Complaints mechanism vital in public health sectorn
What you need to know:
The study further revealed that the suggestion box was the most commonly used complaint mechanism as cited by 80 per cent of the respondents.
The government of Tanzania introduced the concept and practice of complaints mechanism in all its offices as a way of collecting feedback on the services it provides to its people with the intention of using the provided feedback in improving the services.
Within the health sector, the complaints mechanism helps the oversight bodies – health facility governing committees and hospital boards in addressing challenges, feedback given to them by the public on how health services are provided. In this case, any statement or expression regarding dissatisfaction with the services delivered is referred to as a complaint, and the means for expressing this complaint is known as a complaints mechanism.
The effectiveness or ineffectiveness of complaints mechanisms refers to ways through which citizens communicate their complaints to the health authorities and how these complaints are being addressed to improve health service delivery. Generally, the availability of an effective complaints mechanism is beneficial not only to the service users, but also to service providers as well as the government itself since such a mechanism provides an opportunity for reforming the health system in the country, especially at the facility level.
Given a chance, citizens (service users) play a great role in helping to improve service delivery in any health system. In the absence of an effective complaints mechanism, their contribution is obscured and tends to be overlooked.
Sikika conducted a study in Kinondoni, Temeke, Ilala, Kibaha Rural, Kondoa and Mpwapwa districts to explore both the existence and functioning of complaints mechanisms at health facility level. Findings show that, urban-based districts have more complaints systems in place as compared to rural ones.
The percentage of citizens confirming the availability of complaints mechanisms in Kinondoni, Ilala, and Temeke districts was 77 per cent, 73 per cent and 68 per cent respectively while Kondoa, Mpwapwa and Kibaha scored 40 per cent, 37 per cent and 22 per cent respectively. On the whole, the more urbanised settlements are the more established health facility complaints mechanisms are.
The study further revealed that the suggestion box was the most commonly used complaint mechanism as cited by 80 per cent of the respondents. Mpwapwa district was found to have the least effective complaints mechanism as cited by 71 per cent of the respondents followed by Kibaha (68 per cent) and Ilala (62 per cent). The service users (customers) on the other hand, largely complain about the misconduct of health service providers manifested by corrupt practices, favouritism and absenteeism.
The findings further support previous studies conducted in Tanzania such as Downward Accountability (2009) which showed that the majority of Tanzanians complain about the quality of health services delivered to them but they do not even know how to lodge their complaints so that they can reach the authorities. These kinds of studies elucidate that the available complaints mechanisms in many health facilities in Tanzania (if any), though useful,are not effective enough to help the citizens voice their concerns and be heard.
The reasons for the ineffectiveness and unavailability of such complaints mechanisms are many. They include lack of government commitment to having a strong legal framework and lack of a specific policy governing the availability and effectiveness of the complaints mechanisms in the country’s health facilities.
The other reasons are illiteracy among many of the citizens (service users), especially in the rural areas and weaknesses inherent in the management of the existing complaints mechanisms.
Sikika urges responsible institutions such as district authorities, health facilities service boards, health facility governing committees, local government officials, health facility in-charges and the President’s Office - Public Service Management (PO-PSM) to ensure that complaints mechanism are in place in both rural and urban settings health facilities taking into account the nature of the population utilising these mechanisms.
It is the responsibility of the above-mentioned responsible organs to have a system in place that ensure that complaints raised are being addressed ultimately improving health services delivery.
