The functionality of health facility governing committees and their associated factors in selected primary health facilities implementing direct health facility financing in Tanzania: A mixed-method study.
Lower‐Middle Income Countries
community participation
fiscal decentralization
functionality
health facility governing committees
primary healthcare facilities
Journal
Health science reports
ISSN: 2398-8835
Titre abrégé: Health Sci Rep
Pays: United States
ID NLM: 101728855
Informations de publication
Date de publication:
May 2022
May 2022
Historique:
received:
01
12
2021
revised:
20
03
2022
accepted:
22
03
2022
entrez:
5
5
2022
pubmed:
6
5
2022
medline:
6
5
2022
Statut:
epublish
Résumé
In Lower and Middle-Income Countries (LMICs), decentralization has dominated the agenda for reforming the organization of service delivery (LMICs). The fiscal decentralization challenge is a hard one for decentralization. As they strive to make decisions and use health facility funding, primary healthcare facilities encounter the obstacles of fiscal decentralization. LMICs are currently implementing fiscal decentralization reforms to empower health facilities and their Health Facility Governing Committees (HFGCs) to improve service delivery. Given the scarcity of systematic evidence on the impact of fiscal decentralization, this study examined the functionality of HFGCs and their associated factors in primary healthcare facilities in Tanzania that were implementing fiscal decentralization through Direct Health Facility Financing (DHFF). To collect both qualitative and quantitative data, a cross-sectional approach was used. The research was carried out in 32 primary healthcare facilities in Tanzania that were implementing the DHFF. A multistage sample approach was utilized to pick 280 respondents, using both probability and nonprobability sampling procedures. A structured questionnaire, in-depth interviews, and focus group discussions were used to gather data. The functionality of HFGCs was determined using descriptive analysis, and associated factors for the functioning of HFGCs were determined using binary logistic regression. Thematic analysis was used to do qualitative research. HFGC functionality under DHFF has been found to be good by 78.57%. Specifically, HFGCs have been found to have good functionality in mobilizing communities to join Community Health Funds 87.14%, participating in the procurement process 85%, discussing community health challenges 81.43% and planning and budgeting 80%. The functionality of HFGCs has been found to be associated with the planning and budgeting aspects The study found that fiscal decentralization via DHFF increases the functionality of HFGCs significantly. As a result, the report proposes that more effort be placed into making financial resources available to health facilities.
Sections du résumé
Background
UNASSIGNED
In Lower and Middle-Income Countries (LMICs), decentralization has dominated the agenda for reforming the organization of service delivery (LMICs). The fiscal decentralization challenge is a hard one for decentralization. As they strive to make decisions and use health facility funding, primary healthcare facilities encounter the obstacles of fiscal decentralization. LMICs are currently implementing fiscal decentralization reforms to empower health facilities and their Health Facility Governing Committees (HFGCs) to improve service delivery. Given the scarcity of systematic evidence on the impact of fiscal decentralization, this study examined the functionality of HFGCs and their associated factors in primary healthcare facilities in Tanzania that were implementing fiscal decentralization through Direct Health Facility Financing (DHFF).
Methods
UNASSIGNED
To collect both qualitative and quantitative data, a cross-sectional approach was used. The research was carried out in 32 primary healthcare facilities in Tanzania that were implementing the DHFF. A multistage sample approach was utilized to pick 280 respondents, using both probability and nonprobability sampling procedures. A structured questionnaire, in-depth interviews, and focus group discussions were used to gather data. The functionality of HFGCs was determined using descriptive analysis, and associated factors for the functioning of HFGCs were determined using binary logistic regression. Thematic analysis was used to do qualitative research.
Result
UNASSIGNED
HFGC functionality under DHFF has been found to be good by 78.57%. Specifically, HFGCs have been found to have good functionality in mobilizing communities to join Community Health Funds 87.14%, participating in the procurement process 85%, discussing community health challenges 81.43% and planning and budgeting 80%. The functionality of HFGCs has been found to be associated with the planning and budgeting aspects
Conclusion
UNASSIGNED
The study found that fiscal decentralization via DHFF increases the functionality of HFGCs significantly. As a result, the report proposes that more effort be placed into making financial resources available to health facilities.
Identifiants
pubmed: 35509407
doi: 10.1002/hsr2.611
pii: HSR2611
pmc: PMC9059188
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e611Informations de copyright
© 2022 The Authors. Health Science Reports published by Wiley Periodicals LLC.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
Références
J Health Organ Manag. 2011;25(4):400-19
pubmed: 22039660
Glob Health Action. 2013 Nov 25;6:22669
pubmed: 24280341
BMC Health Serv Res. 2011 Sep 22;11:229
pubmed: 21936958
Prim Health Care Res Dev. 2018 Sep;19(5):492-502
pubmed: 29374506
Glob Health Action. 2015 Jun 01;8:26461
pubmed: 26037041
BMC Health Serv Res. 2014 Apr 17;14:178
pubmed: 24742180
Int J Health Plann Manage. 2019 Jan;34(1):e860-e874
pubmed: 30461049
Health Policy Plan. 2012 Sep;27(6):449-66
pubmed: 22155589
BMJ Glob Health. 2018 Oct 3;3(Suppl 3):e000681
pubmed: 30364368
Int J Health Plann Manage. 2016 Apr;31(2):E86-E104
pubmed: 26044888
Health Policy Plan. 2016 Apr;31(3):332-45
pubmed: 26210167
Glob Health Action. 2013 Aug 29;6:20983
pubmed: 23993021
BMC Health Serv Res. 2020 Feb 10;20(1):104
pubmed: 32041609
BMC Health Serv Res. 2019 May 2;19(1):279
pubmed: 31046748
Glob Public Health. 2014;9(10):1125-38
pubmed: 25248312
Int J Health Plann Manage. 2011 Apr-Jun;26(2):e102-120
pubmed: 20603818
Int J Public Health. 2017 Mar;62(2):219-229
pubmed: 27572495
Int J Equity Health. 2012 Jun 07;11:30
pubmed: 22676204
Health Policy Plan. 2001 Dec;16 Suppl 2:61-9
pubmed: 11772991
Health Sci Rep. 2022 Apr 26;5(3):e611
pubmed: 35509407
Int J Equity Health. 2017 Sep 15;16(1):151
pubmed: 28911325
Health Care Manag Sci. 2008 Mar;11(1):41-54
pubmed: 18390167
Health Res Policy Syst. 2019 Jan 30;17(1):11
pubmed: 30700308
BMC Health Serv Res. 2013 Oct 10;13:404
pubmed: 24107094
Lancet Glob Health. 2018 Nov;6(11):e1155-e1157
pubmed: 30196094
Int J Health Policy Manag. 2017 Feb 27;6(7):365-376
pubmed: 28812832
BMC Health Serv Res. 2017 Jun 13;17(1):403
pubmed: 28610626
PLoS One. 2019 Aug 8;14(8):e0220836
pubmed: 31393923
Health Policy Plan. 2018 Jan 1;33(1):41-58
pubmed: 29077844
Trop Med Int Health. 2012 May;17(5):674-82
pubmed: 22487362
BMJ Glob Health. 2018 Sep 28;3(5):e000939
pubmed: 30294460
J Public Health Med. 2002 Dec;24(4):246-51
pubmed: 12546199