The Open UniversitySkip to content

Inclusion by design? Rethinking health care market regulation in the Tanzanian context

Mackintosh, Maureen and Tibandebage, Paula (2002). Inclusion by design? Rethinking health care market regulation in the Tanzanian context. Journal of Development Studies, 39(1) pp. 1–20.

DOI (Digital Object Identifier) Link:
Google Scholar: Look up in Google Scholar


In Tanzania, as in many other low income countries, health care is largely obtained through out-of pocket payment. The current liberalised health care market displays a pattern of exclusion, impoverishment, abuse and poor quality care alongside substantial patches of accessibility and probity, while the government has few resources for inspection and control. This article summarises new evidence on these points. It argues that it is nevertheless possible in these circumstances to pursue the stated aims of health care reform to improve inclusiveness and quality of care, but that to do so requires a rethinking of the dominant concept of health care market regulation as rule setting, moving instead towards a concept of collaborative regulatory intervention. Drawing on current thinking in economics, institutional theory and the theory of regulation, this article proposes such a regulatory framework of thought, which we label 'inclusion by design', and illustrates it with proposals developed within the Tanzanian context.

Item Type: Journal Item
ISSN: 1743-9140
Keywords: health care; Tanzania; health care reform; health care market regulation
Academic Unit/School: Faculty of Arts and Social Sciences (FASS) > Politics, Philosophy, Economics, Development, Geography
Faculty of Arts and Social Sciences (FASS)
Research Group: Innovation, Knowledge & Development research centre (IKD)
Item ID: 4310
Depositing User: Users 13 not found.
Date Deposited: 06 Jul 2006
Last Modified: 19 Dec 2017 11:10
Share this page:


Altmetrics from Altmetric

Citations from Dimensions

Actions (login may be required)

Policies | Disclaimer

© The Open University   contact the OU