Masters of Public Health - see Magister Public Health / Overreliance on donor supported health programs has crippled many African countries and there is inadequate long-term planning on the future sustainability of health systems. In the age of uncertainty in global politics and global economy, the future of these donor funded programs is also uncertain. It is imperative for African nations to begin to take responsibility for their health programs. In as much as the name “donation” suggests that something is given free of charge, in actual sense this may not be the case due to hidden costs attached. In medicine access, the hidden costs are the supply chain costs including cost for clearance, storage and distribution of such medicines which are charged as a percentage of claimed commodity costs on donors’ or suppliers’ invoices. Since the medicines donated are in originators’ brands, the invoiced prices are high thus supply chain costs are high as well. In some cases, it is thought that the hidden costs are higher than the cost of medicines had they been sourced locally as generics. The aim of this research was to assess and determine the hidden supply chain costs associated with the four medicine donation programs supporting the Tanzania Neglected Tropical Diseases Program and inform policy decision on optimal financing options for the program Methodology The cost analysis of the two options was undertaken from a payers’ perspective which in this case is the Government of Tanzania (Ministry of Health). Data was collected on both product and supply chain cost drivers incurred in the medicine donation programs from July 2014 to June 2017. Costs of the current mechanism were obtained from the program’s quantification reports and transaction data for the study period. Transactional data was obtained from shipment documents including sales invoices, parking list, proof of delivery and goods receiving notes were evaluated for actual quantities shipped, commodity prices and other supply chain cost. To verify the actual supply chain cost charged by the program, both the official bills from Medical Stores Department (MSD) to the program and the electronic bills available at MSD electronic database covering the study period were studied.

The primary goal of this dissertation was to gain a better understanding of individuals’ membership benefits preferences and attitudes toward donation programs in the context of urban zoo settings. The first objective of this dissertation was to provide a background on membership and donation related research in the context of zoos and other relevant organizations. Based on the review of literature, the second objective was to empirically examine, through two independent studies, zoo membership benefit preferences and attitudes toward a donation program. <div><br></div><div>Despite a wealth of knowledge in the literature with respect to zoo visitors, animals, exhibits, and related programs, little research has been conducted on individuals’ preferences for zoo membership benefit packages and attitudes toward donation programs. To fill the gaps in these areas, the first empirical study examined factors that influence current and prospective members’ decision-making when choosing a membership package at an urban zoo. More specifically, the study explored preferences for selected membership program benefits and benefit levels, as well as how these preferences varied among visitors grouped by key segmentation variables. The study findings suggested that price of membership package was the most important factor, followed by the discount on food and beverage and the proportion of membership fees devoted to animal conservation. As expected, the visitors who scored high on place attachment to the zoo were more supportive of the zoo and less sensitive to variations in the specific options included in the zoo’s membership package. <br></div><div><br></div><div>In the second study, attitudes toward a donation program at an urban zoo were examined. In particular, this study investigated subgroups’ differences segmented by their membership status, place attachment levels, and attitudinal positions. A two-dimensional/bivariate attitude approach was employed to explore potential differences among attitudinal position groups. The study findings indicated while most respondents held positive attitudes toward the donation program, zoo members and nonmembers did not differ significantly. The likelihood of joining the donation program was significantly higher for those in the positive dominant attitude group compared to those in the negative dominant and equally ambivalent groups. Additionally, a qualitative analysis revealed that many respondents were concerned about the cost or affordability of the donation program; and perceived the benefits of the program as a poor value.<br></div><div><br></div><div>Collectively, the two empirical studies provide useful insight for managers and professionals charged with developing membership and donation programs in zoological parks and other relevant organizations. The study results also suggest a number of potentially productive directions for future research in these areas.<br></div><div><br></div>