Improving the quality of health services
Project description
Project title: Tanzanian–German programme to support health – Thematic area: Quality in health services
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Country: Tanzania
Lead executing agency: Ministry of Health and Social Welfare
Overall term: 2003 to 2016
Context
Inadequate and unequally distributed health services are a major obstacle to the socio-economic development of Tanzania and have a negative impact on the state of health of the population. Rural regions and poor population groups are most affected by these deficits. There is a considerable shortage of qualified health professionals and skilled staff, in addition to deficiencies in local infrastructure and equipment. In addition, poor management in healthcare facilities often lead to inefficient use of scarce financial resources, among other problems. Maternal and neonatal mortality rates remain high: 454 women per 100,000 die giving birth, and there are an average of 26 neonatal deaths per 1,000 live births.
Objective
The quality of health services, especially in the area of sexual and reproductive health, has improved. Demand for and use of health services has increased.
Approach
At political level, improvements to health service quality are being achieved through implementation of the Tanzania Quality Improvement Framework in Health Care. Regional and district health facilities and health authorities receive support in implementing quality measures at local level. A computer-based hospital management system has been introduced with a view to increasing revenue in the health facilities.
The programme develops the competencies and skills of health professionals in planning, implementing and managing high-quality services in the four programme regions – Mbeya, Tanga, Lindi and Mtwara – through professional and organisational advisory services, practical instruction and support, and training courses. Special newborn care training is provided for nurses and midwives.
Results
Better access to family planning services has led to modern contraceptive methods (contraceptive prevalence) becoming more widespread. The number of unwanted pregnancies has decreased.
A computer-based hospital management system has enhanced the efficiency of health services in hospitals. Between 2010 and 2013, revenue increased by 270 per cent in the regional hospital in Tanga, by 45 per cent in Muheza District and by 12 per cent in Lushoto District Hospital.
As a result of the support provided to the Tanzania Quality Improvement Framework, a system for annual self-assessment of service quality has been successfully implemented in most hospitals in the programme region. Furthermore, 29 public and private hospitals have formed committees to promote measures aimed at improving service quality in their facilities.
In Lindi, quality improvement initiatives have been launched with a special focus on maternal and neonatal health, which has led to a noticeable decline in neonatal mortality at Lindi Regional Referral Hospital from 35 to 20 per 1,000 births (2011–2012).