Community participation and accountability in the public health service delivery: a case study of Namtumbo district, Ruvuma

The efforts to improve health service delivery in health facilities have been going on worldwide and Tanzania is no exception. However, the experience has shown that these efforts have been constrained by inadequate community participation. This study sought to examine the community participation and accountability in the public health service delivery. Three wards, Namtumbo, Mkongo and Namabengo in Namtumbo District were selected as the study areas. This study used both qualitative and quantitative approaches in both data collection and analysis. Primary data were collected through questionnaire and interviews with key informants. Secondary data were obtained from published and unpublished materials. The data collected through questionnaire were analysed quantitatively using SPSS and Excel computer packages. Data collected through interviews were analysed qualitatively using content analysis. Findings reveal that the situation of health services delivery in public health facilities in the study areas like in many other rural areas in the country is not satisfactory. This has been influenced by among other factors, low performance of the CHSBs and HFGCs as a result of inadequate empowerment and motivation among the board and committee members, inadequate health facilities and equipments, shortage of human and financial resources and low community participation in the implementation of health plans, supervision and monitoring. The study recommends that the government should supervise and monitor closely the performance of HFGCs and CHSBs. Moreover, adequate resources should be provided on time to ensure that these bodies fulfil their responsibilities effectively. Also members of the boards and committees should be empowered through seminars, training and should be motivated to perform their duties. In addition the community should be informed and sensitized with regard to the duties and responsibilities of health boards and committees. Finally, it is important for the government to encourage NGOs and CSOs dealing with health such as TACOSODE and LHRC to work in rural areas so as to assist in the monitoring of the implementation of health policies and share knowledge and experience with CHSBs and HFGCs members towards improving accountability in the delivering of health services to the community.