Dissertations (Masters)-HME-SOPAM
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Item Evaluation of the effect of integrated logistics system on essential medicine availability at health centres and dispensaries in Tanzania: A case of Mbeya city council(Mzumbe University, 2017) Francis, Lucia.In response to the problem of shortage and wastage of essential medicines, Tanzania introduced the supply chain system for reporting and requesting medicines and other medical supplies to the respective Government owned health facilities called integrated logistics system, despite ILS introduction the health facilities have continued to face the same problem. This evaluation study was intended to evaluate the effect of Integrated Logistics System activities and their contribution to essential medicines availability in the selected 11 Health Facilities in Mbeya City Council. The specific objectives were(i)To determine the stock status of essential medicine for the past 12 months and on the day of assessment.( ii)To examine the extent to which integrated logistics system activities i.e. records keeping, store management, filling report and request forms are implemented as designed (iii) To explore factors influencing the implementation of integrated logistics system(iv)To examine the contribution of integrated logistics system activities i.e. records keeping, report submission time, filling report and request forms on essential medicine availability. The study employed explorative and descriptive study design where by both quantitative and qualitative methods of data collection were used. The study findings revealed that though the facilities had shortage of essential medicines (Tracer medicines) on average the availability on the day of assessment was found to be 87%, for the period 2015/2016 was 78% and for July 2016 to March 2017 was 92% which show improvement on availability compared to 2014 HMIS data which was 70% availability. The results suggested that ILS activities implementation as designed had an effect on essential medicines availability to health facilities. Its activities implementation depend on each other and if implemented as designed can contribute to the availability of essential medicines though other factors like availability of fund and medicines at MSD needs to be checked on which did not included in this study. The result found that ILS activities were not implemented as designed by the most of health facilities and this challenge had to be rectified by MoHCDGEC, Regional and district level together with their facilities.Item Assessment of Health Management Information System (HMIS) perfomance in health facilities in Mbarali, Kyela, and Busokelo District Councils(Mzumbe University, 2015) Sanga, Jactany L.The purpose of this study was to assess the Health Management Information System (HMIS) Performance in health facilities in Mbarali, Kyela and Busokelo District Councils. The study adopted a mixed method design which enabled the study to triangulate the data and information. In this study, four methods of data collection were used, namely questionnaires, semi-structured interviews, focus group discussions and documentary review. The sample size was 49 respondents. PRISM DEAT was used in data analysis. The data analysis included the use of simple description of percentages, tables and graphs this was done using excel spreadsheet. The level of the HMIS performance was measured in terms of data quality and information use. The data accuracy at the facility level was observed using OPD Attendance, ANC and PMTCT MAT and observed to be higher than 95%. The use of information accounted to 65% of the health facilities stored meeting records and 100% of the reports requested were available at the facility and the district level, while 95.5% had a discussion at facility level on the HMIS, of these 83.3% made a decision after discussion, while 95.83% of health facilities referred their issue to higher levels for further assistance. The evaluation report recommend to improve HMIS skills specifically on data interpretation, use of information and problem solving, and the use of the performance improvement tools such as cause and effect analysis, flow chart, priority matrix, control chart, this may be achieved by developing a simplified HMIS training curriculum, conduct training of staff per facility and all health area management team members. The evaluation also recommends the promotion of a culture of information use, motivating health care providers and providing training on moral and ethical issues to improve information use for decision making.Item Assessment of the quality of postnatal care services: A case study of Mbeya District Council(Mzumbe University, 2015) Lotto, Theopista D.Postnatal care services consists of care given to the mother and her new born for the first six weeks following birth, which enable health care providers identify post-delivery problems and provide treatments promptly. This evaluation was conducted to assess the quality of postnatal care services following the unpublished report from Health Management Information System of the District which showed an increase in the number of maternal and infant death within six weeks post-delivery. Methods: The evaluation used descriptive cross sectional study design in which quantitative approach was employed to collect and analyze evaluation data. The study was also guided by Donabedian conceptual framework based on structural and process components. A total of 355 clients attending postnatal care services in five selected facilities participated in an exit interview. Observational checklist adopted from the WHO implementation guideline was used for assessing resource availability. Data was analyzed using STATA version 13.0. Results: The findings established that health facilities that were involved in the study had basic resources to render quality postnatal care, however, there were some deficiencies in both structure and process components for provision of Post Natal Care (PNC) services. None of the five facilities had separate PNC room equipped with facilities for provision of quality services. Discussion and policy implications: The evaluated health facilities scored below 90%, based on agreed standard as set by World Health Organization which implies PNC services offered was sub-standard. Mbalizi Hospital and Inyala Health Centre had the average score of 77%, Santilya dispensary scored the third (75%) followed by Ilembo Health Centre 70% and the last was Igoma dispensary which scored 68% which is equal to partial quality. There is a need for the management of Mbeya District Council to plan for improvement of health facility infrastructures by constructing separate rooms for PNC to be able to provide quality health services and reduce neonatal and maternal death and ensure privacy to patients and clients.