Svoboda | Graniru | BBC Russia | Golosameriki | Facebook
IDEAS home Printed from https://ideas.repec.org/a/oup/econjl/v134y2023i657p436-456..html
   My bibliography  Save this article

Management Practices and Quality of Care: Evidence from the Private Health Care Sector in Tanzania

Author

Listed:
  • Timothy Powell-Jackson
  • Jessica J C King
  • Christina Makungu
  • Matthew Quaife
  • Catherine Goodman

Abstract

We measure the adoption of management practices in over 220 private for-profit and non-profit health facilities in 64 districts across Tanzania and link these data to process quality-of-care metrics, assessed using undercover standardised patients and clinical observations. We find that better managed health facilities are more likely to provide correct treatment in accordance with national treatment guidelines, adhere to a checklist of essential questions and examinations, and comply with infection prevention and control practices. Moving from the 10th to the 90th percentile in the management practice score is associated with a 48% increase in correct treatment. We then leverage a large-scale field experiment of an internationally recognised management support intervention in which health facilities are assessed against comprehensive standards, given an individually tailored quality improvement plan and supported through training and mentoring visits. We find zero to small effects on management scores, suggesting that improving management practices in this setting may be challenging.

Suggested Citation

  • Timothy Powell-Jackson & Jessica J C King & Christina Makungu & Matthew Quaife & Catherine Goodman, 2023. "Management Practices and Quality of Care: Evidence from the Private Health Care Sector in Tanzania," The Economic Journal, Royal Economic Society, vol. 134(657), pages 436-456.
    • Handle: RePEc:oup:econjl:v:134:y:2023:i:657:p:436-456.
    as

    Download full text from publisher

    File URL: http://hdl.handle.net/10.1093/ej/uead075
    Download Restriction: Access to full text is restricted to subscribers.
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Daniela Scur & Raffaella Sadun & John Van Reenen & Renata Lemos & Nicholas Bloom, 2021. "The World Management Survey at 18: lessons and the way forward," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 37(2), pages 231-258.
    2. Sima Berendes & Peter Heywood & Sandy Oliver & Paul Garner, 2011. "Quality of Private and Public Ambulatory Health Care in Low and Middle Income Countries: Systematic Review of Comparative Studies," PLOS Medicine, Public Library of Science, vol. 8(4), pages 1-10, April.
    3. Leonard, Kenneth L. & Masatu, Melkiory C., 2010. "Using the Hawthorne effect to examine the gap between a doctor's best possible practice and actual performance," Journal of Development Economics, Elsevier, vol. 93(2), pages 226-234, November.
    4. Elizabeth H Bradley & Patrick Byam & Rachelle Alpern & Jennifer W Thompson & Abraham Zerihun & Yigeremu Abeb & Leslie A Curry, 2012. "A Systems Approach to Improving Rural Care in Ethiopia," PLOS ONE, Public Library of Science, vol. 7(4), pages 1-7, April.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Renfu Luo & Grant Miller & Scott Rozelle & Sean Sylvia & Marcos Vera-Hernández, 2015. "Can Bureaucrats Really Be Paid Like CEOs? School Administrator Incentives for Anemia Reduction in Rural China," NBER Working Papers 21302, National Bureau of Economic Research, Inc.
    2. Alex Hollingsworth & Krzysztof Karbownik & Melissa A. Thomasson & Anthony Wray, 2024. "The Gift of a Lifetime: The Hospital, Modern Medicine, and Mortality," American Economic Review, American Economic Association, vol. 114(7), pages 2201-2238, July.
    3. Farrukh Iqbal & Aadil Nakhoda, 2024. "Determinants of Management Practices among Manufacturing Firms in Pakistan (Article)," The Pakistan Development Review, Pakistan Institute of Development Economics, vol. 63(1), pages 45-64.
    4. Lannes, Laurence, 2015. "Improving health worker performance: The patient-perspective from a PBF program in Rwanda," Social Science & Medicine, Elsevier, vol. 138(C), pages 1-11.
    5. Yue-Yi Hwa & Clare Leaver, 2021. "Management in education systems," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 37(2), pages 367-391.
    6. Simons, Andrew M. & Beltramo, Theresa & Blalock, Garrick & Levine, David I., 2017. "Using unobtrusive sensors to measure and minimize Hawthorne effects: Evidence from cookstoves," Journal of Environmental Economics and Management, Elsevier, vol. 86(C), pages 68-80.
    7. Nicholas Wilson, 2015. "Can Disease-Specific Funding Harm Health? in the Shadow of HIV/AIDS Service Expansion," Demography, Springer;Population Association of America (PAA), vol. 52(5), pages 1671-1700, October.
    8. Fuhai Hong & Tanjim Hossain & John A. List & Migiwa Tanaka, 2018. "Testing The Theory Of Multitasking: Evidence From A Natural Field Experiment In Chinese Factories," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 59(2), pages 511-536, May.
    9. Jacquelyn Pless, 2022. "To Starve or to Stoke? Understanding Whether Divestment versus Investment Can Steer (Green) Innovation," NBER Chapters, in: Entrepreneurship and Innovation Policy and the Economy, volume 2, pages 107-147, National Bureau of Economic Research, Inc.
    10. Klockmann, Victor & von Schenk, Alicia & von Siemens, Ferdinand A., 2021. "Division of labor and the organization of knowledge in production: A laboratory experiment," Games and Economic Behavior, Elsevier, vol. 130(C), pages 196-210.
    11. Sandra McNally & Luis Schmidt & Anna Valero, 2022. "Do management practices matter in further education?," POID Working Papers 026, Centre for Economic Performance, LSE.
    12. Abate, Gashaw T. & Dereje, Mekdim & Hirvonen, Kalle & Minten, Bart, 2020. "Geography of public service delivery in rural Ethiopia," World Development, Elsevier, vol. 136(C).
    13. Rudy Douven & Minke Remmerswaal & Robin Zoutenbier, 2015. "Do Extrinsically Motivated Mental Health Care Providers Have Better Treatment Outcomes?," CPB Discussion Paper 319.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
    14. Grant Miller & Kimberly Singer Babiarz, 2013. "Pay-for-Performance Incentives in Low- and Middle-Income Country Health Programs," NBER Working Papers 18932, National Bureau of Economic Research, Inc.
    15. Simon SENSALIRE & Dorothy Balaba BYANSI & Zacch AKINYEMI, 2015. "Social Franchising In Context Of Marketing Long-Term And Reversible Contraceptives (Larcs) In Uganda: Analysis Of Pace Social Franchise Model," EcoForum, "Stefan cel Mare" University of Suceava, Romania, Faculty of Economics and Public Administration - Economy, Business Administration and Tourism Department., vol. 4(1), pages 1-6, January.
    16. Anand, Gautam & Atluri, Aishwarya & Crawfurd, Lee & Pugatch, Todd & Sheth, Ketki, 2023. "Improving school management in low and middle income countries: A systematic review," Economics of Education Review, Elsevier, vol. 97(C).
    17. Netsanet Fetene & Erika Linnander & Binyam Fekadu & Hibret Alemu & Halima Omer & Maureen Canavan & Janna Smith & Peter Berman & Elizabeth Bradley, 2016. "The Ethiopian Health Extension Program and Variation in Health Systems Performance: What Matters?," PLOS ONE, Public Library of Science, vol. 11(5), pages 1-19, May.
    18. Leslie A Curry & Patrick Byam & Erika Linnander & Kyeen M Andersson & Yigeremu Abebe & Abraham Zerihun & Jennifer W Thompson & Elizabeth H Bradley, 2013. "Evaluation of the Ethiopian Millennium Rural Initiative: Impact on Mortality and Cost-Effectiveness," PLOS ONE, Public Library of Science, vol. 8(11), pages 1-6, November.
    19. Juliet Mwanga-Amumpaire & Tobias Alfvén & Celestino Obua & Karin Källander & Richard Migisha & Cecilia Stålsby Lundborg & Grace Ndeezi & Joan Nakayaga Kalyango, 2021. "Appropriateness of Care for Common Childhood Infections at Low-Level Private Health Facilities in a Rural District in Western Uganda," IJERPH, MDPI, vol. 18(15), pages 1-16, July.
    20. Sujha Subramanian & Robai Gakunga & Joseph Kibachio & Gladwell Gathecha & Patrick Edwards & Elijah Ogola & Gerald Yonga & Naftali Busakhala & Esther Munyoro & Jeremiah Chakaya & Nancy Ngugi & Nyawira , 2018. "Cost and affordability of non-communicable disease screening, diagnosis and treatment in Kenya: Patient payments in the private and public sectors," PLOS ONE, Public Library of Science, vol. 13(1), pages 1-16, January.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:oup:econjl:v:134:y:2023:i:657:p:436-456.. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Oxford University Press or the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/resssea.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.