Implementation of a digital supportive supervision system in Tanzania successes and challenges among supervisors in Mara Region

The Afya Supportive Supervision System (AfyaSS) was introduced in Tanzania in 2021 to digitize supportive supervision and strengthen service quality through improved planning, monitoring, and data-driven decision-making. However, its utilization has varied, and evidence on its effectiveness remains limited. This study examined the successes and challenges experienced during AfyaSS implementation in Mara Region. A mixed-methods case study design was conducted in Tarime Town Council and Butiama District Council, involving 23 Council Health Management Team (CHMT) members purposively selected for their experience with AfyaSS. Data were collected through in-depth interviews and structured questionnaires. Qualitative data were thematically analyzed, while quantitative data were summarized descriptively using IBM SPSS v20. All respondents had used AfyaSS between 2021 and 2023. Reported successes included simplification of supervision, enhanced data accuracy, reduced paperwork, improved planning, accountability, and teamwork. Major challenges included unreliable internet connectivity, device incompatibility, limited digital literacy, occasional system instability, continued reliance on paper-based feedback, language barriers, and lack of facility-level access. These findings are based on participants’ self-reported experiences and perceptions of system use. AfyaSS demonstrates strong potential to improve supportive supervision and data-driven management within the councils studied in Mara Region. However, its benefits are moderated by technical and operational constraints. Strengthening infrastructure, digital capacity, and facility-level inclusion will be critical to optimizing its implementation. While the findings are context-specific, they provide practical insights that may inform ongoing national scale-up and guide future research on digital supportive supervision systems across low- and middle-income countries.