ArticlePloS one2022
Social accountability in primary health care facilities in Tanzania: Results from Star Rating Assessment.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Mechanisms for stimulating facility quality improvement: A positive deviance study of Tanzania's Star Rating Assessment.PLOS global public health · 2026Article
- Quality of maternal and child health services in Tanzanian primary healthcare: a 2021-2022 star rating review.Reproductive health · 2025Article
- Do health facility governing committees improve health system performance? An ecological study of Mainland Tanzania.BMJ global health · 2025Article
- Healthcare managers' perspectives on direct health facility financing in Tanzania.PLOS global public health · 2025Article
- Has stakeholder participation in health facility governing committees promoted social accountability? A qualitative study in Tanzania.Global health action · 2024Article
- Assessing community awareness and participation in health facility governing committees in two districts of Tanzania: a cross-sectional study.Archives of public health = Archives belges de sante publique · 2024Article
- Health managers' perspectives of community health committees' participation in the annual health sector planning and budgeting process in a devolved unit in Kenya: a cross-sectional study.The Pan African medical journal · 2024Article
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13 authors.
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Abstract
backgroundStar Rating Assessment (SRA) was initiated in 2015 in Tanzania aiming at improving the quality of services provided in Primary Healthcare (PHC) facilities. Social accountability (SA) is among the 12 assessment areas of SRA tools. We aimed to assess the SA performance and its predictors among PHC facilities in Tanzania based on findings of a nationwide reassessment conducted in 2017/18.
methodsWe used the SRA database with results of 2017/2018 to perform a cross-sectional secondary data analysis on SA dataset. We used proportions to determine the performance of the following five SA indicators: functional committees/boards, display of information on available resources, addressing local concerns, health workers' engagement with local community, and involvement of community in facility planning process. A facility needed four indicators to be qualified as socially accountable. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were used to determine facilities characteristics associated with SA, namely location (urban or rural), ownership (private or public) and level of service (hospital, health centre or dispensary).
resultsWe included a total of 3,032 PHC facilities of which majority were dispensaries (86.4%), public-owned (76.3%), and located in rural areas (76.0%). On average, 30.4% of the facilities were socially accountable; 72.0% engaged with local communities; and 65.5% involved communities in facility planning process. Nevertheless, as few as 22.5% had functional Health Committees/Boards. A facility was likely to be socially-accountable if public-owned [AOR 5.92; CI: 4.48-7.82, p = 0.001], based in urban areas [AOR 1.25; 95% CI: 1.01-1.53, p = 0.038] or operates at a level higher than Dispensaries (Health centre or Hospital levels).
conclusionMost of the Tanzanian PHC facilities are not socially accountable and therefore much effort in improving the situation should be done. The efforts should target the lower-level facilities, private-owned and rural-based PHC facilities. Regional authorities must capacitate facility committees/boards and ensure guidelines on SA are followed.
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