Deprivation and the equitable allocation of health care resources to decentralised districts in Tanzania

Type Working Paper
Title Deprivation and the equitable allocation of health care resources to decentralised districts in Tanzania
Publication (Day/Month/Year) 2005
There is growing concern internationally that limited public sector resources for health care should
be allocated equitably. But how can this be done?
Resources can be allocated equitably by using a resource allocation formula that includes
measures of the relative need for health services in individual geographic areas (such as districts)
in a particular country. One indicator of need that is receiving increased attention is deprivation.
This study estimated deprivation levels in each district using data from the 2000 Census.
Deprivation in Tanzania was found to be largely related to three factors:
• the percentage of households without a toilet;
• the percentage of children not enrolled in primary school; and
• the percentage of the population that is illiterate.
There is a marked variation in deprivation between various districts in Tanzania.
Tanzania recently adopted a needs-based formula, which includes a poverty measure, to allocate
resources to districts.
This paper presents an analysis of the allocation of health care resources in Tanzania. It is part of
a series of studies undertaken in different African countries under the auspices of the theme work
on fair financing in the regional network for Equity in Health in east and southern Africa (EQUINET.
More extensive details on needs-based resource allocation formulae, deprivation and the methods
used in these studies can be found in McIntyre et al. (2000), also available on the EQUINET
This paper analyses equity in current resource allocation in Tanzania, and compares these
allocations to equity target allocations, using an index of deprivation. The results revealed that
districts currently receiving relatively high allocations according the current poverty-based formula
would receive slightly lower budgets if the deprivation index was used in the resource allocation
formula. Those with very low allocations would receive slightly more if the deprivation index was
used to guide resource allocation. However, the resource allocation differences between the
poverty-based and deprivation-based formulae were small. This suggests that Tanzania has
already made good progress in addressing equity in resource allocation between districts.

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