Strengthening social accountability for improving health system in Tanzania: how can health facility governing committees fulfil their role?
How and under what conditions informed and competent community organization can improve social accountability in the Tanzanian health system?
Since 2017, the Tanzanian government has further transferred power, autonomy and authority to plan, budget and manage the financial resources of local healthcare facilities. Local committees, which mostly consist of representatives of the local community, the so-called "Health Facility Governing Committees" (HGFCs), now have a central role in ensuring social responsibility within the Tanzanian health system.
Social accountability is important for improving the delivery of health services and empower citizens. The government of Tanzania has since 2017 further transferred authority to plan, budget and manage financial resources to the health facilities. Health facility governing committees (HFGCs) have therefore got a pivotal role in ensuring social accountability. While HFGCs serve as bridges between health facilities and their communities, efforts need to be made to reinforce their capacity.
This project therefore aims to understand if, how, and under what conditions informed and competent (HFGC) improve social accountability. This will be achieved by using a participatory approach to realist evaluation, engaging members of the HFGCs, health managers and providers and community leaders to: 1) map challenges and opportunities of the current reform; 2) develop an initial programme theory that proposes a plan to strengthen the role of the HFGCs; 3) test the programme theory by developing a plan of actions; 4) refine the programme theory through multiple cycles of participatory learning and finally 5) propose a set of recommendations to guide processes to strengthen social accountability in the Tanzanian health system.
This project is part of an ongoing strong collaboration between University of Dar es Saalam, and Umeå University providing true opportunities for action learning and close interactions between researchers, decision makers and practitioners.