Erick S Kinyenje, Martin M Degeh, Joseph C Hokororo, Syabo M Mwaisengela, Ruth R Ngowi, Omary A Nassoro, Chrisogone J German, Radenta P Bahegwa, Yohanes S Msigwa, Atuganile Musyani, Laura E Marandu, Michael Habtu, Jennifer T Mbise, Habibu Ismail, Janeth Masuma, Faraja Msemwa, Joanita Muruve, Saturini Manangwa, Daudi Msasi, Jimmy Mbelwa, Athman Pembe, Ahmad M Makuwani, Ntuli A Kapologwe, Tumaini J Nagu, Eliudi S Eliakimu
{"title":"坦桑尼亚初级卫生保健的妇幼保健服务质量：2021-2022年星级评估","authors":"Erick S Kinyenje, Martin M Degeh, Joseph C Hokororo, Syabo M Mwaisengela, Ruth R Ngowi, Omary A Nassoro, Chrisogone J German, Radenta P Bahegwa, Yohanes S Msigwa, Atuganile Musyani, Laura E Marandu, Michael Habtu, Jennifer T Mbise, Habibu Ismail, Janeth Masuma, Faraja Msemwa, Joanita Muruve, Saturini Manangwa, Daudi Msasi, Jimmy Mbelwa, Athman Pembe, Ahmad M Makuwani, Ntuli A Kapologwe, Tumaini J Nagu, Eliudi S Eliakimu","doi":"10.1186/s12978-025-02105-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Tanzania faces high maternal and infant mortality rates, yet key service quality metrics remain underexamined, limiting targeted improvements. Star Rating Assessment (SRA), introduced in 2015, aims to improve primary health care (PHC) quality, including maternal and child health (MCH) services. This study analyses SRA data to assess the prevalence of PHC quality in MCH and its associated factors.</p><p><strong>Methods: </strong>Data for this cross-sectional study were collected from November 2021 to March 2022 across 10 regions. The tool used included 12 MCH-related indicators, each comprising specific criteria. Facilities scoring ≥ 80% across these criteria were considered to meet MCH quality standards, which was the primary study outcome. A descriptive analysis of indicator performance was conducted, followed by multivariate logistic regression to assess characteristics associated with achieving the quality standard. Results are reported as adjusted odds ratios (AOR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>A total of 2,583 facilities assessed: 2,189 dispensaries (84.7%), 303 health centres (11.7%), and 91 district-level hospitals (3.5%). Only 280(10.8%) met the MCH quality standards. Maternal audit and review practices aligned with guidelines in 2,057 facilities (79.6%). Moderate adherence was observed for family planning guidelines (48.3%), accurate partogram completion (47.9%), and immunisation standards (46.3%). Major gaps included cervical cancer screening, offered by 199 facilities (7.7%), and essential obstetric medicines, available in 424 facilities (16.4%). Among 394 hospitals and health centres, only 60(15.2%) offered postnatal and essential newborn care with dedicated neonatal and Kangaroo Mother Care spaces. Compliance was higher in public, rural, and higher-level facilities. Nurse availability, functional management, and quality improvement teams were key predictors of MCH quality.</p><p><strong>Conclusion: </strong>The quality of MCH services in Tanzania varies widely by facility type, ownership, nurse staffing, and management functionality. Targeted improvements in cervical cancer screening, emergency obstetric care, and newborn care are essential to raise overall MCH service standards.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"180"},"PeriodicalIF":3.4000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486962/pdf/","citationCount":"0","resultStr":"{\"title\":\"Quality of maternal and child health services in Tanzanian primary healthcare: a 2021-2022 star rating review.\",\"authors\":\"Erick S Kinyenje, Martin M Degeh, Joseph C Hokororo, Syabo M Mwaisengela, Ruth R Ngowi, Omary A Nassoro, Chrisogone J German, Radenta P Bahegwa, Yohanes S Msigwa, Atuganile Musyani, Laura E Marandu, Michael Habtu, Jennifer T Mbise, Habibu Ismail, Janeth Masuma, Faraja Msemwa, Joanita Muruve, Saturini Manangwa, Daudi Msasi, Jimmy Mbelwa, Athman Pembe, Ahmad M Makuwani, Ntuli A Kapologwe, Tumaini J Nagu, Eliudi S Eliakimu\",\"doi\":\"10.1186/s12978-025-02105-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Tanzania faces high maternal and infant mortality rates, yet key service quality metrics remain underexamined, limiting targeted improvements. Star Rating Assessment (SRA), introduced in 2015, aims to improve primary health care (PHC) quality, including maternal and child health (MCH) services. This study analyses SRA data to assess the prevalence of PHC quality in MCH and its associated factors.</p><p><strong>Methods: </strong>Data for this cross-sectional study were collected from November 2021 to March 2022 across 10 regions. The tool used included 12 MCH-related indicators, each comprising specific criteria. Facilities scoring ≥ 80% across these criteria were considered to meet MCH quality standards, which was the primary study outcome. A descriptive analysis of indicator performance was conducted, followed by multivariate logistic regression to assess characteristics associated with achieving the quality standard. Results are reported as adjusted odds ratios (AOR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>A total of 2,583 facilities assessed: 2,189 dispensaries (84.7%), 303 health centres (11.7%), and 91 district-level hospitals (3.5%). Only 280(10.8%) met the MCH quality standards. Maternal audit and review practices aligned with guidelines in 2,057 facilities (79.6%). Moderate adherence was observed for family planning guidelines (48.3%), accurate partogram completion (47.9%), and immunisation standards (46.3%). Major gaps included cervical cancer screening, offered by 199 facilities (7.7%), and essential obstetric medicines, available in 424 facilities (16.4%). Among 394 hospitals and health centres, only 60(15.2%) offered postnatal and essential newborn care with dedicated neonatal and Kangaroo Mother Care spaces. Compliance was higher in public, rural, and higher-level facilities. Nurse availability, functional management, and quality improvement teams were key predictors of MCH quality.</p><p><strong>Conclusion: </strong>The quality of MCH services in Tanzania varies widely by facility type, ownership, nurse staffing, and management functionality. Targeted improvements in cervical cancer screening, emergency obstetric care, and newborn care are essential to raise overall MCH service standards.</p>\",\"PeriodicalId\":20899,\"journal\":{\"name\":\"Reproductive Health\",\"volume\":\"22 1\",\"pages\":\"180\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486962/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Reproductive Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12978-025-02105-y\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reproductive Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12978-025-02105-y","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Quality of maternal and child health services in Tanzanian primary healthcare: a 2021-2022 star rating review.
Background: Tanzania faces high maternal and infant mortality rates, yet key service quality metrics remain underexamined, limiting targeted improvements. Star Rating Assessment (SRA), introduced in 2015, aims to improve primary health care (PHC) quality, including maternal and child health (MCH) services. This study analyses SRA data to assess the prevalence of PHC quality in MCH and its associated factors.
Methods: Data for this cross-sectional study were collected from November 2021 to March 2022 across 10 regions. The tool used included 12 MCH-related indicators, each comprising specific criteria. Facilities scoring ≥ 80% across these criteria were considered to meet MCH quality standards, which was the primary study outcome. A descriptive analysis of indicator performance was conducted, followed by multivariate logistic regression to assess characteristics associated with achieving the quality standard. Results are reported as adjusted odds ratios (AOR) with 95% confidence intervals (CI).
Results: A total of 2,583 facilities assessed: 2,189 dispensaries (84.7%), 303 health centres (11.7%), and 91 district-level hospitals (3.5%). Only 280(10.8%) met the MCH quality standards. Maternal audit and review practices aligned with guidelines in 2,057 facilities (79.6%). Moderate adherence was observed for family planning guidelines (48.3%), accurate partogram completion (47.9%), and immunisation standards (46.3%). Major gaps included cervical cancer screening, offered by 199 facilities (7.7%), and essential obstetric medicines, available in 424 facilities (16.4%). Among 394 hospitals and health centres, only 60(15.2%) offered postnatal and essential newborn care with dedicated neonatal and Kangaroo Mother Care spaces. Compliance was higher in public, rural, and higher-level facilities. Nurse availability, functional management, and quality improvement teams were key predictors of MCH quality.
Conclusion: The quality of MCH services in Tanzania varies widely by facility type, ownership, nurse staffing, and management functionality. Targeted improvements in cervical cancer screening, emergency obstetric care, and newborn care are essential to raise overall MCH service standards.
期刊介绍：
Reproductive Health focuses on all aspects of human reproduction. The journal includes sections dedicated to adolescent health, female fertility and midwifery and all content is open access.
Reproductive health is defined as a state of physical, mental, and social well-being in all matters relating to the reproductive system, at all stages of life. Good reproductive health implies that people are able to have a satisfying and safe sex life, the capability to reproduce and the freedom to decide if, when, and how often to do so. Men and women should be informed about and have access to safe, effective, affordable, and acceptable methods of family planning of their choice, and the right to appropriate health-care services that enable women to safely go through pregnancy and childbirth.
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