District Health and Quality Management
Background
Generally, hospitals are considered as centrepieces of the health services in the district. In most cases the national policies provide a hospital per each district although there are cases where some districts have more hospitals (usually faith based hospitals). District hospitals are integral parts of a comprehensive district health system.
Objectives
The component has the goal to enable the district health services in Mtwara, Lindi, Tanga and Mbeya regions to provide efficient and comprehensive health services responding to the people’s needs.
Approach
The component “district support/quality management” gives support to the regional and district health authorities. The team leader responsible for this component is based in Tanga Region and acts as an adviser to the Regional Medical Officer in Tanga, who has a supervisory role in regard to the implementation of national health policy strategies in the districts. So far, the support given to the Regional level is of important benefit to the districts.
Activities
In particular the following activities in the region and in the districts have been supported:
1. Development of national guidelines for establishment of a Comprehensive Council Health Plan (CCHP)
2. Support to districts to establish an annual CCHP
3. Support to districts to improve data collection, processing and analysis in the sector
4. Assistance to establish and train Hospital quality management teams in 14 district and 4 Regional Hospitals
5. Support to develop Hospital performance assessment tool and training on use of the tool
6. Support to refurbish, expand and equip health care infrastructure including staff houses
7. Support to hospital management Teams including installation of computer assisted hospital management system for Tanga Regional Hospital and 3 district hospitals
8. Assistance to establish health care waste management system in 6 hospitals of Tanga Region
9. Computer training for CHMT-members of all 6 districts of Tanga Region
10. Support to put in place a Heath Care Technical Services System
11. Assistance to different district activities aiming to improve obstetric care
At central level support was given to the establishment of a national quality improvement framework which describes the strategies, which Tanzania will adopt to improve quality of the health services
At district level the planned activities will focus on quality improvement in the district hospitals. A nice example of an efficient collaboration of the various German institutions of development cooperation with the Tanzanian partner can be found. The DED adviser for quality improvement at district hospital level in Masasi is a member of District Health Improvement Project.
Achievements
1. Comprehensive Council Health Plans have improved. The guidelines developed are used for planning throughout the country
2. A Primary HealthCare (PHC) tool was developed and in use in Tanga Region. Annual Health reports are better in terms of comprehensiveness and accuracy.
3. 17 out 21 district hospitals in the programme area have functional Quality improvement teams (QT) and Quality Improvement (QI) action plans.
4. Hospitals with QTs are conducting hospital assessments at last once per year
5. A regional Quality conference involving care providers, politicians, service users and other decision makers at council and regional level was conducted. Useful discussions and decisions were concluded in this conference
6. Six hospitals of Tanga Region have been refurbished and expanded. Availability of essential equipment has improved. Training of staff on specific issues related to waste management, sterilization, care of equipment and patient flow has been done.
7. Three hospitals have functional computer assisted management with support from TGPSH.
8. Health care waste management system is operational in 6 hospitals of Tanga region.
9. Six out of seven district hospitals of Tanga have qualified maintenance technicians. A task force to look into details of maintenance organization, coordination and sustainability has been formed and now working.
For more information see the PowerPoint presentation "IntroductionTGPSH-Tanga.ppt". It shows how the DHQM- component fits into the overall structure.