In 1993, the World Development Report suggested that directing health care budgets more proportionally toward the local “burden of disease” could significantly lower rates of death and disease. As the original edition of Fixing Health Systems revealed, the TEHIP program provided powerful evidence in support of that hypothesis. In TEHIP’s two Tanzanian test districts, for example, modest funding increases and sweeping organizational changes contributed to decreases in child mortality of more than 40%.
Now, this second edition moves beyond the hopeful story of how TEHIP’s interlocking web of systemic reforms improved the health outlook in Tanzania. With a new epilogue and preface, this updated volume also explores how the TEHIP example has helped create a paradigm shift in Africa and within the global health community.
Don de Savigny, formerly TEHIP Research Manager for IDRC, is now Head of the Health Systems Interventions Research Unit at the Swiss Tropical Institute.
Harun Kasale, formerly TEHIP Project Coordinator, and Conrad Mbuya, formerly TEHIP Research Coordinator, are, respectively, Lead Consultant and Consultant for the National Expansion of TEHIP Tools and the Strengthening of Zonal Health Resource Centres, Ministry of Health and Social Work, Tanzania.
Graham Reid, formerly TEHIP Project Manager, is now Senior Program Specialist at IDRC’s office in Nairobi.