Analysis of Pathways to Enhancing Facility Utilization under the Direct Health Facility Financing Reform in Tanzania

Abstract

Abstract Tanzania undertook the Direct Health Facility Financing (DHFF) programme in 2017 to improve health services in various aspects including facility utilization. This study analyzed the impact of expenditure as one factor that influences facility utilization using panel data from the Facility Financial Accounting and Reporting System and District Health Information System 2. The study specifically sought to identify the effect of various categories of expenditure and facility type on utilization. Findings revealed all expenditure items significantly impacted utilization up to given levels. Furthermore, dispensary utilization was lower than utilization at council hospitals. Expenditure on direct inputs had the largest impact on facility utilization, although expenditure on indirect inputs was also important. Given the findings, directing expenditure towards as many expenditures significantly impacts utilization. Furthermore, improving quality and range of services at dispensaries can enhance their utilization. Finally, spending on indirect inputs improves results by complementing direct inputs.