The use of data for planning and service improvement in Tanzanian Primary healthcare facilities: Experience from Star Rating Assessment

Abstract

Background The use of data for planning and improving healthcare delivery is sub-optimal among developing countries. In 2015, Tanzania started to implement Star Rating Assessment (SRA) process for primary health care (PHC) facilities to improve various dimensions of quality of services, including the use of data. We aimed at assessing the extent and predictors of data use in Tanzanian PHC facilities. Methodology We used the most current national SRA data available in DHIS2 that was collected in 2017/2018 from all 7,289 PHC facilities. A facility was considered using data if gained 80% of the allocated scores. Other dependent variables were the three components that together contribute to the use of data [If PHC facility has Health Management Information systems (HMIS) functional, disseminate information, and has proper medical records]. We determined the association between data use and facility ownership status (public or private), location of the facility (rural or urban) and facility service level (dispensary, health centre or hospital). Results are presented as proportions of facilities that qualified for data use and the three components. The associations are reported in Adjusted odds ratio (AOR) with a 95% confidence interval (CI). Results A total of 6,663(91.4%) PHC facilities met our inclusion criteria for analysis. Among the facilities: 1,198(18.0%) had used data for planning and services improvement; 3,792(56.9%) had functional HMIS; 1,752(26.3%) had disseminated data; and 631(9.5%) had proper medical records. PHC facilities that are publicly owned (AOR 1.25; 95% CI: 1.05-1.48) and those at higher service level [hospitals (AOR 1.77; 95% CI: 1.27-2.46) and health centres (AOR 1.39; 95% CI: 1.15-1.68) compared to dispensaries] were more likely to use data. Conclusion The use of facility data for planning and services improvement in Tanzanian PHC facilities is low, and much effort needs to be targeted at privately-owned and low-level PHC facilities.