Health Check: Monitoring Primary Health Care Services in Rural Tanzania


Daraja Development Limited

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Basic Project Information

Daraja sought to improve the performance of primary health care facilities by gathering citizen perceptions of services and promoting dialogue between health service providers and community members to produce joint solutions to service delivery challenges.



Project Summary


Improve the performance of primary health care facilities to better meet the needs of local communities

  • Promote dialogue on the quality of services delivered by primary health care facilities between health service providers, administrators, and users at the community, district, and regional level
  • Exert pressure on decision makers to improve the performance of primary health care facilities


Daraja conducted a health amenities assessment of primary health care facilities in order to monitor challenges related to resource allocation and improve the delivery of health commodities and services. Using the Community Score Card (CSC) methodology, the team sought to inform community members of available services and entitlements, and solicit their opinions about the accessibility and quality of primary health care services. Daraja documented both citizen and service provider perceptions of staffing levels, infrastructure, patient treatment, absenteeism, and medicine availability. They gathered this data through structured questionnaires, key-informant interviews, focus group discussions, and patient exit interviews. Local leaders, community members, and health workers then participated in interface meetings to share findings and develop action plans for obtaining commitments from district and regional health officers and government leaders for health sector improvements. Citizens and service providers alike identified a number of health service delivery challenges, including persistent drug stock outs of essential medicines, unutilized medicines, lack of equipment for communication and transport, poor motivation of health workers, and infrastructure problems due to inadequate funding. Daraja shared the outputs of the CSC process with district and regional medical offices, as well as with the Ministry of Health and Social Welfare at the national level, advocating for increased funding for health services with a particular emphasis on essential medicines. They also utilized their organization’s newspaper, Daraja Letu, to share research results with the general public.

Use of Information Communication Technology



4 health facilities in each of the project's 8 districts

Target Population

Primary health care recipients

Results Methodology

Self-reported results – Daraja conducted site visits to dialogue with medical personnel and beneficiaries in order to assess changes (if any) and document any complaints that still existed.

Indicators Used

Not applicable

Reported Results

  • 13 additional health workers employed in target project areas
  • Health workers relocated to understaffed health centers in target project areas
  • Target health centers received a government-issued warning letter to curb absenteeism
  • Increased visits by regional and district level government leaders to health centers
  • Reduced number of complaints regarding lack of laboratory testing kits and equipment
  • Increased citizen awareness of their health rights
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