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Leadership and Governance Effect in Implementing the IMPACT Approach: A Retrospective Observational Study in Simiyu Region

Received: 20 April 2023     Accepted: 16 May 2023     Published: 31 May 2023
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Abstract

The Government of Tanzania in collaboration with USAID Global Health Supply Chain-Technical Assistance-Tanzania (USAID GHSC-TA -TZ), JSI-InSupply Health and United Nations Population Fund (UNFPA) rolled out the IMPACT approach in Simiyu Region in 2019. For the purpose of improve data management and visibility of vertical health commodities supply chain system. The objective of this study was to highlight leadership engagement in implementation of IMPACT Approach to improve reporting rates for vertical health commodities. Since introduction of this approach indicators monitored were not improving; the region facilitated the response performance monitoring processes, through IMPACT approach integrating with performance Scorecard as a visual performance tool for some of the indicators, including the process indicators, and used feedback meetings attended by senior leaders in the region to discuss indicator results and identify areas for improvement for councils. The results of this study revealed that, engagement of leaders in decision making influenced positively the IMPACT meetings conducted by teams whereby supply chain challenges including reporting rates discussed. At a Councils level the meetings conducted as per calendar increased from 6.1% April-June 2021 to 84.9% October- December 2022. Moreover, reporting rate of four (4) vertical health commodities which include (Malaria, HIV/AIDS, TB/L and RMNCAH) demonstrated positive increase from 60.5% January 2021 to 84.7 December 2022, and availability of all four vertical health commodities increased from 85% January 2022 to 93% December 2022. The availability of these commodities resulted into improved service delivery at health facility level. The study was a retrospective observation of the implementation of the IMPACT team approach in Simiyu region. It assessed the availability of vertical health commodities as a function of the number of items reported, data used for computation of reporting rate, availability of health commodities and improved service delivery were retrieved from eLMIS and DHIS2. Action and performance improvement plans were developed and tracked using scorecards to ensure that each planned activity is implemented accordingly and the desired supply chain outcomes are achieved. This was followed by convening leadership engagement forums where underperforming councils had to explain and articulate the reasons for their unsatisfactory performance and eventually commit to improving the required indicators. The study concluded that, good governance and leadership engagement played a major role in implementation of IMPACT Approach and achieve the raised outcomes of availability of vertical health commodities, reporting rates for vertical health commodities and improved service delivery.

Published in International Journal of Health Economics and Policy (Volume 8, Issue 2)
DOI 10.11648/j.hep.20230802.12
Page(s) 35-43
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Vertical Health Commodities, IMPACT Approach, Vertical Health Commodities Reporting Rate

References
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[8] N. Limaro Nathan, N. Azzopardi Muscat, J. Middleton, W. Ricciardi, and G. Permanand, “4 COVID-19 responses in Europe-towards better governance PUBLIC HEALTH LEADERSHIP AND THE COVID-19 PANDEMIC IN EUROPE,” vol. 27, no. 1, pp. 4–9, 2021.
[9] D. Osei Afriyie, B. Hooley, G. Mhalu, F. Tediosi, and S. M. Mtenga, “Governance factors that affect the implementation of health financing reforms in Tanzania: An exploratory study of stakeholders’ perspectives,” BMJ Glob. Heal., vol. 6, no. 8, pp. 1–9, 2021, doi: 10.1136/bmjgh-2021-005964.
[10] M. Mwencha, J. E. Rosen, C. Spisak, N. Watson, N. Kisoka, and H. Mberesero, “Upgrading supply chain management systems to improve availability of medicines in Tanzania: Evaluation of performance and cost effects,” Glob. Heal. Sci. Pract., vol. 5, no. 3, 2017, doi: 10.9745/GHSP-D-16-00395.
[11] M. M. Sibanda, B. Zindi, and T. C. Maramura, “Control and accountability in supply chain management: Evidence from a South African metropolitan municipality,” Cogent Bus. Manag., vol. 7, no. 1, 2020, doi: 10.1080/23311975.2020.1785105.
[12] K. G. Curran et al., “Systems, supplies, and staff: A mixed-methods study of health care workers’ experiences and health facility preparedness during a large national cholera outbreak, Kenya 2015,” BMC Public Health, vol. 18, no. 1, pp. 1–12, 2018, doi: 10.1186/s12889-018-5584-5.
[13] D. A. Mkoka, I. Goicolea, A. Kiwara, M. Mwangu, and A. K. Hurtig, “Availability of drugs and medical supplies for emergency obstetric care: Experience of health facility managers in a rural District of Tanzania,” BMC Pregnancy Childbirth, vol. 14, no. 1, pp. 1–10, 2014, doi: 10.1186/1471-2393-14-108.
[14] S. S. Mwaiseje and L. R. Mwagike, “Effects of Agile Supply Chain Practices on Performance of Health Care Sector in Tanzania: A Case of Selected Public Hospitals in Dodoma City,” African J. Appl. Res., vol. 5, no. 2, pp. 90–102, 2019.
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[17] N. Printz, J. Amenyah, B. Serumaga, D. Van Wyk, USAID, and DELIVER, “Tanzania: Strategic Review of the National Supply Chain for Health Commodities,” Minist. Heal. Soc. Welf., no. April, p. 111, 2013.
Cite This Article
  • APA Style

    Boniphace Richard, Oscar Tenganamba, Chacha Magige, Godfrey Justine, Mathew Mganga, et al. (2023). Leadership and Governance Effect in Implementing the IMPACT Approach: A Retrospective Observational Study in Simiyu Region. International Journal of Health Economics and Policy, 8(2), 35-43. https://doi.org/10.11648/j.hep.20230802.12

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    ACS Style

    Boniphace Richard; Oscar Tenganamba; Chacha Magige; Godfrey Justine; Mathew Mganga, et al. Leadership and Governance Effect in Implementing the IMPACT Approach: A Retrospective Observational Study in Simiyu Region. Int. J. Health Econ. Policy 2023, 8(2), 35-43. doi: 10.11648/j.hep.20230802.12

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    AMA Style

    Boniphace Richard, Oscar Tenganamba, Chacha Magige, Godfrey Justine, Mathew Mganga, et al. Leadership and Governance Effect in Implementing the IMPACT Approach: A Retrospective Observational Study in Simiyu Region. Int J Health Econ Policy. 2023;8(2):35-43. doi: 10.11648/j.hep.20230802.12

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  • @article{10.11648/j.hep.20230802.12,
      author = {Boniphace Richard and Oscar Tenganamba and Chacha Magige and Godfrey Justine and Mathew Mganga and Eddom Silabi and Martha Kikwale and Ondo Baraka and Iddrissa Hassan and Abdi Abdallah and Winfrida Emmanuel and Athanas Ntaganyamba},
      title = {Leadership and Governance Effect in Implementing the IMPACT Approach: A Retrospective Observational Study in Simiyu Region},
      journal = {International Journal of Health Economics and Policy},
      volume = {8},
      number = {2},
      pages = {35-43},
      doi = {10.11648/j.hep.20230802.12},
      url = {https://doi.org/10.11648/j.hep.20230802.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.hep.20230802.12},
      abstract = {The Government of Tanzania in collaboration with USAID Global Health Supply Chain-Technical Assistance-Tanzania (USAID GHSC-TA -TZ), JSI-InSupply Health and United Nations Population Fund (UNFPA) rolled out the IMPACT approach in Simiyu Region in 2019. For the purpose of improve data management and visibility of vertical health commodities supply chain system. The objective of this study was to highlight leadership engagement in implementation of IMPACT Approach to improve reporting rates for vertical health commodities. Since introduction of this approach indicators monitored were not improving; the region facilitated the response performance monitoring processes, through IMPACT approach integrating with performance Scorecard as a visual performance tool for some of the indicators, including the process indicators, and used feedback meetings attended by senior leaders in the region to discuss indicator results and identify areas for improvement for councils. The results of this study revealed that, engagement of leaders in decision making influenced positively the IMPACT meetings conducted by teams whereby supply chain challenges including reporting rates discussed. At a Councils level the meetings conducted as per calendar increased from 6.1% April-June 2021 to 84.9% October- December 2022. Moreover, reporting rate of four (4) vertical health commodities which include (Malaria, HIV/AIDS, TB/L and RMNCAH) demonstrated positive increase from 60.5% January 2021 to 84.7 December 2022, and availability of all four vertical health commodities increased from 85% January 2022 to 93% December 2022. The availability of these commodities resulted into improved service delivery at health facility level. The study was a retrospective observation of the implementation of the IMPACT team approach in Simiyu region. It assessed the availability of vertical health commodities as a function of the number of items reported, data used for computation of reporting rate, availability of health commodities and improved service delivery were retrieved from eLMIS and DHIS2. Action and performance improvement plans were developed and tracked using scorecards to ensure that each planned activity is implemented accordingly and the desired supply chain outcomes are achieved. This was followed by convening leadership engagement forums where underperforming councils had to explain and articulate the reasons for their unsatisfactory performance and eventually commit to improving the required indicators. The study concluded that, good governance and leadership engagement played a major role in implementation of IMPACT Approach and achieve the raised outcomes of availability of vertical health commodities, reporting rates for vertical health commodities and improved service delivery.},
     year = {2023}
    }
    

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    AU  - Boniphace Richard
    AU  - Oscar Tenganamba
    AU  - Chacha Magige
    AU  - Godfrey Justine
    AU  - Mathew Mganga
    AU  - Eddom Silabi
    AU  - Martha Kikwale
    AU  - Ondo Baraka
    AU  - Iddrissa Hassan
    AU  - Abdi Abdallah
    AU  - Winfrida Emmanuel
    AU  - Athanas Ntaganyamba
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    DO  - 10.11648/j.hep.20230802.12
    T2  - International Journal of Health Economics and Policy
    JF  - International Journal of Health Economics and Policy
    JO  - International Journal of Health Economics and Policy
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    AB  - The Government of Tanzania in collaboration with USAID Global Health Supply Chain-Technical Assistance-Tanzania (USAID GHSC-TA -TZ), JSI-InSupply Health and United Nations Population Fund (UNFPA) rolled out the IMPACT approach in Simiyu Region in 2019. For the purpose of improve data management and visibility of vertical health commodities supply chain system. The objective of this study was to highlight leadership engagement in implementation of IMPACT Approach to improve reporting rates for vertical health commodities. Since introduction of this approach indicators monitored were not improving; the region facilitated the response performance monitoring processes, through IMPACT approach integrating with performance Scorecard as a visual performance tool for some of the indicators, including the process indicators, and used feedback meetings attended by senior leaders in the region to discuss indicator results and identify areas for improvement for councils. The results of this study revealed that, engagement of leaders in decision making influenced positively the IMPACT meetings conducted by teams whereby supply chain challenges including reporting rates discussed. At a Councils level the meetings conducted as per calendar increased from 6.1% April-June 2021 to 84.9% October- December 2022. Moreover, reporting rate of four (4) vertical health commodities which include (Malaria, HIV/AIDS, TB/L and RMNCAH) demonstrated positive increase from 60.5% January 2021 to 84.7 December 2022, and availability of all four vertical health commodities increased from 85% January 2022 to 93% December 2022. The availability of these commodities resulted into improved service delivery at health facility level. The study was a retrospective observation of the implementation of the IMPACT team approach in Simiyu region. It assessed the availability of vertical health commodities as a function of the number of items reported, data used for computation of reporting rate, availability of health commodities and improved service delivery were retrieved from eLMIS and DHIS2. Action and performance improvement plans were developed and tracked using scorecards to ensure that each planned activity is implemented accordingly and the desired supply chain outcomes are achieved. This was followed by convening leadership engagement forums where underperforming councils had to explain and articulate the reasons for their unsatisfactory performance and eventually commit to improving the required indicators. The study concluded that, good governance and leadership engagement played a major role in implementation of IMPACT Approach and achieve the raised outcomes of availability of vertical health commodities, reporting rates for vertical health commodities and improved service delivery.
    VL  - 8
    IS  - 2
    ER  - 

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Author Information
  • Health Department, Simiyu Regional Commissioner’s Office, Bariadi, Tanzania

  • Health Department, Simiyu Regional Commissioner’s Office, Bariadi, Tanzania

  • Health Department, Simiyu Regional Commissioner’s Office, Bariadi, Tanzania

  • Health Department, Simiyu Regional Commissioner’s Office, Bariadi, Tanzania

  • Health Commodities & Diagnostics Services Unit, Presidents’ Office, Regional Administration and Local Government, Dodoma, Tanzania

  • Capacity Building and Data Use, United States Agency for International Development, Global Health Supply Chain-Technical Assistance-Tanzania, Dar es Salaam, Tanzania

  • Department of Pharmaceutical Services Unit, Ministry of Health, Dodoma, Tanzania

  • Capacity Building and Data Use, United States Agency for International Development, Global Health Supply Chain-Technical Assistance-Tanzania, Dar es Salaam, Tanzania

  • Health Commodities & Diagnostics Services Unit, Presidents’ Office, Regional Administration and Local Government, Dodoma, Tanzania

  • Department of Pharmaceutical Services Unit, Ministry of Health, Dodoma, Tanzania

  • Health Commodities & Diagnostics Services Unit, Presidents’ Office, Regional Administration and Local Government, Dodoma, Tanzania

  • Capacity Building and Data Use, United States Agency for International Development, Global Health Supply Chain-Technical Assistance-Tanzania, Dar es Salaam, Tanzania

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