The Governance of Pandemics in Primary Health Care: The Governance Strategies Adopted by Health Facility Governing Committees in Times of COVID Pandemic in Tanzania

The governance of COVID 19 in Lower and Middle-Income Countries (LMICs) is very critical for curbing its effects. However, it is unknown what governance strategies are adopted by Health Facility Governing Committees (HFGCs) s as a response to the pandemic. We employed an exploratory qualitative design to study the governance strategies adopted by HFGCs during the COVID19. Since COVID 19 is new, an inductive approach was used as it involves analyzing collected data with little or no predetermined theory for the study. A purposive sampling technique was employed in which multistage clustered sampling was used to select regions, councils, health facilities and respondents. In-depth interviews with HFGCs chairpersons and Focus Group Discussions with members of HFGCs were used to collect data. The data were analyzed based on the themes which emerged during data collection. We found five governance strategies that were found to be commonly adopted by many HFGCs which are financial allocation, re-planing, mobilization of resources, community sensitization and mobilization of stakeholders. however, these governance structures were not all adopted by all HFGCs. The HFGCs slowly adopted governance strategies in the times of COVID 19 pandemics because were unprepared. Despite being empowered by the Direct Health Facility Financing, still, the newest of the COVID 19 has been a challenge to many HFGCs. This calls for urgent capacity building for governance institutions on how to deal will pandemics in primary health facilities. Key Questions Box O_TEXTBOXKey Questions What is Already Known?[tpltrtarr] Governance of pandemics is very critical for minimizing its effects [tpltrtarr]Government in Lower and Middle-Income Countries (LMICs) reacted differently to bring the COVID 19 pandemic under control [tpltrtarr]Little is known on the governance strategies adopted by Health Facility Governing Committees (HFGCs) to control COVID 19 at the primary health care facilities in LMICs What are the new findings?[tpltrtarr] HFGCs response to the COVID 19 is mixed as some HFGCs were so active and others were so slowly in instituting governance strategies to combat the pandemic [tpltrtarr]The common governance strategies adopted were financial allocation, re-planning, embolization of resources, community sensitization and stakeholders mobilization [tpltrtarr]HFGCs in LMICs were not well prepared for the pandemic at the community level What do new findings imply?[tpltrtarr] Capacitated HFGCs in both soft and hard aspects cornerstone for effective governance of the pandemics in primary health care [tpltrtarr]Preparedness of pandemics in LMICs needs to go beyond upper-level governance structures C_TEXTBOX