Raising a mirror to quality of care in Tanzania: the five-star assessment

Despite substantial efforts to improve the quality of care in Tanzania, evidence suggests that most facilities struggle to deliver high-quality services.1–5 Major barriers to accessing services include long distances to health facilities, poorly developed transportation systems, and unfriendly services. The referral system also has severe challenges, including a small number of ambulances, unreliable logistics and communications, and inadequate community-based facilitated referral.6–10 In response to these challenges and the need for greater facility accountability, the Ministry of Health of Tanzania implemented five-star rating assessments, a facility rating system, in 2015.