IDEAS home Printed from https://ideas.repec.org/a/oup/econjl/v134y2023i657p436-456..html

Management Practices and Quality of Care: Evidence from the Private Health Care Sector in Tanzania

Author

Listed:
  • Timothy Powell-Jackson
  • Jessica J C King
  • Christina Makungu
  • Matthew Quaife
  • Catherine Goodman

Abstract

We measure the adoption of management practices in over 220 private for-profit and non-profit health facilities in 64 districts across Tanzania and link these data to process quality-of-care metrics, assessed using undercover standardised patients and clinical observations. We find that better managed health facilities are more likely to provide correct treatment in accordance with national treatment guidelines, adhere to a checklist of essential questions and examinations, and comply with infection prevention and control practices. Moving from the 10th to the 90th percentile in the management practice score is associated with a 48% increase in correct treatment. We then leverage a large-scale field experiment of an internationally recognised management support intervention in which health facilities are assessed against comprehensive standards, given an individually tailored quality improvement plan and supported through training and mentoring visits. We find zero to small effects on management scores, suggesting that improving management practices in this setting may be challenging.

Suggested Citation

  • Timothy Powell-Jackson & Jessica J C King & Christina Makungu & Matthew Quaife & Catherine Goodman, 2023. "Management Practices and Quality of Care: Evidence from the Private Health Care Sector in Tanzania," The Economic Journal, Royal Economic Society, vol. 134(657), pages 436-456.
  • Handle: RePEc:oup:econjl:v:134:y:2023:i:657:p:436-456.
    as

    Download full text from publisher

    File URL: http://hdl.handle.net/10.1093/ej/uead075
    Download Restriction: Access to full text is restricted to subscribers.
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    References listed on IDEAS

    as
    1. Daniela Scur & Raffaella Sadun & John Van Reenen & Renata Lemos & Nicholas Bloom, 2021. "The World Management Survey at 18: lessons and the way forward," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 37(2), pages 231-258.
    2. Sima Berendes & Peter Heywood & Sandy Oliver & Paul Garner, 2011. "Quality of Private and Public Ambulatory Health Care in Low and Middle Income Countries: Systematic Review of Comparative Studies," PLOS Medicine, Public Library of Science, vol. 8(4), pages 1-10, April.
    3. Leonard, Kenneth L. & Masatu, Melkiory C., 2010. "Using the Hawthorne effect to examine the gap between a doctor's best possible practice and actual performance," Journal of Development Economics, Elsevier, vol. 93(2), pages 226-234, November.
    4. Elizabeth H Bradley & Patrick Byam & Rachelle Alpern & Jennifer W Thompson & Abraham Zerihun & Yigeremu Abeb & Leslie A Curry, 2012. "A Systems Approach to Improving Rural Care in Ethiopia," PLOS ONE, Public Library of Science, vol. 7(4), pages 1-7, April.
    5. Nicholas Bloom & John Van Reenen, 2007. "Measuring and Explaining Management Practices Across Firms and Countries," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(4), pages 1351-1408.
    6. Nicholas Bloom & Raffaella Sadun & John Van Reenen, 2016. "Management as a Technology?," Harvard Business School Working Papers 16-133, Harvard Business School, revised Oct 2017.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Daniela Scur & Sarah Wolfolds, 2024. "Revisiting the World Management Survey in Strategy: Applications to Theory and Replication," Strategy Science, INFORMS, vol. 9(1), pages 58-78, March.
    2. Sandra McNally & Luis Schmidt & Anna Valero, 2024. "Do management practices matter in further education?," Economica, London School of Economics and Political Science, vol. 91(363), pages 740-769, July.
    3. Bilicka, Katarzyna & Scur, Daniela, 2024. "Organizational capacity and profit shifting," Journal of Public Economics, Elsevier, vol. 238(C).
    4. Amin, Mohammad & Islam, Asif Mohammed & Padhi, Debasmita, 2026. "Do Informal Businesses with More-Educated Owners Adopt Better Business Practices ? Evidence from the Central African Republic," Policy Research Working Paper Series 11280, The World Bank.
    5. Anna Valero, 2021. "Education and management practices," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 37(2), pages 302-322.
    6. Anyfantaki, Sofia & Caloghirou, Yannis & Dellis, Konstantinos & Karadimitropoulou, Aikaterini & Petroulakis, Filippos, 2024. "The need for an industrial policy for long-term growth," LSE Research Online Documents on Economics 121983, London School of Economics and Political Science, LSE Library.
    7. Sofia Anyfantaki & Yannis Caloghirou & Konstantinos Dellis & Aikaterini Karadimitropoulou & Filippos Petroulakis, 2024. "The 2013 Cypriot Banking Crisis and Blame Attribution: survey evidence from the first application of a bail-in in the Eurozone," GreeSE – Hellenic Observatory Papers on Greece and Southeast Europe 193, Hellenic Observatory, LSE.
    8. Dabalen, Andrew & Paul, Saumik, 2024. "Firm Ownership Control and Management Practices, with an Update on Sub-Saharan Africa," IZA Discussion Papers 17433, IZA Network @ LISER.
    9. Alex Hollingsworth & Krzysztof Karbownik & Melissa A. Thomasson & Anthony Wray, 2024. "The Gift of a Lifetime: The Hospital, Modern Medicine, and Mortality," American Economic Review, American Economic Association, vol. 114(7), pages 2201-2238, July.
    10. Christopher Cornwell & Ian M. Schmutte & Daniela Scur, 2021. "Building a Productive Workforce: The Role of Structured Management Practices," Management Science, INFORMS, vol. 67(12), pages 7308-7321, December.
    11. Yue-Yi Hwa & Clare Leaver, 2021. "Management in education systems," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 37(2), pages 367-391.
    12. Philippe Aghion & Nicholas Bloom & Brian Lucking & Raffaella Sadun & John Van Reenen, 2021. "Turbulence, Firm Decentralization, and Growth in Bad Times," American Economic Journal: Applied Economics, American Economic Association, vol. 13(1), pages 133-169, January.
    13. Delis, Manthos D. & Tsionas, Mike G., 2018. "Measuring management practices," International Journal of Production Economics, Elsevier, vol. 199(C), pages 65-77.
    14. Coraggio, Luca & Pagano, Marco & Scognamiglio, Annalisa & Tåg, Joacim, 2025. "JAQ of all trades: Job mismatch, firm productivity and managerial quality," Journal of Financial Economics, Elsevier, vol. 164(C).
    15. Jacquelyn Pless, 2023. "To Starve or to Stoke? Understanding Whether Divestment versus Investment Can Steer (Green) Innovation," Entrepreneurship and Innovation Policy and the Economy, University of Chicago Press, vol. 2(1), pages 107-147.
    16. Delis, Manthos D. & Iosifidi, Maria & Kazakis, Pantelis & Ongena, Steven & Tsionas, Mike G., 2022. "Management practices and M&A success," Journal of Banking & Finance, Elsevier, vol. 134(C).
    17. Henrik Hansen & John Rand & Finn Tarp & Neda Trifkovic, 2021. "Correction to: On the Link Between Managerial Attributes and Firm Access to Formal Credit in Myanmar," The European Journal of Development Research, Palgrave Macmillan;European Association of Development Research and Training Institutes (EADI), vol. 33(6), pages 2084-2086, December.
    18. Kilian Huber & Volker Lindenthal & Fabian Waldinger, 2021. "Discrimination, Managers, and Firm Performance: Evidence from “Aryanizations” in Nazi Germany," Journal of Political Economy, University of Chicago Press, vol. 129(9), pages 2455-2503.
    19. Fang, Xubing & Liu, Maotao, 2024. "Regional judicial capacity and corporate total factor productivity: Evidence from the establishment of circuit courts," Structural Change and Economic Dynamics, Elsevier, vol. 71(C), pages 465-489.
    20. Karplus, Valerie J. & Geissmann, Thomas & Zhang, Da, 2021. "Institutional complexity, management practices, and firm productivity," World Development, Elsevier, vol. 142(C).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:oup:econjl:v:134:y:2023:i:657:p:436-456.. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Oxford University Press or the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/resssea.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.