Going operational with health systems governance
Supervision and incentives to health workers for increased quality of care in Tanzania
Bibliographic Data
Improving the quality of care is increasingly recognized as a priority of health systems in low- and middle-income countries. Given the labour-intensive nature of healthcare interventions, quality of care largely depends upon the number, training and management of health workers involved in service delivery. Policies available to boost the performance of health workers—and thus the quality of healthcare—include regulation, incentives and supervision—all of which are typically included in quality improvement frameworks and policies. This was the case in Tanzania, where we assessed the role of selected quality improvement policies. To do so, we analysed data from a representative sample of Tanzanian government-managed health facilities, part of the 2014/15 Service Provision Assessment component of the Demographic and Health Survey. We constructed two healthcare quality indicators from data on patient visits: (1) compliance with Integrated Management of Childhood Illness (IMCI) guidelines and (2) patient satisfaction. Using multilevel ordered logistic regression models, we estimated the associations between the outcomes and selected indicators of incentives and supervisory activity at health worker and health facility level. We did not identify any association for the different indicators of top-down supervision at facility and individual level, neither with IMCI compliance nor with patients’ satisfaction. Bottom-up supervision, defined as meetings between community and health facility staff, was significantly associated with higher patient satisfaction. Financial incentives in the form of salary top-ups were positively associated with both IMCI compliance and patient satisfaction. Both housing allowances and government-subsidized housing were positively associated with our proxies of quality of care. Good healthcare quality is crucial for promoting health in Tanzania not only through direct outcomes of the process of care but also through increased care-seeking behaviour in the communities. The results of this study highlight the role of community involvement, better salary conditions and housing arrangements for health workers
Business · Economic growth · Economics · Environmental health · Government (linguistics) · Health care · Health facility · Health services · Incentive · Integrated Management of Childhood Illness · Population · Psychological intervention · Socioeconomics · Tanzania · Global Maternal and Child Health · Healthcare Policy and Management · Healthcare Systems and Reforms · Medicine · Nursing
Critical Analysis of International Collaboration, Crisis Management, And Policy Development In Global Health
Strengthening provider accountability
Investments for effective functionality of health systems towards Universal Health Coverage in Africa
Healthcare managers’ perspectives on direct health facility financing in Tanzania
Relationship of perinatal outcomes to the competence and quantity of contact with community health workers
The State of Health Policy and Systems Research
Community participation
Effectiveness of strategies to improve health-care provider practices in low-income and middle-income countries
Global, regional, and national causes of under-5 mortality in 2000–15
Informal Payments And The Financing Of Health Care In Developing And Transition Countries
Health worker motivation in Africa
How can we achieve and maintain high-quality performance of health workers in low-resource settings?
Overcoming health-systems constraints to achieve the Millennium Development Goals
Motivation and retention of health workers in developing countries
High-quality health systems in the Sustainable Development Goals era
Introducing payment for performance in the health sector of Tanzania- the policy process
Factors that hinder community participation in developing and implementing comprehensive council health plans in Manyoni District, Tanzania
Participation in health planning in a decentralised health system
Factors influencing the implementation of integrated management of childhood illness (IMCI) by healthcare workers at public health centers & dispensaries in Mwanza, Tanzania
What does Access to Maternal Care Mean Among the Urban Poor? Factors Associated with Use of Appropriate Maternal Health Services in the Slum Settlements of Nairobi, Kenya
A systematic review of the literature for evidence on health facility committees in low- and middle-income countries
Support and performance improvement for primary health care workers in low- and middle-income countries
Using incentives to attract nurses to remote areas of Tanzania
Does supportive supervision enhance community health worker motivation? A mixed-methods study in four African countries
The rise and fall of supervision in a project designed to strengthen supervision of Integrated Management of Childhood Illness in Benin
Health governance
Perceptions of per diems in the health sector
Patient satisfaction with health services in Bangladesh
Service quality perceptions and patient satisfaction
How reliable are surveys of client satisfaction with healthcare services? Evidence from matched facility and household data in Madagascar
Missing in Action
The use of direct clinician observation and vignettes for health services quality evaluation in developing countries
Management and health care reform in sub-Saharan Africa
Quality of care and the demand for health services in Bamako, Mali
Motivation, money and respect
The Quality of Medical Advice in Low-Income Countries
| Unique citing works | 6 |
|---|---|
| Citations per year | 0,86 |
| Citation span | 2019 - 2025 (7) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 5 |