Evaluation of implementation process of Star Rating Assessment and quality improvement plans in primary healthcare facilities in Tanzania : A case of Kibaha Town and Rufiji District councils.
Date
2019
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Mzumbe University
Abstract
The Government of Tanzania through Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) introduced the Star Rating Assessment (SRA) system as initiative under Big Results Now (BRN) to assess the quality of health services. The SRA system used standardized tools for assessing the quality of health services and the star level ranges from 0-5 stars depending on the quality of services provided. The SRA had a target of 80% of Primary Health Care (PHC) facilities be rated 3 stars and above by June 2018 but unfortunately only 20% of facilities attained this target countrywide. The study aimed at assessing the implementation process of SRA and Quality Improvement Plans (QIPs) as one of the initiatives in improving the quality of healthcare delivery in primary health facilities in Kibaha TC and Rufiji DC. I adopted a descriptive cross-sectional study design whereby qualitative technique was employed to gain the experiences of individual healthcare providers and groups of Quality Improvement Teams (QITs) on implementation of SRA. Data was collected through Focus Group Discussions (FGDs) in which 4 FGDs were conducted comprising between 4-7 participants for QITs and in-depth interviews (with 19 participants) for facility in-charges, CHMTs (DMO or District Health Secretary), Council and Regional QI Focal Person, and SRA coordinators at national level (MoHCDGEC and PO-RALG). Data were analyzed using qualitative content analysis, which offers the development of categories from the text data inductively in capturing experiences from the key informants. The study findings revealed mixed results regarding implementation of SRA and QIPs in PHC facilities. The results showed that the awareness on SRA system was low among healthcare providers, the QIT members were not aware of their roles in implementation of QIPs and the CHMTs were not including QIP follow up progress as part of their quarterly supportive supervision. Some of the reported challenges that were encountered during implementation of SRA and QIP included but not limited to shortage of staff, financial resources, inadequate training of staff on SRA system, and inadequate CHMTs support through supportive supervision. The implementation of SRA has shown some improvement in the delivery of quality healthcare in the study sites. However, enhancing the proper implementation of SRA especially QIP follow up and overcoming the barriers to implementation will improve the quality healthcare in Tanzania. MoHCDGEC, PO-RALG, R/CHMTs, Facility in Charges and QITs should play their roles for effective implementation of SRA system in Tanzania.
Description
A dissertation submitted to the School of Public Administration and Management of Mzumbe University in Partial Fulfillment of the requirements for the award of Master of Science Degree in Health
Monitoring and Evaluation (Msc.HM&E) of Mzumbe University.
Keywords
Health Facilities, Quality Health care -Tanzania, Primary Healthcare, Cross-sectional study, Star Rating Assessment
Citation
APA