Implementation of a Digital Supportive Supervision System in Tanzania: Successes and Challenges from Mara Region

Background 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. Methods A mixed-methods case study 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. Results 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. Conclusions AfyaSS has improved supportive supervision and data quality in Tanzania but remains underutilized. To enhance its impact, the Ministry of Health should strengthen digital infrastructure, expand system access to health facilities, and build user capacity. Lessons from Mara Region can inform national scale-up and guide digital supervision efforts across low- and middle-income countries.