Forces and Continuities in the Historical Implementation of Public-Private Partnership in Tanzania Healthcare Services, 1961–2015

The provision of healthcare in Tanzania through public–private partnerships (PPP) has evolved over time. However, the driving forces for its subsequent implementation have not been adequately addressed. This article uses historical accounts to examine driving forces for the implementation of PPP in Tanzanian healthcare service provision. Data was gathered from interviews, archival sources, and secondary sources from five regions implementing PPP through district designated hospitals. Accordingly, the article indicates that while the implementation of PPP in Tanzania dates back to the colonial period, the post-colonial government maintained such arrangements by continuing collaborations with faith-based organizations that managed Mission hospitals. Following the implementation of PPP, mission hospitals were converted into district designated hospitals. It follows then that the introduction and implementation of PPP in Tanzania have been shaped by such forces as colonial legacy, mutual recognition of the need for complementation between the government and respective mission hospitals, and limited government budget for adequate healthcare provision. Furthermore, the Millennium Development Goals and Sustainable Development Goals have addressed specific health targets to be achieved by the Tanzanian government, necessitating additional PPP implementation in districts without government hospitals.