Perceived performance of health facility governing committees in overseeing healthcare services delivery in primary health care facilities in Tanzania.

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.

Clinical governance and quality of health services in public health facilities: evidence from three councils in Tanzania

Objective: Our objective was to assess clinical governance and the quality of health services in public primary health facilities in three councils of Arusha Region. Participants: We conducted a study involving 270 clients from 19 primary health facilities in three councils in Arusha Region. Methods: We conducted a cross-sectional study. The clients were selected using multistage-cluster sampling. Data were collected using exit interview and observation. A descriptive statistical method was used to analyse data. Results: We found that health facilities had the key policies and structures for quality improvement and limited governance for quality of health services. In total,109(43%) of the clients reported receiving all the prescribed medicines and 230 (85%) of the clients had a positive experience with care processes. Also, 181(72%) of the clients were satisfied with the health services and 230 (85%) of clients had confidence and trust in public primary health facilities. Conclusion: This research has generated valuable evidence on governance and the quality of health services offered in public primary health facilities in three councils of the Arusha Region. Our research has indicated that: facilities had limited governance for quality of health services and clients had limited access to essential medicines; the majority of clients had a positive experience with the processes of health care; the majority of clients were satisfied with health services offered and had confidence and trust in public primary health facilities. The empirical evidence of this study should inform quality improvement efforts in the studied councils and Tanzania