Does Human Resources for Health competence and skill mix status affect compliance with healthcare quality standards among Primary Healthcare Facilities? Evidence from dispensaries in Tanzania

Abstract

<title>Abstract</title> <bold>Background:</bold><italic><bold> </bold></italic>Globally, it is known that, there is a close correlation between the concentration of qualified Human Resources for Health (HRH) and key health outcomes. Inadequate numbers with poor skill mix compromise health system functioning that negatively affect delivery of quality healthcare services. <bold>Objective:</bold> This study aims to ascertain, effect of HRH skills and competence mix to compliance with healthcare quality standards (HCQS) among dispensaries in Tanzania. <bold>Methods: </bold>This is a quantitative secondary data analysis using the Star Rating Assessment (SRA) data collected in the fiscal year 2017/2018. Compliance with HCQS was measured by considering service delivery areas of SRA Tool, HRH availability that estimated skill mix status were deduced by considering its recommended number as provided by staffing levels guidelines. Proportions of skill mix status and compliance with HCQS were compared by chi square test while Prevalence Ratios were estimated by Multivariate Poisson Regression with 95% Confidence Interval. <bold>Results:</bold> This study involved 4239 dispensaries majority of which were rural located (81.2%) and public owned (83.6%). On average, 36.8% of dispensaries had skill mix while 63.2% had no skill mix. Dispensaries with skill mix were significantly more likely to comply with HCQS compared to dispensaries with no skill mix (p&lt;0.001). <bold>Conclusions:</bold> This study demonstrates the critical role that HRH skill mix has in ensuring adherence to HCQS. The observed challenge of HRH availability and hence skill mix should be worked on. Deliberate measures including increasing recruitment budgets and equitable distribution of available HRH should be taken to address the challenge.