Fig 1.
Chart of the three-stage process of the e-TIQH supportive supervision approach [37].
Fig 2.
Key features of the e-TIQH supportive supervision approach [37–39].
Fig 3.
Map of Tanzania with councils where the e-TIQH supportive supervision approach was implemented (status 2008).
Morogoro Region: (1) Kilosa DC (later split into Kilosa DC and Gairo DC), (2) Mvomero DC, (3) Morogoro DC, (4) Kilombero DC, (5) Ulanga DC; Pwani Region: (6) Bagamoyo DC, (7) Rufiji DC; Iringa Region: (8) Iringa MC. Asterisks mark the three study councils.
Table 1.
Description of councils selected for the study.
Table 2.
Number of in-depth interviews done in the three study councils (Mvomero DC/ Rufiji DC/ Iringa MC).
Table 3.
Relevant characteristics of an average rural and urban council in Tanzania.
Fig 4.
Activities conducted during routine CHMT and e-TIQH supportive supervision.
1The preparatory meeting included setting up the teams and their routes; logistics included informing health facilities and request transport and per diems; 2Data entry after routine CHMT supportive supervision was hardly ever done; 3Charging devices was reported to take seven minutes for six tablets per team and day; 4Quality dimension 1 was evaluated as a team and subsequently quality dimensions 2 to 6 were assessed concurrently by one assessor each; 5Provision of feedback included the completion of five page feedback summary form; 6Estimated time for data processing (quality check and uploading survey forms) was one and a half hours per team and day.
Fig 5.
Comparison of routine CHMT and e-TIQH supportive supervision.
Upwards arrows show a perceived improvement and downwards arrows a perceived decline when switching from routine CHMT to e-TIQH supportive supervision. Perceived change based on the qualitative data (statements given frequently and/or across administrative levels and sectors) is given by single (likely change) and double (clear change) arrows. Asterisks indicate that the particular change could primarily* or partially(*) be attributed to the usage of an electronic tool per se. For items without an asterisk or an asterisk in brackets (*), the overall e-TIQH supportive supervision approach was relevant as well. For physical resources it was assumed that tablets need be bought.
Table 4.
Cost of introducing e-TIQH supportive supervision in a new council in 2016 USD by type of council, resource and activity.
Fig 6.
Possible supportive supervision schedule showing assessment days required by the supportive supervision approach in an average rural (A) and urban (B) council. Vertical lines indicate a working day, consisting of eight hours (08:00–16:00). For simplicity schedule presented was developed for one team assessing the whole council.
Table 5.
Estimated hours required by the assessment team for one round of routine CHMT and e-TIQH supportive supervision, by type of council and activity.
Table 6.
Cost for one round of CHMT (A) and e-TIQH supportive supervision (B&C) in 2016 USD by type of council, resource and activity.
Table 7.
Annual dissemination meeting cost in 2016 USD by type of council, resource and activity.