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Guide for Assessing Health Facility Performance Quality Improvement and Recognition initiative

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GUIDE FOR ASSESSING HEALTH FACILITY PERFORMANCE QUALITY IMPROVEMENT AND RECOGNITION INITIATIVE UNITED REPUBLIC OF TANZANIA MINISTRY OF HEALTH REPRODUCTIVE AND CHILD HEALTH SECTION The QIR Initiative is using a performance improvement approach to improve the quality of services available at health facilities in Singida region (Singida rural and Manyoni district). Within this approach, the services available at health facilities will be compared with the expectations of these services, as defined by the national standards of care and community preferences. Performance gaps will be identified when the observed services fail to meet these expectations. A performance gap at a health care facility can often be attributed to five factors: 1) Job expectations Do health providers know what is expected from them? 2) Performance feedback Do health providers know whether they are meeting these expectations? 3) Physical environment and tools Does the health facility have sufficient resources and provide a supportive environment to enable health providers to meet these expectations? 4) Motivation Are health providers interested in meeting these expectations? 5) Skills and knowledge Do health providers have sufficient skills and knowledge to meet these expectations? An additional factor, Client satisfaction, was added to this list to acknowledge the role of the community in defining performance expectations. This guide presents a list of indicators for assessing each of these six factors at participating health facilities. This guide is intended to serve as a tool for identifying whether a performance gap exists at a particular health facility and, if so, the specific areas that need to be addressed to reduce the gap. Health facilities at which no performance gap is observed will be considered "Quality" facilities. INDICATORS OF QUALITY JOB EXPECTATIONS 1.1. FOCAL AREA Up-

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