School of Public Administration and Management (SOPAM)

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    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.
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    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.
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    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.
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    Factors influencing employee retention in health sector: A case study of Geita district hospital
    (Mzumbe University, 2016) Mahagura, Grace J.
    The study focused on examining the factors influencing employee retention in health sector, a case study of Geita District Hospital. The specific objectives of the study was to examine retention strategies available at Geita District Hospital, to examine factors influencing employee’s retention at Geita District Hospital, to determine the rate of retention at Geita District Hospital and to investigate the challenges facing Geita District Hospital in retaining its staff. A sample size of 60 respondents was used to obtain enough information for the study. Interview and Questionnaire were used to analyse both Qualitative and Quantitative data by using thematic technique and presented in direct quotations with respect to research objectives and through tabular forms, with frequencies and percentages respectively. The data were coded and analysed through Statistical Package for Social Sciences (SPSS version 16.0) computer programs. The study found that good working conditions at GDH have been influencing employee retention, whereby there are enough of working equipment’s, job security, job scheduling variations which facilitate a healthier balance between work and personal obligations, employee’s suggestions and grievances are considered, also there are staff houses. Employees are compensated and satisfied with overtime allowance, leave allowance, health insurance, and the retirement benefits such as Pension, Provident Fund, and Gratuity. Also majority of employees are satisfied with the training and development opportunities available at GDH, whereby training opportunity is available for any employee, employees get regular training programs, the trainings are relevant to their work, and the tracings have been improving their work performance. GDH retain its employees to a great extent since they have high rate of retention. Hence, the study recommends that the government should provide enough funds for Geita District Hospital, so that the hospital can improve the working condition by its own funds, instead of depending funds from donors which is unreliable; the government should improve the compensation package for doctor and nurses, so as to retain these employees for long period of time, since there are other hospitals which provide more competitive packages.
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    Factors inhibiting employee promotion in the health department of Moshi district council
    (Mzumbe University, 2013) Isangya, Pamela
    This study was conducted in Moshi District Council and was prompted by the fact that promotion in the public sector, both in Central and Local Governments was a big problem that needed to be addressed. A case study design was used in this research. The study used a sample of 56 employees selected through convenience sampling technique and purposive sampling technique. Data were collected through questionnaire, interviews and documentary review methods. Quantitative data were analyzed by using Statistical Package for Social Sciences (SPSS). The findings were presented in tables, figures and text to simplify interpretation. Findings revealed that employee promotion in the Moshi District Council was being implemented and 71.5% of respondents were already upgraded at least once from the time of appointment to their job positions. However, the existing policy on employee promotion was likely to be weak as it is implemented without the application of OPRAS. The study also identified the promotion process, in which the majority (53.1%) of the respondents claimed that the promotion was not fair due to reasons such as unfairness which included promotion delay and inappropriate employee promotion. On the specific objective to determine the challenges posed in the implementation, the findings revealed that there were a number of challenges behind the situation such as budget constraints, corruption, favoritism, poor qualification and poor record keeping. Suggestions to improve the situation include improving record keeping system, avoiding favoritism, etc. The study recommends that the management should improves record keeping, avoid favoritism, information on non-promotion be delivered on time, furtherance of employee education and further studies be conducted.
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    Factors affecting enrollment of community health fund members: A Case of Kwimba district
    (Mzumbe University, 2015) Simime, Benjamin
    This study explored the factors affecting CHF enrollment in Kwimba District Council. It was set to explore the community’s knowledge, perception, preferences participation or involvement in decision making. Cross sectional study design was employed in this study as research design. In line with this design, simple random sampling and purposive sampling techniques were used for sample selection, whose respondents were chosen from Ngudu and Wala Ward, particularly in four villages; Kakora, Welamasonga, Isaga, and Sumaha. Data were collected through questionnaire to key informants. These comprised both open ended and close ended questions. Findings of the study revealed that majority of population in Kwimba district were peasant. They preferred government health facilities as their primary health service provider due to its cheapness, availability and accessibility. Despite these facts, in favor of Community Health Fund, Kwimba district suffered from low enrollment. Only 3.2% were members (2120 households out of 64,720) mainly because the community had not received enough information on CHF. This has been due to low knowledge on existence and benefits of CHF among the community (especially nonmembers in remote areas). Other factors entailed poor quality of health services in terms of availability of drugs, medicine, medical equipment, supplies and diagnosis, referral systems, poor involvement of community on CHF management, and decisions. Study revealed that Community knowledge and perception towards CHF, community participation on CHF, and community preferences on health providers affected enrollment of CHF members. This study recommends for the following; that the district Management should increase efforts on sensitization of CHF benefits especially in remote areas at harvesting seasons. The district should also improve quality of health services by setting aside some amount of drugs for CHF in case they run out of drugs. There is a necessity too for the district to improve community participation in the local organization and implementation of the CHF scheme and lastly discourage user fee by increasing cost to encourage CHF enrollment
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    The efficiency of National Health Insurance Fund in health provision to the beneficiaries: The case study of Morogoro municipality
    (Mzumbe University, 2013) Msaki, Sibilina J
    The study investigates the efficiency of National Health Insurance Fund in health provision to the beneficiaries a case in Morogoro Municipality and 242 respondents participated in the study. The overall purpose of the study is to enhance efficiency in the provision of health services to the beneficiaries at all levels from dispensary to referral hospital. The study intended to answer the following questions; what are the operations of the NHIF in implementing its policies and terms, what are the operations of the accredited health facilities in implementing the NHIF policies and terms, what is the essence of the members‘ complaints, what are the existing mechanisms of flow of information to and fro between the members and the Fund, to what extent do the members have knowledge on their entitlements from the scheme and what extent knowledge on entitlements of the members do the primary service/care givers at the hospitals, pharmacies and NHIF offices have. The case study research design was employed during the study and research methods used included interviews, questionnaires, survey and documentary review schedules. The Statistical Package for Social Sciences (SPSS) was used to analyze data. By using descriptive analysis with simple quantitative technique the findings revealed that the operations of the NHIF in implementing its policies and terms. Accredited of health facilities and flow of information to and fro between members and fund are well planned. Also the findings indicated that both NHIF members and their entitlements have the knowledge about the rights and benefits package provided by the Fund. The findings showed that NHIF faces the following challenges in providing health services: late of payments from the fund to care providers ,lack of education to members, category of some services, low quality of services, poor communication, and improper facility inspection and supervision. It is recommended that NHIF should be sensitive to provide education to the beneficiaries and care providers which are the major obstacle to majority.