Location of Private Health Care Facilities in RApidly Urbanising Cities. The case of Peri-Urban Areas in Dar es Salaam, Tanzania

Licentiatavhandling, 2011

For a long time, provisioning of health care facilities in Tanzania has been based on a threshold population and hierarchy of administrative units. Access to health care facilities is very low particularly within informal settlements in peri-urban areas. Focusing on the case of Charambe and Chamazi Administrative Wards in Dar es Salaam city, the study analyses the location of private health care facilities in the context of rapid urbanisation. Theories which illuminate research questions include neo-liberal planning theory, sustainable urban form theory, interest based theory and central place theory. The study has found that provisioning of health care facilities based on the hierarchy of administrative units is not successful due to the oversight of the variation that exists among administrative wards as results of rapid urbanisation. Moreover, locational preferences of private health care facilities are not clearly analysed and integrated into the overall spatial organisation of the health care system. There are limitations of the private health care providers in investing in health care facilities of higher order and locating health care facilities based on population size and distribution. Therefore, spatial disparities of health care facilities’ distribution are due to an inability of the Government to regulate spatial location of private health care facilities; it has also failed to adequately locate public health care facilities in less accessible areas including peri-urban area. The paper concludes that location and distribution of health care facilities in rapid urbanising contexts should respond to population dynamics, nature of city growth and infrastructure in general. One of the key challenges is how to promote active participation of the private sector in addressing spatial location and distribution of health care facilities. Key words: Location, health care facilities, administrative units, privatisation, accessibility, motivations, equity, population dynamics and hierarchy.