A Dissertation Submitted in Partial Fulfillment of the Requirement for the Award of Degree of Masters of Science in Leadership and Management (MSc-L&M) of Mzumbe University
Surgical care is a vital service which should undergo surveillance so as to identify factors that affect its performance. This is a case study whose main objective was to assess factors that affect the performance of surgical services in Tanzania. The specific objectives were to identify factors which are related to the referral system, patients, employees, and to hospital, that contribute to the poor performance in surgical services.
The Data was collected from employees of the Department of General Surgery through questionnaires, from patients admitted in general surgical wards through schedules, and observation was carried out in the operating rooms and in the departmental meeting room. Purposive sampling was employed. Analysis of the data was done aiming at answering the research questions.
The study revealed that the performance in surgical care is contributed by the poor economy of the country, poorly managed and inefficient referral system, MNH holding unofficial roles of all health facilities along the referral hierarchy and lack of a zonal referral hospital for communities residing in the coastal zone. Late presentation of diseases emerged as one of the prominent human related factors, whereas poor human resource management and poor time management were the hospital related factors that were identified.
Recommendations were made aiming at improving the quality of surgical services and relieving the surgical care from the burden by tackling the above identified factors. The need to improve infrastructure, diagnostic and therapeutic equipment to all health care levels, in addition to improving human resource management, were recommended.
However, further Researches aiming at identifying more factors, particularly: factors that contribute to retardation of economic growth and development in Tanzanian, factors affecting the efficiency and effectiveness of health facilities and the referral system, and factors contributing to poor employees’ performance were recommended too.