Functionality of Primary Health Facilities Management Teams: Learning from 2017/2018’s Tanzania Star Rating Assessment

Abstract

Background: Having a proper health system management with skilled health managers has been shown to be an important foundation for a high-quality health system. Primary Health Care (PHC) is important in ensuring the achievement of universal health coverage. To achieve this objective, it is important to strengthen the management of PHC facilities. This study aims at ascertaining the functionality of Health Facility Management Teams (HFMTs) in PHC facilities in the context of Star Rating Assessment (SRA) in Tanzania. Methods: This is a quantitative secondary data analysis using the SRA re-assessment data collected in the fiscal year 2017/18. HFMTs functionality was measured by the desirable performance of four indicators, namely availability of the HFMTs, formal appointment of HFMTs, regular meeting of HMT and quarterly meetings conducted. The proportions were compared by using proportion Z and chi-square tests. Results: This study involved 5933 PHC facilities, the majority of which were dispensaries (87.6%), rural located (78.3%) and public owned (77.2%). On average, 23.3% of HFMTs were functional. Among health facilities located in urban areas, 27.7% (95% C.I = 25.3% - 30.2%) had functional HFMTs which is significantly higher than rural located with 22.1% (95% C.I = 20.9% - 23.3%) (P -owned PHC facilities had 23.4% (95% C.I = 22.2% - 24.7%) of health facilities with functional HFMTs which is insignificantly different from 22.8% (95% C.I = 20.6% - 25.0%) of privately owned (P = 0.63). 47.5% of hospitals at the council level have functional HFMTs which is significantly higher compared to health centers (32.2%) and dispensaries (21.8%) (P Conclusions: Non-functionality of HFMTs is a challenge in PHC facilities in Tanzania. The challenge is more pronounced in rural located health facilities and lower-level PHC facilities (dispensaries). Measures including management and leadership training and mentorships are to be taken to enhance HFMTs functionality in these facilities.