Human Resources Management

Exercising Leadership to Make Decentralization Work

This issue of The Manager shows how health managers, though faced with multiple challenges of decentralization, can redefine their roles and responsibilities to better support both the people they serve and the staff at management levels closest to the population. It shows how health managers can adopt leadership practices to carry out their new roles and ultimately make decentralization work. [editor’s description]

Managing Performance Improvement of Decentralized Health Services

This issue of The Manager will help managers at all levels understand the principles of local-level performance assessment and improvement. It also presents the concept of essential public health functions as a useful policy framework for decentalizing service management while maintaining and improving the coverage and quality of services. [editor’s description]

Leading Changes in Practices to Improve Health

This issue of The Manager focuses mainly on leading changes in practices that improve health, rather than on overall strategic and structural change. The issue can help health managers work with a team as change agents to address community and organizational challenges that require a change in clinical or management practices.

Growing Management and Leadership for Health in Aswan, Egypt

This short documentary film chronicles the four year journey, initially funded by USAID’s Office of Population, that the governorate of Aswan, Egypt embarked upon to develop greater leadership within all levels of its health care staff. The video shows an innovative process that develops leaders at all levels, including the front lines of health care, to identify challenges and work in teams to overcome obstacles and achieve service improvements.

Competency Development in Public Health Leadership

As the complexity of the challenges facing the public health workforce has increased, many have argued that insufficient resources have been devoted to the preparation of the workforce, including its leaders. Here we describe the growth of national advocacy for public health leadership and workforce development.

District Health Management Team Training Modules

This publication is an effort to respond to the different needs for capacity building in management and implementation of health programmes and delivery of essential services. It reflects the thinking acquired from experience working with health sector reforms being implemented in the African Region. The District Health Management Training modules cover the principles that are applicable across the Region and are meant to guide and strengthen the management capacity of district health management teams. [author’s description]

Findings of the Egyptian Health Care Provider Survey

This report presents results from the Egypt Health Care Providers Surveys, the objectives of which were to: provide a comprehensive picture of all sources of health care services; provide policy relevant data on critical issues for health sector reform; and create a database on health care providers for use by the Ministry of Health and Population in developing policy reform proposals. Five separate surveys were conducted on health care institutions, private clinics, pharmacies, dayas (traditional birth attendants), and other practitioners. The sample of 10,048 providers was developed from a complete enumeration of all health care providers in sampling areas and data from the 1986 national census.

Management of Expatriate Medical Assistance in Mozambique

This paper discusses how Mozambique coped with the health system needs in terms of specialized doctors since independence, in a troubled context of war, lack of financial resources and modifying settings of foreign aid. The Ministry of Health (MOH) managed to make up for its severe scarcity of specialist MDs especially through contracting expatriate technical assistance.

Guide to Managing for Quality

Managing for Quality is a collaborative effort between Management Sciences for Health and UNICEF to develop a practical, useful and interactive resource that managers can use to improve quality in the many different types of health and family planning programs in which they work.

Participatory Supervision with Provider Self-Assessment Improves Doctor-Patient Communication in Rural Mexico

In this setting, physicians were already making site visits to clinics to monitor technical standards of care. An intervention was designed to reinforce doctors’ interpersonal communication (IPC) training. Under the intervention, doctors received IPC job aids, self-assessment forms, and tape recorders. They taped themselves during consultations and assessed their skills from the recordings, using the forms and in consultation with their supervisors. The self-assessment form and the supervisor assessment form were modified to be reproduced in this report. [publisher’s description]

Family Planning Manager's Handbook

The Family Planning Manager’s Handbook is a standard text in management training courses around the world and has received wide recognition as a practical guide for managers of health and family planning programs. [publisher’s description]

Impact of Supervision on Stock Management and Adherence to Treatment Guidelines: a Randomized Controlled Trial

Ensuring the availability of essential drugs and using them appropriately are crucial if limited resources for health care are to be used optimally. While training of health workers throughout Zimbabwe in drug management (including stock management and rational drug use) resulted in significant improvements in a variety of drug use indicators, these achievements could not be sustained, and a new strategy was introduced based on the supervision of primary health care providers.

Beyond the Clinic Walls

This book contains a series of case studies which depict the management issues a family planning organization faces in designing and implementing a new community-based distribution (CBD) program for contraceptives. The cases, which take place in a fictional country Momonboro, are based on an actual program initiated in an African country, and reflect the problems and successes which that program experienced.

Nine Step Guide to Implementing Clinic Supervision

There is no doubt that one of the most effective ways of improving quality of health care at district level, is by means of clinic supervision. To that end, the Clinic Supervisor’s Manual is being used to implement supervision throughout health districts in South Africa. This booklet is a simple tool which guides the effective use of the Clinic Supervisor’s Manual in addition to guiding the day to day activities involved in supervision towards successful and improved outcomes.

Checklist for Review of the Human Resource Development Component of National Plans to Control Tuberculosis

The checklist described in this document has been developed as a tool to assist those involved in a systematic review of the human resource development component of the NTP. This component is often referred to as “training.” In this document, the term training is used in a broader context than the more traditional interpretation of the term, where training refers to organization and implementation of training courses. Training in this document is often replaced by the term “HR development” to stress the need for a broader and more long-term approach within NTPs. [from introduction]

Perspectives about and Models for Supervision in the Health Professions

This presentation is from a Capacity Project sponsored interactive workshop to consider fresh perspectives on supportive supervision, exploring alternative approaches to the standard visiting-supervisor model from within and outside the international health care sector.

Supervision Training: Some Lessons from Kenya

This presentation is from a Capacity Project sponsored interactive workshop to consider fresh perspectives on supportive supervision, exploring alternative approaches to the standard visiting-supervisor model from within and outside the international health care sector.

Leadership for Performance Improvement: a New Approach for Supervision

This presentation is from a Capacity Project sponsored interactive workshop to consider fresh perspectives on supportive supervision, exploring alternative approaches to the standard visiting-supervisor model from within and outside the international health care sector. The presentation discusses a leadership approach to supervision.

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Visiting Supervisor Model: What is the Evidence?

This presentation is from a Capacity Project sponsored interactive workshop to consider fresh perspectives on supportive supervision, exploring alternative approaches to the standard visiting-supervisor model from within and outside the international health care sector.

Technical Review of Health Service Delivery at District Level

The 2003 technical review report covers only one main strategy: district health services. It looks at district health service performance from the viewpoint of Council Health Management Teams (CHMT) and LG. The report presents a short general appraisal of district health services (section 1). Planning and budgeting for better health (section 2) looks at what the requirements are for a performing planning and budgeting process (section 2.1, including guidelines and process) and what information should be available at council level to develop a comprehensive council health plan (section 2.2). Issues related to implementing the council health plan (section 3) include financial resources (3.1), non-financial resources (3.2), systems development (3.3) and service delivery (3.4).

Egypt Service Provision Assessment Survey 2004

The 2004 Egypt Service Provision Assessment (ESPA 2004) survey was designed to collect informationon the provision of reproductive health and child health services in Egypt in order to complement the information obtained through the 2003 Egypt Interim Demographic and Health Survey. The ESPA 2004 collected information on the preparedness of health facilities in Egypt to provide high quality care to clients seeking services for family planning, maternal health, child health, and sexually transmitted infections. A representative sample of 659 clinics of all types of facilities, in both government and nongovernmental organization facilities, was assessed. The survey included, in addition to the resources of the facilities, interviews with service providers, observations of consultations between the providers and clients, and interviews with clients after they were served. The information included in this report is important for identifying areas of intervention that will help improve the quality of family planning, maternal health, and child health services provided to clients. [preface]

Supporting Staff Through Effective Supervision: How to Assess, Plan and Implement More Effective Clinic Supervision

This Kwik-Skwiz addresses the important area of clinic supervision. This document is aimed at district management teams; clinic supervisors and program managers may find it especially useful. Key areas of effective supervision are presented with the aim of assisting district management teams to critically assess clinic supervision in your district. [author’s description]

Setting Safe Nurse Staffing Levels: an Exploration of the Issues

One of the resolutions at the RCN’s 2000 Congress expressed concerned at the lack of a universal mechanism to determine safe staffing levels. This reflected widespread concern within the profession about the potential increase in risks to patient safety posed by increased levels of activity, and inadequate levels of nurse staffing, in the NHS. Over the years, there have been many attempts to develop a universally acceptable and reliable formula which will be able to predict the precise nurse staffing levels needed to ensure patient safety. Even if this is not a realistic goal, and the literature on workforce planning suggests that it is not, the Congress resolution provided a timely opportunity to reconsider the important professional and managerial issues associated with setting safe staffing levels.

Defining a Performance Improvement Intervention for Kenya Reproductive Health Supervisors: Results of a Performance Analysis

The competency-based approach used in JHPIEGO-supported training improves performance by ensuring that trainees go back to their worksites with the knowledge and skills required to provide FP services. Once back at the workplace, however, participants often face constraints that limit their ability to provide quality services. Factors that can affect the performance of the healthcare provider include: job expectations, performance feedback, supplies and equipment, motivation, possessing the knowledge and skills to provide services, and supervision.

Facilitative Supervision Handbook

The handbook includes descriptions of the facilitative approach to supervision and the roles and characteristics of facilitative supervisors in involving staff in the QI process, leading staff through change, creating a nonthreatening environment, and helping staff use data for decision making. [publisher’s description]

High-Performing Reproductive Healthcare Facilities in Kenya: Why They Exceed Expectations

This report summarizes findings from Phase 2 of a two-phase case study to determine why certain reproductive healthcare facilities in low-resource settings perform better than others. The study examined the characteristics, behaviors, and coping strategies of high-performing reproductive healthcare facilities in Kenya, exploring elements of resilience and factors influencing performance.

COPE for Child Health in Kenya and Guinea: an Analysis of Service Quality

This report presents the results of a longitudinal, quasi-experimental study evaluating the introduction and use of COPE and the resulting changes in service quality in two countries, Kenya and Guinea. At the end of a 15-month period, providers’ attitudes, providers’ ability to solve problems, service quality, and client satisfaction were assessed at eight intervention sites and at eight matched control sites, using both qualitative and quantitative methods. [author’s description]

COPE Handbook: a Process for Improving Quality in Health Services, Revised Edition

COPE, which stands for “client-oriented, provider-efficient” services, is a process that helps health care staff continuously improve the quality and efficiency of services provided at their facility and make services more responsive to clients’ needs. COPE provides staff with practical, easy-to-use tools to identify problems and develop solutions using local resources, and it encourages all levels of staff and supervisors to work together as a team and to involve clients in assessing services. Through COPE, staff develop a customer focus, learning to define quality in concrete terms by putting themselves in their clients’ shoes.

Facilitative Supervision: a Vital Link in Quality Reproductive Health Service Delivery

AVSC defines facilitative supervision as an approach to supervision that emphasizes mentoring, joint problem solving, and two-way communication between the supervisor and those being supervised. This definition recognizes that supervisors play an essential role as intermediaries who can facilitate the implementation of institutional goals and who can facilitate local-level problem solving and quality improvement.

Health Worker Motivation in Africa: the Role of Non-Financial Incentives and Human Resource Management Tools

There is a serious human resource crisis in the health sector in developing countries, particularly in Africa. One of the challenges is the low motivation of health workers. Experience and the evidence suggest that any comprehensive strategy to maximize health worker motivation in a developing country context has to involve a mix of financial and non-financial incentives. This study assesses the role of non-financial incentives for motivation in two cases, in Benin and Kenya. [abstract]