Measuring hospital performances of regional referral hospitals in Tanzania

In Tanzania, regional referral hospitals (RRHs) play a major role in providing curative and diagnostic services and influence the performance of the entire health system. The results of a baseline survey conducted in 2015 to determine the status of RRHs in Tanzania indicated that there were many supportive supervisory and assessment tools for RRHs but none of them specifically focused on the performance of hospitals. In an endeavor to enhance the performance of RRHs, the Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) and the President Office – Regional Administration and Local Government (PO-RALG) developed an external hospital performance assessment (EHPA) tool to analyze all aspects of the performance of RRHs. EHPA was started in 2017 to assess the performance of 28 RRHs in the country. This study examines the changes to the performance of the RRHs based on the introduction of the EHPA and the supportive interventions by the Ministry of Health. It is also studying the factors that influence the assessment of EHPA. As the results of this study, there is a great indication of the overall performance of RRHs being improved as observed from an upward gradient of average EHPA scores from 2017 to 2019 in all RRHs. This improvement is exemplified by the decrease in the standard deviation gap amongst RRHs. The three years (2017–2019) of consecutive assessment has also observed implicit competition in improving hospital services among Regional Referral Hospital Management Teams (RRHMTs) using the findings from the EHPA.