Hospital managers in Tanzania have always been expected to manage and deliver quality services to patients under resource constrained situation. In the organizational structure of regional referral hospitals (RRHs) in Tanzania, including, clinicians with very limited knowledge of and skills in management hold over 80% of the managerial positions. The Ministry of Health, Community Development, Gender, Elderly and Children of Tanzania has identified the strengthening of management at RRHs as a key to improving efficiency and effectiveness in health service delivery. The ministry launched a five-year project for strengthening hospital management in RRHs in collaboration with the Japan International Cooperation Agency. The project provided a series of training courses for capacitating RRH management Team (RRHMT), and developed and introduced several planning, monitoring, and evaluation tools. This study was conducted to identify the positive factors and approaches for strengthening management of RRHs. Necessary information and data were collected through the intervention and analyzed to measure the effectiveness of the interventions. RRHMT members obtained basic knowledge of and skills for hospital management through the project interventions with those deferent management tools to improve the completion of their hospital management tasks. Based on the findings, it can be concluded that the interventions were effective in strengthening the managerial capacity of RRHMTs. The study also confirmed that the strategy to improve hospital management was on the right track for improving health service delivery in efficient and effective manners. The lessons learned from the project can be adjusted for the management of lower healthcare facilities.
Monitoring and evaluation of contracts for health service delivery in Costa Rica
