A Dissertation Submitted in Fulfillment of the Requirement for the Degree of Master of Business Administration in Corporate Management (MBA-CM) of Mzumbe University
The Government of Tanzania has directed a lot of financial resources towards this universal health care and embraced the use of RBF in health sector to meet the 2030 threshold set out by the WHO to ensure provision of quality healthcare and access by all citizens. This study intended to assess the impact of RBF on health care services in primary health facilities in Simiyu. It has used a case study of 14 selected public health care facilities to measure technical efficiency levels and to investigate determinants of the technical efficiencies among the health facilities. The data was collected through interview with 20 health managers, 60 questionnaires from health care providers, documentary review and observation. The content, thematic and data triangulation analysis was used in analyzing qualitative data while descriptive analysis through SPSS was used in analyzing quantitative data.
RBF incentive at health facility level has improved the level of service monitoring increased supportive supervisions and pear accountability. RBF bonuses on the other hand has influenced quality of health care services in most health facilities, increased availability of essential medicines, drugs and medical supplies. The study findings indicate that most health facilities (97%) are using at least 50% of its revenue collection on medicines and in the first two years of RBF antenatal and postnatal care services have improved both in clinic visits and service coverage.
The results of the study indicate increase in health facility technical efficiency under RBF program. It shows that RBF has significantly influenced institutional deliveries which grew from 64.5% in 2016 to 79.2% in 2018 and deliveries by skilled attendants from 60.3% in 2016 to 75.4% in 2018. The trends of technical inefficiency reveal a decreased gap from 4.2 % in 2016 to 3.8 % in 2018. Findings indicate that there is indeed evidence of providers delivering services up to their full ability (knowledge) with highest technical inefficiency 65.2(68.63%). RBF as a health intervention need adequate staffing level in HFs therefore it is hereby recommended that the government should increase supply of skilled and trained human resources for health in PHCFs.