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The objective of the study was to determine the extent to which market orientation (MO) is related to university performance. The study was based on 212 respondents from private and public universities across Tanzania. Market orientation was measured by MKTOR. Structural Equation Model (AMOS 22) and SPSS were deployed for data analysis. Tests for reliability and validity showed that the measures have sound psychometric properties. Two hypotheses were tested and both were supported. This is the first study in Tanzania which is pan territorial drawing its sample from both public as well as private universities, notwithstanding the relatively low representation by private universities. This study is cross sectional. A longitudinal study would have provided a more appropriate explanation on underlying relationships over a period of time. Furthermore, in view of complexity of high education industry, mediating variables would have shaded more light on the relationship between the two constructs under different set of circumstances. Obvious practical implication is that universities should design programs that address wider customer needs which will make them a “go to” universities and in the process increase their reputation. High reputation will attract funding from different sources thereby giving the universities ability to offer scholarships to students. This will lead to increased access to university education and hence help the Government to solve some of social problems. Abstrak dalam Bahasa Indonesia. Tujuan dari penelitian ini adalah untuk mengetahui sejauh mana orientasi pasar (MO) terkait dengan kinerja universitas. Studi ini didasarkan pada 212 responden dari universitas swasta dan negeri di seluruh Tanzania. Orientasi pasar diukur dengan MKTOR. Model Persamaan Struktural (AMOS 22) dan SPSS digunakan untuk analisis data. Uji reliabilitas dan validitas menunjukkan bahwa langkah-langkah tersebut memiliki sifat psikometrik yang baik. Dua hipotesis diuji dan keduanya didukung. Ini adalah studi pertama di Tanzania yang merupakan pan teritorial yang mengambil sampelnya dari universitas negeri maupun swasta, meskipun perwakilan universitas swasta relatif rendah. Penelitian ini bersifat cross sectional. Studi longitudinal akan memberikan penjelasan yang lebih tepat tentang hubungan yang mendasari selama periode waktu tertentu. Selain itu, mengingat kompleksitas industri pendidikan tinggi, variabel mediasi akan lebih memperjelas hubungan antara dua konstruksi dalam keadaan yang berbeda. Implikasi praktis yang jelas adalah bahwa universitas harus merancang program yang menjawab kebutuhan pelanggan yang lebih luas yang akan membuat mereka menjadi universitas “go to” dan dalam proses meningkatkan reputasi mereka. Reputasi tinggi akan menarik pendanaan dari berbagai sumber sehingga memberikan kemampuan universitas untuk menawarkan beasiswa kepada mahasiswa. Hal ini akan mengarah pada peningkatan akses ke pendidikan universitas dan karenanya membantu Pemerintah untuk memecahkan beberapa masalah sosial.

Abstract Background Globally, there is increased advocacy for community-based health insurance (CBHI) schemes. Like other low and middle-income countries (LMICs), Tanzania officially established the Community Health Fund (CHF) in 2001 for rural areas; and Tiba Kwa Kadi (TIKA) for urban population since 2009. This study investigated the implementation of TIKA scheme in urban districts of Tanzania. Methods A descriptive qualitative case study was conducted in four urban districts in Tanzania in 2019. Data were collected using semi-structured interviews, focus group discussions and review of documents. A thematic approach was used to analyse the data. Results While TIKA scheme was important in increasing access to health services for the poor and other disadvantaged groups, it faced many challenges which hindered its performance. The challenges included frequent stock-out of drugs and medical supplies, which frustrated TIKA members and hence contributed to non-renewal of membership. In addition, the scheme was affected by poor collections and management of the revenue collected from TIKA members, limited benefit packages and low awareness of the community. Conclusions Similar to rural-based Community Health Fund, the TIKA scheme faced structural and operational challenges which subsequently resulted into low uptake of the schemes. In order to achieve universal health coverage, the government should consider integrating or merging Community-Based Health Insurance schemes into a single national pool with decentralised arms to win national support while also maintaining local accountability.

Background Decentralisation in the health sector has been promoted in low- and middle-income countries (LMICs) for many years. Inherently, decentralisation grants decision-making space to local level authorities over different functions such as: finance, human resources, service organization, and governance. However, there is paucity of studies which have assessed the actual use of decision-making space by local government officials within the decentralised health system. The objective of this study was to analyse the exercise of decision space across four districts in Tanzania and explore why variations exist amongst them. Methods The study was guided by the decision space framework and relied on interviews and documentary reviews. Interviews were conducted with the national, regional and district level officials; and data were analysed using thematic approach. Results Decentralisation has provided moderate decision space on the Community Health Fund (CHF), accounting for supplies of medicine, motivation of health workers, additional management techniques and rewarding the formally established health committees as a more effective means of community participation and management. While some districts innovated within a moderate range of choice, others were unaware of the range of choices they could utilise. Leadership skills of key district health managers and local government officials as well as horizontal relationships at the district and local levels were the key factors that accounted for the variations in the use of the decision space across districts. Conclusion This study concludes that more horizontal sharing of innovations among districts may contribute to more effective service delivery in the districts that did not have active leadership. Additionally, the innovations applied by the best performing districts should be incorporated in the national guidelines. Furthermore, targeted capacity building activities for the district health managers may improve decision-making abilities and in turn improve health system performance.