A Thesis Submitted to Mzumbe University, Dar es Salaam Campus College in Partial Fulfillment of the Requirements for the Award of the Degree of Master of Science in Human Resource Management (MSc-HRM) of Mzumbe University.This report is a summary of my findings on the Open Performance Review and Appraisal System (OPRAS) in Tanzania public health services, the case study of Monduli and Meru District Hospitals. The hypothesis is premised on the fact that, where as Monduli and Meru District Hospitals have 161 permanent and pensionable staff, about fifty percent of them have not filled the OPRAS Forms as required by the President’s Office, Public Service Management. The first possible cause for noncompliance of OPRAS implementation is due to lack of training on how to fill in the OPRAS Forms. The second factor is due to lack of monitoring and evaluation mechanism for OPRAS implementation process. During the study, data collection was done through administered questionnaires to 88 employees from Monduli and Meru District Hospitals. The study revealed that 59.5 per cent of the respondents were within the middle management level, 19.1 percent were within lower management level while 21.4 per cent of the respondents were within top management level. The study also revealed that action plan for training staff was not put in place neither showing the importance of filling the OPRAS Forms. This was evidenced by 54.8per cent of the respondents who agreed with the statement that training of staff at all levels is needed. The study also revealed that both hospitals lacked an effective mechanism for monitoring implementation of OPRAS. This was evidenced by 60 per cent of the respondents who were claiming, unless the system is monitored and evaluated, it will be difficult to understand whether OPRAS is attaining its targeted goals. As Michael (2002) claims, ‘the essence of management is learning how to achieve results through other people,” in view of this, until you learn make the most of people resources through supervision, your success will be limited. Based on the above explanation, it is recommended that in order to ensure effective employee performance appraisal employees need to be well trained as well as putting in place monitoring and evaluation mechanism so as to evaluate the implementation process of OPRAS.