Perceived performance of health facility governing committees in overseeing healthcare services delivery in primary health care facilities in Tanzania.
Tanzania
health facility governing committees
performance
training needs
Journal
The International journal of health planning and management
ISSN: 1099-1751
Titre abrégé: Int J Health Plann Manage
Pays: England
ID NLM: 8605825
Informations de publication
Date de publication:
Jan 2023
Jan 2023
Historique:
revised:
25
08
2022
received:
09
01
2022
accepted:
09
09
2022
pubmed:
22
9
2022
medline:
5
1
2023
entrez:
21
9
2022
Statut:
ppublish
Résumé
Health Facility Governing Committees (HFGCs) play a vital role in overseeing health services delivery in the primary health care system. However, despite their existence in Tanzania hiccups remain reported on the quality of health services delivered in primary health care facilities. The latter poses a question on the performance of HFGCs in overseeing the services delivery at the primary health facilities. This study sought to assess the perceived performance of the HFGCs and the associated factors in overseeing the healthcare services delivery at the primary health facilities in Tanzania. A cross-sectional study was conducted in five regions of Tanzania: Mwanza, Dar Es Salaam, Kilimanjaro, Pwani, and Arusha. A self-administered questionnaire containing structured questions was used to gather information from randomly selected 574 HFGC members. Data were analyzed descriptively and the binary logistic regression model was used to determine factors associated with the perceived performance. Half (50.52%) of the HFGCs members perceived themselves to have good performance. Furthermore, only 51.05% of all the participants had received any form of health management and governance training whereby about two-thirds had received training for only 1 day. The main factors associated with the perceived low performance of the HFGCs members were age, level of education and duration served in the HFGC. A low level of education was associated with the poor perceived performance of the HFGC (AOR 0.36 [CI: 0.23-0.55]). Similarly with increasing age, the odds of good-perceived performance lowered (AOR 0.26 [CI: 0.13, 0.55]). Serving as a HFGC member for less than 1 year was associated with poor perceived performance (AOR 0.40 [CI: 0.17, 0.95]). From these findings, it is recommended that the criteria for recruitment of HFGC members should be revisited. Furthermore, a qualitative study to explore contextual factors influencing the perforce of HFGCs is recommended.
Types de publication
Journal Article
Langues
eng
Pagination
239-251Informations de copyright
© 2022 John Wiley & Sons Ltd.
Références
Kuwawenaruwa A, Remme M, Mtei G, Makawia S, Maluka S, Kapologwe N, Borghi S. Bank accounts for public primary health care facilities: reflections on implementation from three districts in Tanzania. Int J Health Plann Manag. 2019;34(1):e860-e874. https://doi.org/10.1002/hpm.2702
Maluka S, Chitama D, Dungumaro E, Masawe C, Rao K, Shroff Z. Contracting-out primary health care services in Tanzania towards UHC: how policy processes and context influence policy design and implementation. Int J Equity Health. 2018;17(1):1-13. https://doi.org/10.1186/s12939-018-0835-8
Barker KM, Ling EJ, Fallah M, et al. Community Engagement for health system resilience: Evidence from Liberia’s Ebola Epidemic. Health Policy Plan. 2020:1-8. https://doi.org/10.1093/heapol/czz174
Frumence G, Nyamhanga T, Mwangu M, Hurtig A. Participation in health planning in a decentralised health system: experiences from facility governing committees in the Kongwa district of Tanzania. Global Publ Health. 2014;9(10):1125-1138. https://doi.org/10.1080/17441692.2014.953563
Kessy FL. Improving health services through empowered community health governance structures in Tanzania. Journal of Rural and Community Development. 2014;9(2):14-31.
Kapologwe NA, Kalolo A, Kibusi SM, et al. Understanding the implementation of Direct Health Facility Financing and its effect on health system performance in Tanzania: a non-controlled before and after mixed method study protocol. Health Res Pol Syst. 2019;17(1):1-13. https://doi.org/10.1186/s12961-018-0400-3
Kesale AM, Mahonge CP, Muhanga M. 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. Health Sci Rep. 2022;5(3):e611. https://doi.org/10.1002/hsr2.611
Tanzania J, ya M wa. MWONGOZO WA UUNDAJI NA UENDESHAJI WA BODI ZA HUDUMA ZA AFYA ZA HALMASHAURI NA KAMATI ZA USIMAMIZI ZA HOSPITALI, VITUO VYA AFYA NA ZAHANATI NCHINI TANZANIA Aprili; 2013.
Falisse JB, Meessen B, Ndayishimiye J, Bossuyt M. Community participation and voice mechanisms under performance-based financing schemes in Burundi. Trop Med Int Health. 2012;17(5):674-682. https://doi.org/10.1111/j.1365-3156.2012.02973.x
Mwandulusya A, Id K, Mahonge C, Muhanga M. The quest for accountability of Health Facility Governing committees implementing direct Health Facility Financing in Tanzania: a supply-side experience. 2022:1-16. https://doi.org/10.1371/journal.pone.0267708
WHO. A network for improving quality of care for maternal, newborn and child health: Monitoring framework. March 2016;14-16.
Lodenstein E, Mafuta E, Kpatchavi AC, et al. Social accountability in primary health care in West and Central Africa: exploring the role of health facility committees. BMC Health Serv Res. 2017;17:1-15. https://doi.org/10.1186/s12913-017-2344-7
Molyneux S, Atela M, Angwenyi V, Goodman C. Community accountability at peripheral health facilities: a review of the empirical literature and development of a conceptual framework. Health Pol Plann. 2012;27(7):541-554. https://doi.org/10.1093/heapol/czr083
James C, Beazley I, Penn C, et al. Decentralisation in the health sector and responsibilities across levels of government Impact on spending decisions and the budget. In: 7th Meeting of the OECD Joint Network of Senior Budget and Health Officials. OECD; 2019.
Kesale AM, Mahonge C, Muhanga M. The quest for accountability of Health Facility Governing committees implementing direct Health Facility Financing in Tanzania: a supply-side experience. PLOS ONE. 2022;17(4):e0267708. https://doi.org/10.1371/journal.pone.0267708
Sitienei J, Manderson L, Nangami M. Community participation in the collaborative governance of primary health care facilities, Uasin Gishu County, Kenya. PLOS ONE. 2021;16(3):e0248914. https://doi.org/10.1371/journal.pone.0248914
Frumence G, Nyamhanga T, Mwangu M, Hurtig AK. Challenges to the implementation of health sector decentralization in Tanzania: experiences from kongwa district council. Glob Health Action. 2013;6(1):20983. https://doi.org/10.3402/gha.v6i0.20983
Renggli S, Mayumana I, Mboya D, et al. Towards improved health service quality in Tanzania: contribution of a supportive supervision approach to increased quality of primary healthcare. BMC Health Serv Res. 2019;19(1):1-23. https://doi.org/10.1186/s12913-019-4648-2
Samadi AH, Keshtkaran A, Kavosi Z, Vahedi S. The effect of fiscal decentralization on under-five mortality in Iran: a panel data analysis. Int J Health Pol Manag. 2013;1(4):301-306. https://doi.org/10.15171/ijhpm.2013.60
Saunders M, Lewis P, Thornhill A. Research Methods for Business Students, 4th ed. Financial Times Prentice Hall; 2007.
Hart T, Welham B. Fiscal decentralisation A public financial management introductory guide. November; 2016.
Panda B, Thakur HP. Decentralization and health system performance-a focused review of dimensions, difficulties, and derivatives in India. BMC Health Serv Res. 2016;16(Suppl 6):1-14. https://doi.org/10.1186/s12913-016-1784-9
Mwakasangula E, Igulu GR, Kamugisha D, Kesale A, Fundi S. The influence of leadership on good governance: the case of Selected villages in Rungwe and Babati district councils in Tanzania. SSRN Electron J. 2015:1-66. https://doi.org/10.2139/ssrn.2562328
Waweru E, Opwora A, Toda M, et al. Are Health Facility Management Committees in Kenya ready to implement financial management tasks Findings from a nationally representative survey. BMC Health Serv Res. 2013;13(1):1. https://doi.org/10.1186/1472-6963-13-404
Boex J. (n.d.) Decentralized Local Health Services in Tanzania. Vol 34.
Kesale A, Mahonge CMM. The determinants of the performance of Health Facility Governing committees (HFGC) in selected primary health facilities in Tanzania. Tanzania J Commun Dev J Commun Dev Prof. 2021;1(2).
Mwakatumbula H. The Implementation of Direct Health Facility Financing (DHFF): Prospects and Challenges. Repoa Brief; 2021. PB 16.May.
Tukay SM, Pasape L, Tani K, Manzi F. Evaluation of the direct Health Facility Financing Program in Improving maternal Health Services in Pangani district, Tanzania. Int J Wom Health. 2021;13(December):1227-1242. https://doi.org/10.2147/ijwh.s333900
Nunnally JC, Bernstein IH. Psychometric theory. PsycCRITIQUES. 1979;24:275-280. https://doi.org/10.1037/018882
Goodman C, Opwora A, Kabare M, Molyneux S. Health facility committees and facility management-exploring the nature and depth of their roles in Coast Province, Kenya. BMC Health Serv Res. 2011;11(1):229. https://doi.org/10.1186/1472-6963-11-229
Falisse J-B, Ntakarutimana L. When information is not power: community-elected health facility committees and health facility performance indicators. Soc Sci Med. 2020;265:113331. https://doi.org/10.1016/j.socscimed.2020.113331
Bossert TJ, Beauvais JC. Decentralization of health systems in Ghana, Zambia, Uganda and the Philippines: a comparative analysis of decision space. Health Pol Plann. 2002;17(1):14-31. https://doi.org/10.1093/heapol/17.1.14
Bossert TJ, Mitchell AD. Health sector decentralization and local decision-making: decision space, institutional capacities and accountability in Pakistan. Soc Sci Med. 2011;72(1):39-48. https://doi.org/10.1016/j.socscimed.2010.10.019
Somi G, Matee I, Wengaa D, Darcy N, Perera S. Analysis of data Dissemination and Use Practices in the Health Sector in Tanzania: results of desk review and interviews with key stakeholders. J Health Inform Afr. 2017;4(1):79-89.