Sharon, additional, Ngilangwa, Richard, additional, Santos, Cristina, additional, Ngoma, Twalib, additional, and Mujinja, Phares G. M., additional
- Published
- 2024
- Full Text
- View/download PDF
3. Patients’ pathways to cancer care in Tanzania: documenting and addressing social inequalities in reaching a cancer diagnosis
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Makene, Fortunata Songora, Ngilangwa, Richard, Santos, Cristina, Cross, Charlotte, Ngoma, Twalib, Mujinja, Phares G. M., Wuyts, Marc, and Mackintosh, Maureen
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- 2022
- Full Text
- View/download PDF
4. Pharmaceutical Manufacturing Decline in Tanzania: How Possible Is a Turnaround to Growth?
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Tibandebage, Paula, Wangwe, Samuel, Mackintosh, Maureen, Mujinja, Phares G. M., Mackintosh, Maureen, editor, Banda, Geoffrey, editor, Tibandebage, Paula, editor, and Wamae, Watu, editor
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- 2016
- Full Text
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5. NGOs, Consumer Rights and Access to Essential Medicines: Non-Governmental Public Action in a Low-Income Market Context
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Mujinja, Phares G. M., Koivusalo, Meri, Mackintosh, Maureen, Chaudhuri, Sudip, and Howell, Jude, editor
- Published
- 2013
- Full Text
- View/download PDF
6. Additional file 1 of Patients��� pathways to cancer care in Tanzania: documenting and addressing social inequalities in reaching a cancer diagnosis
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Makene, Fortunata Songora, Ngilangwa, Richard, Santos, Cristina, Cross, Charlotte, Ngoma, Twalib, Mujinja, Phares G. M., Wuyts, Marc, and Mackintosh, Maureen
- Subjects
Data_FILES - Abstract
Additional file 1.
- Published
- 2022
- Full Text
- View/download PDF
7. Upgrading under globalization in health-related industries in Tanzania: the case for dynamic industrial deepening.
- Author
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Wangwe, Samuel, Simonetti, Roberto, Tibandebage, Paula, Mackintosh, Maureen, Israel, Caroline, and Mujinja, Phares G. M.
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LOW-income countries ,INDUSTRIAL policy ,GLOBALIZATION ,SUSTAINABLE development ,PRODUCT quality - Abstract
Globalization of markets and production networks has made it progressively harder for low income countries to industrialize. This article addresses a conundrum facing industrial firms and industrial policy in a low-income African country: how to achieve upgrading necessary for sustained competitiveness. Using data from a study of manufacturers of health products in Tanzania, we document the double 'squeeze' on firms' profits exerted by sharp price competition alongside competitive pressure for rising product quality within globalized markets. Drawing on Sutton's model of competing on capabilities, and the sectoral systems of innovation and production framework, we argue that 'dynamic industrial deepening', strengthening domestic inter-firm linkages, is a key requirement for sustainable development of these health industries. We present evidence that sectoral industrial support for the health industries can promote sustainable technological upgrading, and reflect on the challenge of building developmental linkages where external investment to support upgrading is transforming existing business structures. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
8. Upgrading under globalization in health-related industries in Tanzania: the case for dynamic industrial deepening
- Author
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Wangwe, Samuel, primary, Simonetti, Roberto, additional, Tibandebage, Paula, additional, Mackintosh, Maureen, additional, Israel, Caroline, additional, and Mujinja, Phares G. M., additional
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- 2021
- Full Text
- View/download PDF
9. Indian Generics Producers, Access to Essential Medicines and Local Production in Africa: An Argument with Reference to Tanzania
- Author
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Chaudhuri, Sudip, primary, Mackintosh, Maureen, additional, and Mujinja, Phares G M, additional
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- 2010
- Full Text
- View/download PDF
10. Household perceptions towards a redistributive policy across health insurance funds in Tanzania.
- Author
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Chomi, Eunice N., Mujinja, Phares G. M., Hansen, Kristian, Kiwara, Angwara D., and Enemark, Ulrika
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HEALTH insurance , *LOGISTIC regression analysis , *EXCHANGE reactions , *WILLINGNESS to pay - Abstract
Background: The Tanzanian health insurance system comprises multiple health insurance funds targeting different population groups but which operate in parallel, with no mechanisms for redistribution across the funds. Establishing such redistributive mechanisms requires public support, which is grounded on the level of solidarity within the country. The aim of this paper is to analyse the perceptions of CHF, NHIF and non-member households towards cross-subsidisation of the poor as an indication of the level of solidarity and acceptance of redistributive mechanisms. Methods: This study analyses data collected from a survey of 695 households relating to perceptions of household heads towards cross-subsidisation of the poor to enable them to access health services. Kruskal-Wallis test is used to compare perceptions by membership status. Generalized ordinal logistic regression models are used to identify factors associated with support for cross-subsidisation of the poor. Results: Compared to CHF and NHIF households, non-member households expressed the highest support for subsidised CHF membership for the poor. The odds of expressing support for subsidised CHF membership are higher for NHIF households and non-member households, households that are wealthier, whose household heads have lower education levels, and have sick members. The majority of households support a partial rather than fully subsidised CHF membership for the poor and there were no significant differences by membership status. The odds of expressing willingness to contribute towards subsidised CHF membership are higher for households that are wealthier, with young household heads and have confidence in scheme management. Conclusion: The majority may support a redistributive policy, but there are indications that this support and willingness to contribute to its achievement are influenced by the perceived benefits, amount of subsidy considered, and trust in scheme management. These present important issues for consideration when designing redistributive policies. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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11. Health care seeking behaviour and utilisation in a multiple health insurance system: does insurance affiliation matter?
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Nahyuha Chomi, Eunice, Mujinja, Phares G. M., Enemark, Ulrika, Hansen, Kristian, and Kiwara, Angwara Dennis
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MEDICAL care , *ANALYSIS of variance , *COMPARATIVE studies , *DECISION making , *HELP-seeking behavior , *INSURANCE , *MEDICAL care use , *MULTIVARIATE analysis , *RESEARCH funding , *STATISTICS , *TIME , *MULTIPLE regression analysis , *SECONDARY analysis , *PREDICTIVE validity , *CROSS-sectional method , *DESCRIPTIVE statistics - Abstract
Background Many countries striving to achieve universal health insurance coverage have done so by means of multiple health insurance funds covering different population groups. However, existence of multiple health insurance funds may also cause variation in access to health care, due to the differential revenue raising capacities and benefit packages offered by the various funds resulting in inequity and inefficiency within the health system. This paper examines how the existence of multiple health insurance funds affects health care seeking behaviour and utilisation among members of the Community Health Fund, the National Health Insurance Fund and non-members in two districts in Tanzania. Methods Using household survey data collected in 2011 with a sample of 3290 individuals, the study uses a multinomial logit model to examine the influence of predisposing, enabling and need characteristics on the probability of seeking care and choice of provider. Results Generally, health insurance is found to increase the probability of seeking care and reduce delays. However, the probability, timing of seeking care and choice of provider varies across the CHF and NHIF members. Conclusions Reducing fragmentation is necessary to provide opportunities for redistribution and to promote equity in utilisation of health services. Improvement in the delivery of services is crucial for achievement of improved access and financial protection and for increased enrolment into the CHF, which is essential for broadening redistribution and cross-subsidisation to promote equity. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
12. Equity implications of coverage and use of insecticide treated nets distributed for free or with co-payment in two districts in Tanzania: A cross-sectional comparative household survey.
- Author
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Ruhago, George M., Mujinja, Phares G. M., and Norheim, Ole F.
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INSECTICIDE-treated mosquito nets , *SOCIAL marketing , *SOCIOECONOMIC factors , *SURVEYS - Abstract
Background: In Tanzania, the distribution and coverage of insecticide-treated nets (ITNs) is inequitable. Arguments about the most effective and equitable approach to distributing ITNs centre around whether to provide ITNs free of charge or continue with existing social marketing strategies. The Government has decided to provide free ITNs to all children under five in the country. It is still uncertain whether this strategy will achieve equitable coverage and use. This study examined the equity implications of ownership and use of ITNs in households from different socioeconomic quintiles in a district with free ITNs and a district without free ITN distribution. Methods: A cross-sectional comparative household survey was conducted in two districts: Mpanda in Rukwa Region (with free ITN roll out) and Kisarawe in Coast region (without free ITNs). Heads of 314 households were interviewed in Mpanda and Kisarawe. The concentration index was estimated and regression analysis was performed to compare socioeconomic inequalities in ownership and use of ITNs. Results: Ownership of ITNs increased from 29% in the 2007/08 national survey to 90% after the roll out of free ITNs in Mpanda, and use increased from 13% to 77%. Inequality was considerably lower in Mpanda, with nearly perfect equality in use (concentration index 0.009) and ownership (concentration index 0.010). In Kisarawe, ownership of ITNs increased from 48% in the 2007/08 national survey to 53%, with a marked inequality concentration index 0.132. ITN use in Kisarawe district was 42% with a pro rich concentration index of 0.027. Conclusions: The results shed some light on the possibilities of reducing inequality in ownership and use of ITNs and attaining Roll Back Malaria and Millennium Development Goals through the provision of free ITNs to all. This has the potential to decrease the burden of disease and reduce disparity in disease outcome. [ABSTRACT FROM AUTHOR]
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- 2011
- Full Text
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13. Can NGOs regulate medicines markets? Social enterprise in wholesaling, and access to essential medicines.
- Author
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Mackintosh, Maureen, Chaudhuri, Sudip, Mujinja, Phares G. M., and Mujinja, Phares Gm
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NONPROFIT organizations ,PHARMACEUTICAL industry ,WHOLESALE trade ,TRADE regulation ,HEALTH policy - Abstract
Background: Citizens of high income countries rely on highly regulated medicines markets. However low income countries' impoverished populations generally struggle for access to essential medicines through out-of-pocket purchase on poorly regulated markets; results include ill health, drug resistance and further impoverishment. While the role of health facilities owned by non-governmental organisations (NGOs) in low income countries is well documented, national and international wholesaling of essential medicines by NGOs is largely unstudied. This article describes and assesses the activity of NGOs and social enterprise in essential medicines wholesaling.Methods: The article is based on a set of interviews conducted in 2006-8 with trading NGOs and social enterprises operating in Europe, India and Tanzania. The analysis applies socio-legal and economic perspectives on social enterprise and market regulation.Results: Trading NGOs can resist the perverse incentives inherent in medicines wholesaling and improve access to essential medicines; they can also, in definable circumstances, exercise a broader regulatory influence over their markets by influencing the behaviour of competitors. We explore reasons for success and failure of social enterprise in essential medicines wholesaling, including commercial manufacturers' market response; social enterprise traders' own market strategies; and patterns of market advantage, market segmentation and subsidy generated by donors.Conclusions: We conclude that, in the absence of effective governmental activity and regulation, social enterprise wholesaling can improve access to good quality essential medicines. This role should be valued and where appropriate supported in international health policy design. NGO regulatory impact can complement but should not replace state action. [ABSTRACT FROM AUTHOR]- Published
- 2011
- Full Text
- View/download PDF
14. Local production of pharmaceuticals in Africa and access to essential medicines: 'urban bias' in access to imported medicines in Tanzania and its policy implications.
- Author
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Mujinja, Phares Gm, Mackintosh, Maureen, Justin-Temu, Mary, Wuyts, Marc, and Mujinja, Phares G M
- Abstract
Background: International policy towards access to essential medicines in Africa has focused until recently on international procurement of large volumes of medicines, mainly from Indian manufacturers, and their import and distribution. This emphasis is now being challenged by renewed policy interest in the potential benefits of local pharmaceutical production and supply. However, there is a shortage of evidence on the role of locally produced medicines in African markets, and on potential benefits of local production for access to medicines. This article contributes to filling that gap.Methods: This article uses WHO/HAI data from Tanzania for 2006 and 2009 on prices and sources of a set of tracer essential medicines. It employs innovative graphical methods of analysis alongside conventional statistical testing.Results: Medicines produced in Tanzania were equally likely to be found in rural and in urban areas. Imported medicines, especially those imported from countries other than Kenya (mainly from India) displayed 'urban bias': that is, they were significantly more likely to be available in urban than in rural areas. This finding holds across the range of sample medicines studied, and cannot be explained by price differences alone. While different private distribution networks for essential medicines may provide part of the explanation, this cannot explain why the urban bias in availability of imported medicines is also found in the public sector.Conclusions: The findings suggest that enhanced local production may improve rural access to medicines. The potential benefits of local production and scope for their improvement are an important field for further research, and indicate a key policy area in which economic development and health care objectives may reinforce each other. [ABSTRACT FROM AUTHOR]- Published
- 2014
- Full Text
- View/download PDF
15. From papers to practices: district level priority setting processes and criteria for family planning, maternal, newborn and child health interventions in Tanzania.
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Chitama, Dereck, Baltussen, Rob, Ketting, Evert, Kamazima, Switbert, Nswilla, Anna, Mujinja, Phares Gm, and Mujinja, Phares G M
- Abstract
Background: Successful priority setting is increasingly known to be an important aspect in achieving better family planning, maternal, newborn and child health (FMNCH) outcomes in developing countries. However, far too little attention has been paid to capturing and analysing the priority setting processes and criteria for FMNCH at district level. This paper seeks to capture and analyse the priority setting processes and criteria for FMNCH at district level in Tanzania. Specifically, we assess the FMNCH actor's engagement and understanding, the criteria used in decision making and the way criteria are identified, the information or evidence and tools used to prioritize FMNCH interventions at district level in Tanzania.Methods: We conducted an exploratory study mixing both qualitative and quantitative methods to capture and analyse the priority setting for FMNCH at district level, and identify the criteria for priority setting. We purposively sampled the participants to be included in the study. We collected the data using the nominal group technique (NGT), in-depth interviews (IDIs) with key informants and documentary review. We analysed the collected data using both content analysis for qualitative data and correlation analysis for quantitative data.Results: We found a number of shortfalls in the district's priority setting processes and criteria which may lead to inefficient and unfair priority setting decisions in FMNCH. In addition, participants identified the priority setting criteria and established the perceived relative importance of the identified criteria. However, we noted differences exist in judging the relative importance attached to the criteria by different stakeholders in the districts.Conclusions: In Tanzania, FMNCH contents in both general development policies and sector policies are well articulated. However, the current priority setting process for FMNCH at district levels are wanting in several aspects rendering the priority setting process for FMNCH inefficient and unfair (or unsuccessful). To improve district level priority setting process for the FMNCH interventions, we recommend a fundamental revision of the current FMNCH interventions priority setting process. The improvement strategy should utilize rigorous research methods combining both normative and empirical methods to further analyze and correct past problems at the same time use the good practices to improve the current priority setting process for FMNCH interventions. The suggested improvements might give room for efficient and fair (or successful) priority setting process for FMNCH interventions. [ABSTRACT FROM AUTHOR]- Published
- 2011
- Full Text
- View/download PDF
16. Rethinking health sector procurement as developmental linkages in East Africa.
- Author
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Mackintosh M, Tibandebage P, Karimi Njeru M, Kariuki Kungu J, Israel C, and Mujinja PGM
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- Humans, Kenya, Tanzania, Drugs, Essential supply & distribution, Equipment and Supplies supply & distribution, Health Services Accessibility, Private Sector organization & administration, Public Sector organization & administration
- Abstract
Health care forms a large economic sector in all countries, and procurement of medicines and other essential commodities necessarily creates economic linkages between a country's health sector and local and international industrial development. These procurement processes may be positive or negative in their effects on populations' access to appropriate treatment and on local industrial development, yet procurement in low and middle income countries (LMICs) remains under-studied: generally analysed, when addressed at all, as a public sector technical and organisational challenge rather than a social and economic element of health system governance shaping its links to the wider economy. This article uses fieldwork in Tanzania and Kenya in 2012-15 to analyse procurement of essential medicines and supplies as a governance process for the health system and its industrial links, drawing on aspects of global value chain theory. We describe procurement work processes as experienced by front line staff in public, faith-based and private sectors, linking these experiences to wholesale funding sources and purchasing practices, and examining their implications for medicines access and for local industrial development within these East African countries. We show that in a context of poor access to reliable medicines, extensive reliance on private medicines purchase, and increasing globalisation of procurement systems, domestic linkages between health and industrial sectors have been weakened, especially in Tanzania. We argue in consequence for a more developmental perspective on health sector procurement design, including closer policy attention to strengthening vertical and horizontal relational working within local health-industry value chains, in the interests of both wider access to treatment and improved industrial development in Africa., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
17. Health care seeking behaviour and utilisation in a multiple health insurance system: does insurance affiliation matter?
- Author
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Chomi EN, Mujinja PG, Enemark U, Hansen K, and Kiwara AD
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Family Characteristics, Female, Health Care Surveys, Humans, Infant, Male, Middle Aged, Tanzania, Universal Health Insurance, Young Adult, Health Services statistics & numerical data, Health Services Accessibility economics, Healthcare Disparities economics, Insurance, Health, National Health Programs, Patient Acceptance of Health Care, Poverty
- Abstract
Background: Many countries striving to achieve universal health insurance coverage have done so by means of multiple health insurance funds covering different population groups. However, existence of multiple health insurance funds may also cause variation in access to health care, due to the differential revenue raising capacities and benefit packages offered by the various funds resulting in inequity and inefficiency within the health system. This paper examines how the existence of multiple health insurance funds affects health care seeking behaviour and utilisation among members of the Community Health Fund, the National Health Insurance Fund and non-members in two districts in Tanzania., Methods: Using household survey data collected in 2011 with a sample of 3290 individuals, the study uses a multinomial logit model to examine the influence of predisposing, enabling and need characteristics on the probability of seeking care and choice of provider., Results: Generally, health insurance is found to increase the probability of seeking care and reduce delays. However, the probability, timing of seeking care and choice of provider varies across the CHF and NHIF members., Conclusions: Reducing fragmentation is necessary to provide opportunities for redistribution and to promote equity in utilisation of health services. Improvement in the delivery of services is crucial for achievement of improved access and financial protection and for increased enrolment into the CHF, which is essential for broadening redistribution and cross-subsidisation to promote equity.
- Published
- 2014
- Full Text
- View/download PDF
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