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Objective: Our objective was to assess clinical governance and the quality of health services in public primary health facilities in three councils of Arusha Region. Participants: We conducted a study involving 270 clients from 19 primary health facilities in three councils in Arusha Region. Methods: We conducted a cross-sectional study. The clients were selected using multistage-cluster sampling. Data were collected using exit interview and observation. A descriptive statistical method was used to analyse data. Results: We found that health facilities had the key policies and structures for quality improvement and limited governance for quality of health services. In total,109(43%) of the clients reported receiving all the prescribed medicines and 230 (85%) of the clients had a positive experience with care processes. Also, 181(72%) of the clients were satisfied with the health services and 230 (85%) of clients had confidence and trust in public primary health facilities. Conclusion: This research has generated valuable evidence on governance and the quality of health services offered in public primary health facilities in three councils of the Arusha Region. Our research has indicated that: facilities had limited governance for quality of health services and clients had limited access to essential medicines; the majority of clients had a positive experience with the processes of health care; the majority of clients were satisfied with health services offered and had confidence and trust in public primary health facilities. The empirical evidence of this study should inform quality improvement efforts in the studied councils and Tanzania. [ABSTRACT FROM AUTHOR]

Objective: The research objective was to assess the practices of implementing, monitoring and evaluating the Health Sector Strategic Plan IV(HSSPIV) in Tanzania Mainland. Participants: This research involved a quantitative sample of 290 from 23 councils and a qualitative sample of 15 council health managers from 15 councils. Methods: We used mixed-method research. Data were collected using a questionnaire and semi-structured interview. We collected data on practices of implementing, monitoring and evaluating the HSSPIV. Data were analysed using descriptive and thematic analyses. Results: We found that the council health managers generally used nine practices recommended by experts to implement, monitor and evaluate the HSSPIV. Specifically, our study has found and described five practices the council health managers used to implement the HSSPIV. Also, the study identified and described four practices the council health managers used to monitor and evaluate the progress of achieving the results set out in the HSSPIV. Conclusion: Overall, the study evidence suggest that the council health managers generally used practices recommended by experts to implement, monitor and evaluate the HSSPIV. We recommend that the council health managers should continue to use the identified practices to implement future HSSPs. Future studies should be done to identify practices associated with health sector strategic results in Tanzania Mainland. [ABSTRACT FROM AUTHOR]