Towards improved health service quality in Tanzania: contribution of a supportive supervision approach to increased quality of primary healthcare

• Published in: BMC health services research Vol. 19; no. 1; p. 848
• Main Authors: Renggli, Sabine, Mayumana, Iddy, Mboya, Dominick, Charles, Christopher, Mshana, Christopher, Kessy, Flora, Glass, Tracy R, Lengeler, Christian, Schulze, Alexander, Aerts, Ann, Pfeiffer, Constanze
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 20.11.2019; BioMed Central; BMC
• Subjects: Adolescent; Adult; Aged; Attitude of Health Personnel; Child; Child, Preschool; Councils; Electronic tool; Feedback; Female; Health aspects; Health care industry; Health care reform; Health facilities; Health Facilities - standards; Health Personnel - standards; Health services; Humans; Infant; Infant, Newborn; Male; Medical care; Medical care quality; Medical wastes; Middle Aged; Motor vehicle drivers; National health insurance; Patient care; Primary health care; Primary Health Care - organization & administration; Primary Health Care - standards; Quality; Quality control; Quality improvement; Quality Improvement - standards; Quality improvement approach; Quality Indicators, Health Care; Quality management; Quality of care; Quality of Health Care - standards; Quality of service; Rural Health Services - standards; Self evaluation; Services; Supervision; Supportive supervision; Tanzania; Universal health coverage; Universal Health Insurance - organization & administration; Young Adult; Tanzania; Supportive supervision; Quality improvement approach; Quality of care; Universal health coverage; Tanzania; Electronic tool
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-019-4648-2

Universal Health Coverage only leads to the desired health outcomes if quality of health services is ensured. In Tanzania, quality has been a major concern for many years, including the problem of ineffective and inadequate routine supportive supervision of healthcare providers by council health management teams. To address this, we developed and assessed an approach to improve quality of primary healthcare through enhanced routine supportive supervision. Mixed methods were used, combining trends of quantitative quality of care measurements with qualitative data mainly collected through in-depth interviews. The former allowed for identification of drivers of quality improvements and the latter investigated the perceived contribution of the new supportive supervision approach to these improvements. The results showed that the new approach managed to address quality issues that could be solved either solely by the healthcare provider, or in collaboration with the council. The new approach was able to improve and maintain crucial primary healthcare quality standards across different health facility level and owner categories in various contexts. Together with other findings reported in companion papers, we could show that the new supportive supervision approach not only served to assess quality of primary healthcare, but also to improve and maintain crucial primary healthcare quality standards. The new approach therefore presents a powerful tool to support, guide and drive quality improvement measures within council. It can thus be considered a suitable option to make routine supportive supervision more effective and adequate.