The Accountability of Health Facility Governing Committees and its Implications to Health Services Delivery in Njombe District Council, Tanzania.

Abstract

Abstract Introduction: Decentralization is important instrument for development in many countries around the world including the developing countries like Tanzania. In health care system, decentralization has been promoted by international donors as a sectoral reform in health with the objective of improving efficiency and suitability of health programs to community needs. Health Facility Governing Committees (HFGCs) have been introduced at all levels of the health system as a mechanism for improving accountability between health care providers and communities. Despite the presence of HFGCs, health facilities are not performing well. This study intended to assess factors impinging accountability of HFGCs to the community and to the Council Health Governing Boards. Methods: A cross sectional study design was employed to 98 respondents who comprised Council Health Management Team, HFGCs and health staff. Simple random sampling, purposive and convenience sampling techniques were employed in arriving at the sample size. The study used interviews, literature review, Focus Group Discussions, questionnaires and observation. Data were analyzed descriptively by using Statistical Package for Social Sciences computer software version 21. Results: Factors impinging accountability of HFGCs includes: Low level of education among committees member, lack of training, low knowledge of committees about their roles and inadequate fund. Conclusion Accountability of HFGCs is low which is contributed by low level of education, lack of training and inadequate fund. There is a need to review the guideline on formation of health committees particularly the part of education level, building ability and capacity to the committees and to have enough budget for HFGCs activities.