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Tanzania German Programme to Support Health

Improving quality of services delivered in primary health care facilities


Improving the quality of health services is essential for the health and wellbeing of a population, including reducing maternal and childhood mortality. The Tanzanian government prioritised the improvement of quality services, but this has been hampered by various factors including a lack of funds and a limited number of skilled providers.

Options worked as part of the Tanzania German Programme to Support Health (TGPSH), funded by GIZ, to improve quality of care in regional and district hospitals in four regions. Our work strengthened overall health administration and prioritised quality as an essential component of service delivery.

We worked at national and regional level to create a conducive framework for quality improvement in the country.

National level: We supported the Ministry of Health to develop a road that will inform subsequent steps to develop accreditation systems for health facilities in Tanzania.

We also supported the country to develop health sector specific client complaint guidelines, partly informed of our support to complaint mechanisms in regional and district hospitals in the four regions. The guidelines will enable clients to lodge complaints, opinions or compliments to inform client centred service provision.

Regional level: Our Regional Quality Improvement Advisors worked closely with government counterparts in Regional and Council Health Management Teams to implement a culture of quality across facilities, and build the capacity through mentoring, coaching and training. We also supported the Regional and Council Health Management Teams by providing technical advice and establishing functional quality improvement structures. We introduced regular supportive supervision in the facilities, to ensure quality improvement remains a constant agenda at regional, council and hospital levels aiming to improve the quality of services delivered.

Our approach to quality improvement has resulted in a dramatic increase in the quality of services delivered in the four regions, along with a marked increase in patient satisfaction, from 48.9% in 2016 to 70.6% in 2017.

Project achievements
  • A roadmap that details the steps needed to develop a national accreditation system for all health facilities in Tanzania has been produced. The roadmap will be crucial in setting up national accreditation systems in the future.
  • We helped set up quality improvement structures and teams in 22 district hospitals, and developed plans for responding to gaps in quality of care.
  • Through these efforts, care satisfaction among female clients improved as a result of increased mentoring and a focus on quality.
  • All 28 supported hospitals have functional client complaint mechanisms.
  • Support to quality improvement has been strengthened to involve regional and district administrative leadership which has helped to attract more resources and prioritisation of quality improvement beyond the health sector.



out of 22 supported facilities met the minimum national quality level criteria, or higher, up from only 2 at baseline.


satisfaction with services among female clients improved from 48.9% in 2016 to 70.6% in 2017.


All supported hospitals (22 district hospitals, 4 regional hospitals and 2 hospitals at regional level) implemented annual quality improvement plans.

Focus areas
Maternal and Newborn Health
Quality Improvement
East Africa

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