Syabo Mwaisengela | Muhimbili University of Health and Allied Sciences (MUHAS) (original) (raw)

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Research paper thumbnail of Status of countrywide laboratory services quality and capacity in primary healthcare facilities in Tanzania: Findings from Star Rating Assessment

PLOS Global Public Health

Accurate disease diagnosis relies on a well-organized and reliable laboratory system. This study ... more Accurate disease diagnosis relies on a well-organized and reliable laboratory system. This study assesses the quality of laboratory services in Tanzania based on the nationwide Star Rating Assessment (SRA) of Primary Healthcare (PHC) facilities conducted in 2017/18. This cross-sectional study utilized secondary data from all the country’s PHC facilities stored in the SRA database. Laboratory service quality was assessed by aggregating scores as percentages of the maximum achievable score across various indicators: dedicated laboratory department/room, adequate equipment, staffing levels, adherence to testing protocols, establishment of turnaround times, internal and external quality controls, and safety and supplies management. Scores equal to or exceeding 80% were deemed compliant. Multiple linear regression was used to determine the influence of facility characteristics (level, ownership, location, staffing) on quality scores, with statistical significance set at p < 0.05. The ...

Research paper thumbnail of Functionality of Quality Improvement Teams in Primary Healthcare Facilities in Tanzania: Findings from Star Rating Assessment

Journal of Service Science and Management

Research paper thumbnail of Assessment of Implementation of the Star Rating System in Primary Health Facilities: Experience from Tanzania

Journal of Service Science and Management

Research paper thumbnail of Functionality of Quality Improvement Teams in Primary Healthcare Facilities in Tanzania: Findings from Star Rating Assessment

Journal of Service Science and Management

Research paper thumbnail of Public Primary Health Facilities Autonomy: Findings from Tanzania Star Rating Assessment

International Journal of Health Policy Planning

Background: In many countries, health facility autonomy has been a crucial component of health se... more Background: In many countries, health facility autonomy has been a crucial component of health sector reform. Reducing direct government control over public health facilities and increasing their exposure to the market and market-like forces are part of this reform strategy. The degree of financial independence is a crucial characteristic that determines health facility financing and it has an impact on how well public health facilities function. This study aims at ascertaining Primary Health Facilities autonomy 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. Facility autonomy was measured by the desirable performance of six indicators, namely submission of a health facility plan, having operational bank account, competent handling of funds and financial reporting, deposit of self-generated funds in a facility bank account, health facility receiv...

Research paper thumbnail of Assessment of Implementation of the Star Rating System in Primary Health Facilities: Experience from Tanzania

Journal of Service Science and Management

Research paper thumbnail of Public Primary Health Facilities Autonomy: Findings from Tanzania Star Rating Assessment

Background: In many countries, health facility autonomy has been a crucial component of health se... more Background: In many countries, health facility autonomy has been a crucial component of health sector reform. Reducing direct government control over public health facilities and increasing their exposure to the market and market-like forces are part of this reform strategy. The degree of financial independence is a crucial characteristic that determines health facility financing and it has an impact on how well public health facilities function. This study aims at ascertaining Primary Health Facilities autonomy 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. Facility autonomy was measured by the desirable performance of six indicators, namely submission of a health facility plan,

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

Journal of Service Science and Management

Research paper thumbnail of The Use of Data for Planning and Services Improvement in Tanzanian Primary Healthcare Facilities: Experience from Star Rating Assessment

Journal of Service Science and Management

Research paper thumbnail of Clients satisfaction at primary healthcare facilities and its association with implementation of client service charter in Tanzania

PLOS ONE

Background Client service charter (CSC) provides information about what people can expect in a fa... more Background Client service charter (CSC) provides information about what people can expect in a facility’s services; what is expected of clients and service providers. Tanzania implemented Star Rating Assessment (SRA) of primary health care (PHC) facilities in 2015/16 and 2017/18 using SRA tools with 12 service areas. This paper assesses the status of service area 7, namely client focus that checked if client was satisfied with services provided and implementation of CSC through three indicators–if: CSC was displayed; CSC was monitored; client feedback mechanism and complaints handling was in place. Methods We extracted and performed a cross-sectional secondary data analysis of data related to clients’ focus that are found in national SRA database of 2017/2018 using STATA version 15. Client satisfaction was regarded as dependent variable while facility characteristics plus three indicators of CSC as independent variables. Multivariate logistic regression with p-value of 5% and 95% co...

Research paper thumbnail of Contribution of quality improvement initiative in strengthening laboratory services in Primary Healthcare Facilities in Tanzania: findings from 2017/2018 Star Rating Assessment

ABSTRACTBackgroundAccurate and reliable diagnosis is the cornerstone of disease management and co... more ABSTRACTBackgroundAccurate and reliable diagnosis is the cornerstone of disease management and control. A reliable and properly organized laboratory system not only generates information critical to individual case management but also to disease surveillance, control, and outbreak management. This study presents the status of quality of laboratory services in Tanzania after a nationwide quality assessment, Star Rating Assessment (SRA) of PHC facilities conducted in 2017/18.MethodsThis was a cross-sectional study using secondary data from SRA dataset. Eight indicators were used to measure quality of laboratory services; of which together with facility characteristics are considered independent variables. Dependent variable is the general scores for laboratory services during SRA. Firstly, proportions of facilities for the indicators was calculated. Then, multiple linear regression was employed to determine impact of each variable on quality of laboratory services. P-value of < 0.0...

Research paper thumbnail of Contribution of quality improvement initiative in strengthening laboratory services in Primary Healthcare Facilities in Tanzania: findings from 2017/2018 Star Rating Assessment

ABSTRACTBackgroundAccurate and reliable diagnosis is the cornerstone of disease management and co... more ABSTRACTBackgroundAccurate and reliable diagnosis is the cornerstone of disease management and control. A reliable and properly organized laboratory system not only generates information critical to individual case management but also to disease surveillance, control, and outbreak management. This study presents the status of quality of laboratory services in Tanzania after a nationwide quality assessment, Star Rating Assessment (SRA) of PHC facilities conducted in 2017/18.MethodsThis was a cross-sectional study using secondary data from SRA dataset. Eight indicators were used to measure quality of laboratory services; of which together with facility characteristics are considered independent variables. Dependent variable is the general scores for laboratory services during SRA. Firstly, proportions of facilities for the indicators was calculated. Then, multiple linear regression was employed to determine impact of each variable on quality of laboratory services. P-value of < 0.0...

Research paper thumbnail of Clients satisfaction at primary healthcare facilities and its association with implementation of client service charter in Tanzania

PLOS ONE

Background Client service charter (CSC) provides information about what people can expect in a fa... more Background Client service charter (CSC) provides information about what people can expect in a facility’s services; what is expected of clients and service providers. Tanzania implemented Star Rating Assessment (SRA) of primary health care (PHC) facilities in 2015/16 and 2017/18 using SRA tools with 12 service areas. This paper assesses the status of service area 7, namely client focus that checked if client was satisfied with services provided and implementation of CSC through three indicators–if: CSC was displayed; CSC was monitored; client feedback mechanism and complaints handling was in place. Methods We extracted and performed a cross-sectional secondary data analysis of data related to clients’ focus that are found in national SRA database of 2017/2018 using STATA version 15. Client satisfaction was regarded as dependent variable while facility characteristics plus three indicators of CSC as independent variables. Multivariate logistic regression with p-value of 5% and 95% co...

Research paper thumbnail of Social accountability in primary health care facilities in Tanzania: Results from Star Rating Assessment

PLOS ONE

Background Star Rating Assessment (SRA) was initiated in 2015 in Tanzania aiming at improving the... more Background Star Rating Assessment (SRA) was initiated in 2015 in Tanzania aiming at improving the quality of services provided in Primary Healthcare (PHC) facilities. Social accountability (SA) is among the 12 assessment areas of SRA tools. We aimed to assess the SA performance and its predictors among PHC facilities in Tanzania based on findings of a nationwide reassessment conducted in 2017/18. Methods We used the SRA database with results of 2017/2018 to perform a cross-sectional secondary data analysis on SA dataset. We used proportions to determine the performance of the following five SA indicators: functional committees/boards, display of information on available resources, addressing local concerns, health workers’ engagement with local community, and involvement of community in facility planning process. A facility needed four indicators to be qualified as socially accountable. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were used to determine facilities c...

Research paper thumbnail of The use of data for planning and service improvement in Tanzanian Primary healthcare facilities: Experience from Star Rating Assessment

Background The use of data for planning and improving healthcare delivery is sub-optimal among de... more Background The use of data for planning and improving healthcare delivery is sub-optimal among developing countries. In 2015, Tanzania started to implement Star Rating Assessment (SRA) process for primary health care (PHC) facilities to improve various dimensions of quality of services, including the use of data. We aimed at assessing the extent and predictors of data use in Tanzanian PHC facilities. Methodology We used the most current national SRA data available in DHIS2 that was collected in 2017/2018 from all 7,289 PHC facilities. A facility was considered using data if gained 80% of the allocated scores. Other dependent variables were the three components that together contribute to the use of data [If PHC facility has Health Management Information systems (HMIS) functional, disseminate information, and has proper medical records]. We determined the association between data use and facility ownership status (public or private), location of the facility (rural or urban) and faci...

Research paper thumbnail of Contribution of Results-Based Financing in Quality improvement of Health Services at Primary Healthcare Facilities: Findings from Tanzania Star Rating Assessment

Background Performance-based financing (PBF) is an important mechanism for improving the quality ... more Background Performance-based financing (PBF) is an important mechanism for improving the quality of health services in low- and middle- income countries. In 2014, Tanzania launched a country-wide quality approach known as Star Rating Assessment (SRA) aims to assess the quality of healthcare service delivery in all Primary Health Care (PHC) Facilities in the country. Furthermore, by 2015, the country rolled out RBF initiatives into eight regions in which PHC facilities were paid incentives based on their level of achievement in SRA assessments. This study aims to compare performance in quality between PHC facilities under RBF regions and non-RBF regions using the findings from the two-phases SRA assessments; baseline (2015/16) and follow-up (2017/18). Methods Analysis of performance of SRA indicators in the SRA service areas were identified based on the star rating tool that was used. The star rating tool had 12 service areas. For the sake of this implementation study, only seven ser...

Research paper thumbnail of Status of countrywide laboratory services quality and capacity in primary healthcare facilities in Tanzania: Findings from Star Rating Assessment

PLOS Global Public Health

Accurate disease diagnosis relies on a well-organized and reliable laboratory system. This study ... more Accurate disease diagnosis relies on a well-organized and reliable laboratory system. This study assesses the quality of laboratory services in Tanzania based on the nationwide Star Rating Assessment (SRA) of Primary Healthcare (PHC) facilities conducted in 2017/18. This cross-sectional study utilized secondary data from all the country’s PHC facilities stored in the SRA database. Laboratory service quality was assessed by aggregating scores as percentages of the maximum achievable score across various indicators: dedicated laboratory department/room, adequate equipment, staffing levels, adherence to testing protocols, establishment of turnaround times, internal and external quality controls, and safety and supplies management. Scores equal to or exceeding 80% were deemed compliant. Multiple linear regression was used to determine the influence of facility characteristics (level, ownership, location, staffing) on quality scores, with statistical significance set at p < 0.05. The ...

Research paper thumbnail of Functionality of Quality Improvement Teams in Primary Healthcare Facilities in Tanzania: Findings from Star Rating Assessment

Journal of Service Science and Management

Research paper thumbnail of Assessment of Implementation of the Star Rating System in Primary Health Facilities: Experience from Tanzania

Journal of Service Science and Management

Research paper thumbnail of Functionality of Quality Improvement Teams in Primary Healthcare Facilities in Tanzania: Findings from Star Rating Assessment

Journal of Service Science and Management

Research paper thumbnail of Public Primary Health Facilities Autonomy: Findings from Tanzania Star Rating Assessment

International Journal of Health Policy Planning

Background: In many countries, health facility autonomy has been a crucial component of health se... more Background: In many countries, health facility autonomy has been a crucial component of health sector reform. Reducing direct government control over public health facilities and increasing their exposure to the market and market-like forces are part of this reform strategy. The degree of financial independence is a crucial characteristic that determines health facility financing and it has an impact on how well public health facilities function. This study aims at ascertaining Primary Health Facilities autonomy 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. Facility autonomy was measured by the desirable performance of six indicators, namely submission of a health facility plan, having operational bank account, competent handling of funds and financial reporting, deposit of self-generated funds in a facility bank account, health facility receiv...

Research paper thumbnail of Assessment of Implementation of the Star Rating System in Primary Health Facilities: Experience from Tanzania

Journal of Service Science and Management

Research paper thumbnail of Public Primary Health Facilities Autonomy: Findings from Tanzania Star Rating Assessment

Background: In many countries, health facility autonomy has been a crucial component of health se... more Background: In many countries, health facility autonomy has been a crucial component of health sector reform. Reducing direct government control over public health facilities and increasing their exposure to the market and market-like forces are part of this reform strategy. The degree of financial independence is a crucial characteristic that determines health facility financing and it has an impact on how well public health facilities function. This study aims at ascertaining Primary Health Facilities autonomy 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. Facility autonomy was measured by the desirable performance of six indicators, namely submission of a health facility plan,

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

Journal of Service Science and Management

Research paper thumbnail of The Use of Data for Planning and Services Improvement in Tanzanian Primary Healthcare Facilities: Experience from Star Rating Assessment

Journal of Service Science and Management

Research paper thumbnail of Clients satisfaction at primary healthcare facilities and its association with implementation of client service charter in Tanzania

PLOS ONE

Background Client service charter (CSC) provides information about what people can expect in a fa... more Background Client service charter (CSC) provides information about what people can expect in a facility’s services; what is expected of clients and service providers. Tanzania implemented Star Rating Assessment (SRA) of primary health care (PHC) facilities in 2015/16 and 2017/18 using SRA tools with 12 service areas. This paper assesses the status of service area 7, namely client focus that checked if client was satisfied with services provided and implementation of CSC through three indicators–if: CSC was displayed; CSC was monitored; client feedback mechanism and complaints handling was in place. Methods We extracted and performed a cross-sectional secondary data analysis of data related to clients’ focus that are found in national SRA database of 2017/2018 using STATA version 15. Client satisfaction was regarded as dependent variable while facility characteristics plus three indicators of CSC as independent variables. Multivariate logistic regression with p-value of 5% and 95% co...

Research paper thumbnail of Contribution of quality improvement initiative in strengthening laboratory services in Primary Healthcare Facilities in Tanzania: findings from 2017/2018 Star Rating Assessment

ABSTRACTBackgroundAccurate and reliable diagnosis is the cornerstone of disease management and co... more ABSTRACTBackgroundAccurate and reliable diagnosis is the cornerstone of disease management and control. A reliable and properly organized laboratory system not only generates information critical to individual case management but also to disease surveillance, control, and outbreak management. This study presents the status of quality of laboratory services in Tanzania after a nationwide quality assessment, Star Rating Assessment (SRA) of PHC facilities conducted in 2017/18.MethodsThis was a cross-sectional study using secondary data from SRA dataset. Eight indicators were used to measure quality of laboratory services; of which together with facility characteristics are considered independent variables. Dependent variable is the general scores for laboratory services during SRA. Firstly, proportions of facilities for the indicators was calculated. Then, multiple linear regression was employed to determine impact of each variable on quality of laboratory services. P-value of < 0.0...

Research paper thumbnail of Contribution of quality improvement initiative in strengthening laboratory services in Primary Healthcare Facilities in Tanzania: findings from 2017/2018 Star Rating Assessment

ABSTRACTBackgroundAccurate and reliable diagnosis is the cornerstone of disease management and co... more ABSTRACTBackgroundAccurate and reliable diagnosis is the cornerstone of disease management and control. A reliable and properly organized laboratory system not only generates information critical to individual case management but also to disease surveillance, control, and outbreak management. This study presents the status of quality of laboratory services in Tanzania after a nationwide quality assessment, Star Rating Assessment (SRA) of PHC facilities conducted in 2017/18.MethodsThis was a cross-sectional study using secondary data from SRA dataset. Eight indicators were used to measure quality of laboratory services; of which together with facility characteristics are considered independent variables. Dependent variable is the general scores for laboratory services during SRA. Firstly, proportions of facilities for the indicators was calculated. Then, multiple linear regression was employed to determine impact of each variable on quality of laboratory services. P-value of < 0.0...

Research paper thumbnail of Clients satisfaction at primary healthcare facilities and its association with implementation of client service charter in Tanzania

PLOS ONE

Background Client service charter (CSC) provides information about what people can expect in a fa... more Background Client service charter (CSC) provides information about what people can expect in a facility’s services; what is expected of clients and service providers. Tanzania implemented Star Rating Assessment (SRA) of primary health care (PHC) facilities in 2015/16 and 2017/18 using SRA tools with 12 service areas. This paper assesses the status of service area 7, namely client focus that checked if client was satisfied with services provided and implementation of CSC through three indicators–if: CSC was displayed; CSC was monitored; client feedback mechanism and complaints handling was in place. Methods We extracted and performed a cross-sectional secondary data analysis of data related to clients’ focus that are found in national SRA database of 2017/2018 using STATA version 15. Client satisfaction was regarded as dependent variable while facility characteristics plus three indicators of CSC as independent variables. Multivariate logistic regression with p-value of 5% and 95% co...

Research paper thumbnail of Social accountability in primary health care facilities in Tanzania: Results from Star Rating Assessment

PLOS ONE

Background Star Rating Assessment (SRA) was initiated in 2015 in Tanzania aiming at improving the... more Background Star Rating Assessment (SRA) was initiated in 2015 in Tanzania aiming at improving the quality of services provided in Primary Healthcare (PHC) facilities. Social accountability (SA) is among the 12 assessment areas of SRA tools. We aimed to assess the SA performance and its predictors among PHC facilities in Tanzania based on findings of a nationwide reassessment conducted in 2017/18. Methods We used the SRA database with results of 2017/2018 to perform a cross-sectional secondary data analysis on SA dataset. We used proportions to determine the performance of the following five SA indicators: functional committees/boards, display of information on available resources, addressing local concerns, health workers’ engagement with local community, and involvement of community in facility planning process. A facility needed four indicators to be qualified as socially accountable. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were used to determine facilities c...

Research paper thumbnail of The use of data for planning and service improvement in Tanzanian Primary healthcare facilities: Experience from Star Rating Assessment

Background The use of data for planning and improving healthcare delivery is sub-optimal among de... more Background The use of data for planning and improving healthcare delivery is sub-optimal among developing countries. In 2015, Tanzania started to implement Star Rating Assessment (SRA) process for primary health care (PHC) facilities to improve various dimensions of quality of services, including the use of data. We aimed at assessing the extent and predictors of data use in Tanzanian PHC facilities. Methodology We used the most current national SRA data available in DHIS2 that was collected in 2017/2018 from all 7,289 PHC facilities. A facility was considered using data if gained 80% of the allocated scores. Other dependent variables were the three components that together contribute to the use of data [If PHC facility has Health Management Information systems (HMIS) functional, disseminate information, and has proper medical records]. We determined the association between data use and facility ownership status (public or private), location of the facility (rural or urban) and faci...

Research paper thumbnail of Contribution of Results-Based Financing in Quality improvement of Health Services at Primary Healthcare Facilities: Findings from Tanzania Star Rating Assessment

Background Performance-based financing (PBF) is an important mechanism for improving the quality ... more Background Performance-based financing (PBF) is an important mechanism for improving the quality of health services in low- and middle- income countries. In 2014, Tanzania launched a country-wide quality approach known as Star Rating Assessment (SRA) aims to assess the quality of healthcare service delivery in all Primary Health Care (PHC) Facilities in the country. Furthermore, by 2015, the country rolled out RBF initiatives into eight regions in which PHC facilities were paid incentives based on their level of achievement in SRA assessments. This study aims to compare performance in quality between PHC facilities under RBF regions and non-RBF regions using the findings from the two-phases SRA assessments; baseline (2015/16) and follow-up (2017/18). Methods Analysis of performance of SRA indicators in the SRA service areas were identified based on the star rating tool that was used. The star rating tool had 12 service areas. For the sake of this implementation study, only seven ser...