Clinical Officers' Competence in Case Management: An Outcome Evaluation of the Competence-Based Curriculum in Tanzanian Primary Health Facilities.

Background: Clinical officers (COs) are at the heart of Tanzania's primary healthcare system, particularly in health centres and dispensaries where they serve as frontline healthcare providers. With the recent rollout of the competence-based curriculum (CBC) in CO training, aimed at strengthening their knowledge, skills, and attitudes for delivering quality healthcare, there remains limited evidence on whether this objective has been realized. This study set out to determine the competences of COs trained under CBC in managing clinical cases in primary healthcare facilities. Objectives: To determine the competences of clinical officers trained under competence based curriculum on case management in primary health facilities in Tanzania. Study Design: Analytical cross-sectional evaluation study design conducted from March to June 2025 in Morogoro region. Study Setting: Public and Private Primary Health Facilities at Kilosa district council and Morogoro municipal council in Morogoro region. Participants: Clinical Officers trained under the competence-based curriculum (CBC) who were working in primary health facilities in Kilosa District Council and Morogoro Municipal Council, Morogoro Region. Primary Outcome: Competence in case management. Results: The findings revealed that 73.7% of the clinical officers were competent in managing clinical cases. Competence was associated with four factors: the type of facility in which the clinical officers were working ( Conclusion: The study demonstrates that the majority of clinical officers trained under the competence-based curriculum possess adequate competence in managing clinical cases within primary health facilities. However, competence levels vary significantly across facility types, categories, roles, and years of experience. The finding that clinical officers with fewer years of experience exhibited higher competence suggests the positive impact of the recently introduced competence-based curriculum on enhancing clinical skills. Strengthening ongoing mentorship and supportive supervision across all facility levels may further sustain and improve competence among clinical officers in Tanzania's primary healthcare system.