How are Health Centres Managed?

Primary Health Care facilities (PHC) are the first place of contact for most of the citizens seeking treatment or preventive services in Tanzania. But how efficiently are they run?

Due to growing concerns over the way primary health care facilities are managed, the Controller and Auditor General did a performance audit of a sample of the health facilities. The audit covered thirty two health Centres in Seven regions.

This leaflet highlights what the auditor general unearthed in the exercise. It shows that there are major shortfalls in the functioning of the management chain of command established for  primary health care:  

  • Health centres are not efficiently managed;
  • Funding of Health centres is done without proper consideration of performance; and,
  • The system for performance monitoring, evaluation and reporting is neither properly updated nor effectively utilised.

The weakness in the management chain of command stretches across all Government levels (from the Central  Government (Ministry of Health and Social Welfare and Prime Minister's Office-Regional Administration and Local Governments), to the Regional administration, and further down to the Council level). As a consequence, the Primary Health Care systems fails to guarantee equitable and quality services to the general public.

To correct these shortcomings, the CAG recommends that responsible departments in the government improve the way management chain functions:

  • MOHSW and PMO-RALG: Strive to improve monitoring and controlling (supervision) and communication (feedback) and reporting mechanisms at all levels.
  • Regional Secretariats: Put more emphasis on performance issues in their monitoring and evaluation of PHC at the Council level. This includes also examining how Councils manage and safeguard effective allocation and efficient utilisation of resources set aside for PHC services.
  • Councils: promote efficient spending of resources for PHC services. This includes making budgets and human resource allocations transparent and based on performance, improving communication and feedback mechanisms, and undertaking regular monitoring of HC spending and performance.

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