Browsing by Author "Joseph, Chakupewa"

Now showing 1 - 1 of 1
  • No Thumbnail Available
    Item
    Management and leadership practices and the performance of community health fund in Tanzania:a comparative Study of Iramba and Iringa Districts
    (University of Dar es Salaam, 2014) Joseph, Chakupewa
    Introduction of user fee in the health sector in Tanzania in 1990s was accompanied with adverse effects. This led to the introduction of health insurance including Community Health Fund (CHF) in order to counteract the negative effects of the user fee. CHF is a voluntary pre-payment scheme, targeting 85% of the rural population. While the country enrollment of the CHF is low (9.2%), there are marked variations among districts. This study looked at the role of management and leadership practices in the uptake of the CHF in Tanzania by comparing good performing (Iramba) and poor performing (Iringa) districts. Questionnaires and in-depth interview were administered to the Council Health Management Team (CHMT); Council Health Service Board (CHSB); Health Facility Governing Committee (HFGCs); and Health Facility Staff (HFSs). Minutes and other documents were used to verify and triangulate data.Findings revealed that knowing and executing of responsibilities by the CHF managers was a cornerstone for the CHF performance in Iramba than Iringa. Also, personal initiatives of the top districts leaders marked the difference in CHF performance. Again, the capacity of CHF managers to successfully handle HFSs matters pertaining to their welfare was an important milestone for CHF performance. Iramba conducted Performance Assessment (PA) as scheduled which in turn improved health delivery alongside with CHF. Higher performance of CHF in Iramba also was found to be tied on well established system of motivation and incentives to the HFSs, HFGC and CHSB. Lastly, managing of CHF information system played crucial role in enhancing CHF in Iramba than Iringa district.The study concludes that in achieving higher CHF performance effective management and leadership practices need special attention. The district council needs to have CHF managers who are capable of initiating things by being proactive and innovative. Again, motivation and incentives to the HFSs, HFGC and CHSB need to be prioritized. Performance Assessment needs to be frequently conducted among HFSs. Also, CHF information system should be highly strengthened. Support to the HFSs welfare to be granted by the CHF managers. Above all, CHF managers need to have capacity to not only know their responsibilities but also execute thoroughly well.