Author(s)

Syabo Mwaisengela^1*, Joseph Christopher Hokororo², Chrisogone Justine German², Erick Stephen Kinyenje², Radenta Paul Bahegwa², Talhiya Abdulhakim Yahya³, Mohamed Ally Mohamed^4,5, Omary Abdallah Nassoro², Ruth Raymond Ngowi², Yohannes Silipamwambo Msigwa², Mbwana Martine Degeh², Laura Edward Marandu², Bush Nzagamba Lugoba⁶, Edwin Cyprian Mkwama⁷, Lilian Didas Lyakurwa², Alpha Emmanuel Cholobi⁸, Michael Habtu⁹, Grace Saguti⁹, Yoti Zabuloni⁹, Eliudi Saria Eliakimu²

¹Division of Policy and Planning, Ministry of Health, Dodoma, United Republic of Tanzania.
²Health Quality Assurance Unit, Ministry of Health, Dodoma, United Republic of Tanzania.
³The Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health (MSH), Dar es Salaam, United Republic of Tanzania.
⁴Tanzania Field Epidemiology and Laboratory Training Programme (TFELTP), Dar es Salaam, United Republic of Tanzania.
⁶Health Quality Assurance and Clinical Audit Unit, Benjamin Mkapa Hospital, Dodoma, United Republic of Tanzania.
⁷Centre for Distance Education, Morogoro College of Health and Allied Sciences, Morogoro, United Republic of Tanzania.
⁸Health Emergency Preparedness and Response Unit, Ministry of Health, Dodoma, United Republic of Tanzania.
⁹Emergency Preparedness and Response Unit, World Health Organization, Dar es Salaam, United Republic of Tanzania.

Background: A strong primary healthcare (PHC) system is essential for achieving universal health coverage (UHC). The coronavirus disease 2019 (COVID-19) effects in health systems have reminded us on the importance of strengthening PHC. Quality of services is an integral component of UHC that requires strong governance and leadership. This study aims to assess functionality of Quality Improvement Teams (QITs) in PHC facilities in the context of Star Rating Assessment (SRA). Methods: This is a quantitative secondary data analysis using the SRA re-assessment data collected in the fiscal year 2017/18. QITs functionality was measured by desirable performance of four (4) indicators namely availability of the QITs, regular meeting of QITs, quarterly meetings and self-internal assessment conducted. The proportions were compared by using chi square test. Prevalence ratios were estimated by multivariate Poisson regression poisson regression model with 0.05 as a level of significance. Results: This study involved 5933 PHC facilities majority of which were dispensaries (87.6%), rural located (78.3%) and public owned (77.2%). On average, 22.5% of QITs were functional. Urban located health facilities were 13% more likely to have functional QITs compared to rural located ones (APR = 1.13, p = 0.06), health facilities with satisfactory availability of human resource for health were 29% more likely to have functional QITs (APR = 1.29, P < 0.001), health facilities with functional Health Facility Management Teams were about 3 times likely to have functional QITs (APR = 2.86, P < 0.001). Moreover, health facility level was not a good predictor of QITs functionality whereby health centers were 35% more likely to have functional QITs (p = 0.21) while dispensaries were 20% less likely to have functional QITs compared to district hospitals (p = 0.35). Conclusions: Non functionality of QITs is a challenge in PHC facilities in Tanzania. The challenge is more pronounced in rural located PHC facilities. Measures are to be taken to enhance QITs functionality in these facilities.

Primary Health Care, Star Rating Assessment, Quality Improvement Teams, Work Improvement Teams, Tanzania

Mwaisengela, S. , Hokororo, J. , German, C. , Kinyenje, E. , Bahegwa, R. , Yahya, T. , Mohamed, M. , Nassoro, O. , Ngowi, R. , Msigwa, Y. , Degeh, M. , Marandu, L. , Lugoba, B. , Mkwama, E. , Lyakurwa, L. , Cholobi, A. , Habtu, M. , Saguti, G. , Zabuloni, Y. and Eliakimu, E. (2023) Functionality of Quality Improvement Teams in Primary Healthcare Facilities in Tanzania: Findings from Star Rating Assessment. Journal of Service Science and Management, 16, 409-427. doi: 10.4236/jssm.2023.164023.