Evaluating the Effectiveness of Good Governance Practices in Public Health Service Delivery in Kahama District Hospital Tanzania

Abstract

This study aimed to evaluate the effectiveness of good governance practices in government departments, specifically focusing on the transparency, accountability, and participation in health service delivery at Kahama District Hospital. Using a mixed-methods research approach, the study employed both qualitative and quantitative methods to collect data from a sample of 196 respondents, selected through simple random and purposive sampling techniques. The research philosophy was grounded in pragmatism, which advocates for using multiple methods to gain a comprehensive understanding of the research problem. Data were collected via questionnaires and interviews, with quantitative data analyzed using descriptive statistics, including mean scores, while qualitative data were analyzed through thematic coding, identifying key themes and patterns related to governance practices and health service delivery challenges. The findings revealed that while the hospital had made notable progress in promoting transparency (mean score of 3.7) and accountability (mean score of 3.5), several challenges such as inadequate facilities, financial constraints, and limited information systems were hindering optimal service delivery. Client satisfaction was relatively high, with 71% of respondents indicating that their service expectations were met. The study concludes that while Kahama District Hospital has laid a strong foundation in governance practices, there is a need for targeted interventions such as enhanced staff training, improved decision-making policies, increased government funding for infrastructure, and alignment of governance structures with theoretical frameworks. These recommendations are in line with studies by authors such as Ochieng et al. (2016), Mushi and Chacha (2018), and Mhando (2020), who emphasize the need for continuous improvements in governance to enhance health service delivery. The qualitative analysis provided further insights into the key governance challenges faced by the hospital, offering a richer understanding of how the hospital can better align its governance practices with community expectations to achieve better health outcomes.