Resource allocation for health in Tanzania - determinants and development implications

The optimal allocation of scarce resources for health improvement is a crucial factor to lower the burden of disease and to strengthen the productive capacities of people living in developing countries. This research project aims to devise tools in narrowing the gap between the actual allocation and a more efficient allocation of resources for health in the case of Tanzania. Firstly, the returns from alternative government spending across sectors such as agriculture, water etc. are analysed. Maximisation of the amount of Disability Adjusted Life Years (DALYs) averted per dollar invested is used as criteria. A Simultaneous Equation Model (SEM) is developed to estimate the required elasticities. The results of the quantitative analysis show that the highest returns on DALYs are obtained by investments in improved nutrition and access to safe water sources, followed by spending on sanitation. Secondly, focusing on the health sector itself, scarce resources for health improvement create the incentive to prioritise certain health interventions. Using the example of malaria, the objective of the second stage is to evaluate whether interventions are prioritized in such a way that the marginal dollar goes to where it has the highest effect on averting DALYs. PopMod, a longitudinal population model, is used to estimate the cost-effectiveness of six isolated and combined malaria intervention approaches. The results of the longitudinal population model show that preventive interventions such as insecticide–treated bed nets (ITNs) and intermittent presumptive treatment with Sulphadoxine-Pyrimethamine (SP) during pregnancy had the highest health returns (both US$ 41 per DALY averted).