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 Tanzanian Essential Health Initiatives Program (TEHIP) 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.

With its accompanying CD, which presents the associated website (, this book remains an indispensable resource for decision-makers, researchers, policy advisors, and activists in health and international development around the world.

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Publisher: International Development Reseasrch Center, 2008