Conducted an End Term Evaluation for community engagement service management project in Simiyu

supported by AMREF Health Africa, 2018

The goal of this project was to contribute to the sustained improvement of quality of health service delivery in Itilima district by 2016.

Expected Outcomes:

• Community health governance structures able to manage, lead and govern health system in Itilima District by 2016.
• Health facility in charges and CHMTs able to better manage district health services by 2016.
• Community members are aware of their rights and responsibilities as consumers of health services by 2016.
• Functionality and effectiveness of community health governance structures in relation to quality of health service delivery analysed by 2016.

Objectives of the End Term of the Evaluation (ETE)

Main Objective was to evaluate the relevance, performance, achievements, lessons learned and success of the project on the beneficiaries and sustainability of its results.

Specific Objectives were:

• To assess the extent to which the project has attained its objectives and goal, focusing on early signs of impact and sustainability of results;
• To evaluate the cost effectiveness of the project. Specifically, assess the financial efficiency around the implementation of activities, output development and partners’ contributions.
• To assess the knowledge, skills and practice of community health Facility Governing Committees, and Village Health Committees to manage, lead and govern health system
• To assess the knowledge, skills and practice of health facility in charges and CHMT to better manage, lead and govern the health service delivery by 2016.
• To assess the extent in which community is aware on their rights and responsibility as consumers of health services
• To evaluate factors that contributes to or inhibits the delivery of the project outcomes
• To provide specific, actionable and practical recommendations for future programming

The study population comprised of health service users, key informants, health facility in-charges and project manager.

The study showed that

• On functionality of the Health facility Governing Committees (HFGCs), the committees were introduced to all health facilities of Itilima and Bariadi Districts. The members of the Committees include from the Community, Health facility, the Village Government and Ward Development Committee (WDC).
• It was found that, in all health centers (HC), and dispensaries covered in Itilima District, some respondents were aware of the roles of their committees. However, community mobilization was said to be limited due to lack of motivation and allowances to committee members. Some committee members were unwilling to give up their time in the absence of allowances to attend committee meetings and/or activities.
• The quality of the health services delivered in therespective health facilities was reported to have improved. However there were still some challenges experienced in shortage of drug, due to increased number of health facility users and inadequacy of skilled health staff.
• The performance of health facilities covered were reported to be performing well. The facilities were supervised by the Council Health Management Team (CHMT)quarterly. They monitored performance of health planned activities and gave comments. When shortcomings were identified, the facilities were identified and in some cases coached.
• On community utilization of health services, it was explained that the communities were sensitized on the importance of utilizing health services.