Has stakeholder participation in health facility governing committees promoted social accountability? A qualitative study in Tanzania
Background Since the 1990s, Tanzania has actively encouraged stakeholder participation in health services through Health Facility Governing Committees (HFGCs) to promote social accountability within its broader health system reforms. While previous studies have explored the functionality of the HFGC...
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| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Global Health Action |
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| Online Access: | http://dx.doi.org/10.1080/16549716.2024.2432067 |
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| author | Hussein Athuman Kapuya Stephen Oswald Maluka Anna-Karin Hurtig Miguel San Sebastian |
| author_facet | Hussein Athuman Kapuya Stephen Oswald Maluka Anna-Karin Hurtig Miguel San Sebastian |
| author_sort | Hussein Athuman Kapuya |
| collection | DOAJ |
| description | Background Since the 1990s, Tanzania has actively encouraged stakeholder participation in health services through Health Facility Governing Committees (HFGCs) to promote social accountability within its broader health system reforms. While previous studies have explored the functionality of the HFGCs, this study aimed to understand whether stakeholder participation in the HFGCs contributes to promoting social accountability in the health system. Methods Between July and October 2022, a qualitative study in two districts of Tanzania was carried out. Selected participants, knowledgeable about HFGCs, included facility managers, HFGC members representing diverse stakeholders in the committees, local government leaders, district health secretaries, and religious leaders. Twenty in-depth interviews were conducted and analysed thematically. Results Findings revealed low stakeholder participation in the committees´ activities, partly due to the committees´ inability to effectively sensitize and mobilize them. Inadequate support from local government leaders and the dominance of the facility managers in the committees´ activities, also affected the committees´ role as promoters of social accountability. Conclusion The HFGCs in Tanzania have faced challenges in promoting social accountability due to weak stakeholder participation. Key issues include limited awareness of HFGCs, inadequate mobilization, and insufficient training, supervision, and guidelines from district councils. Additionally, flawed election processes, leadership interference, lack of political support, and limited financial resources undermined the committees’ effectiveness. To improve engagement, district councils should enhance stakeholder sensitization, build HFGC capacity, ensure that facilities allocate 5% of their budgets for committee activities, monitor performance, and encourage local government support for HFGCs. |
| format | Article |
| id | doaj-art-5943c155ec9d4132abfc8ddcb592e220 |
| institution | Kabale University |
| issn | 1654-9880 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Global Health Action |
| spelling | doaj-art-5943c155ec9d4132abfc8ddcb592e2202025-02-05T12:46:14ZengTaylor & Francis GroupGlobal Health Action1654-98802024-12-0117110.1080/16549716.2024.24320672432067Has stakeholder participation in health facility governing committees promoted social accountability? A qualitative study in TanzaniaHussein Athuman Kapuya0Stephen Oswald Maluka1Anna-Karin Hurtig2Miguel San Sebastian3University of Dar es SalaamUniversity of Dar es SalaamUmeå UniversityUmeå UniversityBackground Since the 1990s, Tanzania has actively encouraged stakeholder participation in health services through Health Facility Governing Committees (HFGCs) to promote social accountability within its broader health system reforms. While previous studies have explored the functionality of the HFGCs, this study aimed to understand whether stakeholder participation in the HFGCs contributes to promoting social accountability in the health system. Methods Between July and October 2022, a qualitative study in two districts of Tanzania was carried out. Selected participants, knowledgeable about HFGCs, included facility managers, HFGC members representing diverse stakeholders in the committees, local government leaders, district health secretaries, and religious leaders. Twenty in-depth interviews were conducted and analysed thematically. Results Findings revealed low stakeholder participation in the committees´ activities, partly due to the committees´ inability to effectively sensitize and mobilize them. Inadequate support from local government leaders and the dominance of the facility managers in the committees´ activities, also affected the committees´ role as promoters of social accountability. Conclusion The HFGCs in Tanzania have faced challenges in promoting social accountability due to weak stakeholder participation. Key issues include limited awareness of HFGCs, inadequate mobilization, and insufficient training, supervision, and guidelines from district councils. Additionally, flawed election processes, leadership interference, lack of political support, and limited financial resources undermined the committees’ effectiveness. To improve engagement, district councils should enhance stakeholder sensitization, build HFGC capacity, ensure that facilities allocate 5% of their budgets for committee activities, monitor performance, and encourage local government support for HFGCs.http://dx.doi.org/10.1080/16549716.2024.2432067stakeholder participationsocial accountabilityhealth facility governing committeeshealth systemtanzania |
| spellingShingle | Hussein Athuman Kapuya Stephen Oswald Maluka Anna-Karin Hurtig Miguel San Sebastian Has stakeholder participation in health facility governing committees promoted social accountability? A qualitative study in Tanzania Global Health Action stakeholder participation social accountability health facility governing committees health system tanzania |
| title | Has stakeholder participation in health facility governing committees promoted social accountability? A qualitative study in Tanzania |
| title_full | Has stakeholder participation in health facility governing committees promoted social accountability? A qualitative study in Tanzania |
| title_fullStr | Has stakeholder participation in health facility governing committees promoted social accountability? A qualitative study in Tanzania |
| title_full_unstemmed | Has stakeholder participation in health facility governing committees promoted social accountability? A qualitative study in Tanzania |
| title_short | Has stakeholder participation in health facility governing committees promoted social accountability? A qualitative study in Tanzania |
| title_sort | has stakeholder participation in health facility governing committees promoted social accountability a qualitative study in tanzania |
| topic | stakeholder participation social accountability health facility governing committees health system tanzania |
| url | http://dx.doi.org/10.1080/16549716.2024.2432067 |
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