Quality of primary health care: facilities supervision and RRX associated factors: the case of Mbeya city council.

Abstract

Despite of a growing pool of health sector reform resources channeled to the district, supervision of (PEC) Primary 1 Health Care facilities has continually remained poor and inadequate. This has contributed to poor performance of health care providers and quality of health services, hence increasing user's dissatisfaction to the services offered. A descriptive cross sectional study involving 32 private and public PHC facilities and 7 Council Health Management Team (CHMT) members was conducted in Mbeya City Council in July, 2008 to determine the quality of CHMT supervisory visits to PHC facilities in the past 12 months. A structured questionnaire with both open and close ended question was used to interview participants. The study revealed that only If) (S()(;;',) health r<lcilities were supervised at least once in the past 12 11101ltl1 .of thcsc only 5 (16(/'0) were supervised [our times or more (the standard supervision guideline minimum number of visits per facility in a year), 14(88%) were not informed prior to the visit in the last visit. Furthermore it was found that supervision is not documented in table 6 of Health Management Information System' MTUHA' Book 2 in II facilities ((ll O~,) Majority, 17(94%) facilities were not given written feedback report and that Callow up action was developed in only 9(50%). Adherence to Supervision Guideline and staff satisfaction to last supervision was slightly higher in private facilities than government facilities. The study recommends that RHMTs should strengthen regular districts inspectorate and supportive visits, for checking Cl-lMT on site supervision performance and that CIIMT should develop and use local checklist in all facilities supervision so as 'to ensure consistency.