A Dissertation Submitted in Partial/ Fulfillment of the Requirement for Award of Master Degree of Science in Health Monitoring and Evaluation (MSc. HME) of Mzumbe University
2019
Primary Health care facilities are the basic health care providers for the majority poor community of Tanzania since 1961 when our Government of Tanzania gained Independence to date, however a number of problems and challenges that hinders the
Performances of these primary health care facilities have been reported repeatedly since then. But several efforts and programs have been implemented by the Government of Tanzania to improve performance of Primary health facilities for the provision of quality and affordable services to the Majority poor communities but the outcome are not yet tangible. Therefore of recent the government of Tanzania has decided to co-operate with Global Health Basket fund stakeholders introduce a new Approach so-called Direct Health Facility Financing programme (DHFF) since the Financial Year 2016/2017 the aim is to address some of these problems and challenges facing the Primary Health care facilities in Tanzania. Thus, the study aimed to evaluate the process underlying the implementation of DHFF program at health facilities in Bukoba Municipal Council; objectively aiming to establish the degree of implementation at the sampled health facilities; ascertain the extent to which the program has reached the targeted population, as well as to indicates the factors limiting and influencing program implementation at selected health facilities in the study area.
This study employed a case study design to allow qualitative and quantitative analysis of first hand and secondary data collected through questionnaires, interviews, and documentary review from 60 respondents obtained through rough guide criteria approach and purposive sampling. Data were analyzed through STATA, ATLAs.Ti and excel program.
The descriptive results regarding the degree of program implementation reveal that respondents agreed that health facilities in the study area have met the basic criteria for the successful implementation of the program bearing a mean of 3.56. Nevertheless, bearing a mean of 3.28 respondents agreed that program implementers provide feedback and required reports in the course of program implementation. Furthermore, by bearing a mean of 3.61 respondents agreed that they have so far experienced the expected results and significance of the program being implemented. Eventually, in identifying the barriers and influential factors towards program implementation, the results reveal that inadequate infrastructure and technology (51.7%); limited human capacity (28.3%); and limited community response (20%) are the identified factors limiting program implementation. Hitherto, sound supervision and feedback (45%); availability of knowledge, skills, and experience of health professionals (41.7%); and available rules, procedures, and regulations (13.3%) guiding the implementation process are the identified factors influencing the successful implementation of the DHFF program.
Finally, by exploring the degree of program implementation, the factors limiting and influencing the implementation; the findings of the process evaluation enlighten program stakeholders on the course of implementation. Thus, to accelerate the successful implementation of the program, implementers and other stakeholders should maintain proper supervision and feedbacks, yet, to mentor and coach health professionals to improve their skills, knowledge and experience; not to mention the establishment of friendly rules, procedures, and regulations to lead the implementation to its right course.