| Summary: | Bibliography: leaves 50-51. === In the late 1980s, many governments in the low-income countries could not fund their health care budgets adequately due to poor availability of fmancial resources. This resulted into deterioration of the public health sectors in general. Inadequacy of consumables and other supplies, and low payment for health workers were among the problems faced. Governments in some of these countries introduced public private mix (PPM) to address these problems. In 1996, the government of Tanzania allowed private practice in public hospitals called 'the fast track' service. This study investigated the organizational and management system of this type of PPM, its impacts and the factors determining people's demand for the fast track service. Data was collected through interviews with health care providers and patients, and document reviews. Systematic and random sampling methods were used to select participants. Data was analysed using STAT A package. The study found that the executive directors of the hospitals headed the fast track management teams, with the executive committees coordinated by the executive secretaries. The committees included specialist doctors involved in the PPM. The study findings also show that about 85% of health care providers reported that the practice played an important role in supplementing the hospitals' budgets as well as health workers' incomes. In one of the study hospitals, the "fast track" services contributed more than 26% of the total income during a 5-year period. Likewise, it has significantly improved the access to health care services. This was achieved through retaining health workers, improving the infrastructure, adequate supply of consumables and drugs, and raising funds to subsidise treatments for poor patients. However, the fast track services resulted in specialists spending less time with public patients. In addition, the standards of private care were still lower in the "fast track" when compared to what is expected in a private health care setting, and private patients were offered very poor diagnostic tests and investigation services. Concerns were also raised about the poor management of the funds generated from private services.
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