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

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.