Acceptability and feasibility of inter-related activities to improve agency among African district health managers: A four-country study

Fonn, Sharon; Ray, Sunanda; Couper, Ian; Ezeh, Alex; Omigbodun, Akinyinka; Morhason-Bello, Imran O.; Ng’wena, Gideon; Oyungu, Eren; Muchiri, Lucy; Tumwine, James; Ibingira, Charles; Conco, Daphney Nozizwe; Blaauw, Duane

doi:10.1080/17441692.2021.1924220

Cited by 3 publications

(1 citation statement)

References 35 publications

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“…Although leadership is crucial to managers' improved performance at primary health care Units (PHCUs), the African health system is perceived as fragile and feeble due to its inadequate leadership (13).The biggest obstacle to implementing health changes in Ethiopia is a lack of commitment from the leadership (14). Deaths may result from a lack of medical personnel linked to ineffective leadership (15).As a result, the ve public hospitals in Addis Ababa that participated in healthcare leadership assessments had a prevalence of 61%(16).…”

Section: Introductionmentioning

confidence: 99%

Level of leadership effectiveness and associated factors among managers in Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, 2023. A mixed-methods study

Ayenew,

Liyew,

Azale

et al. 2024

Preprint

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Background: The capacity to shape workers' attitudes, convictions, and skills in order to accomplish company objectives is known as leadership. It is essential to whether organizational performance is successful or unsuccessful. To successfully and efficiently manage health service delivery improvements, healthcare institutions require strong leadership. On the other hand, insufficient data exists on the present state of healthcare leaders to support evidence-based decision-making. Thus, the purpose of this study is to evaluate healthcare leadership effectiveness and associated factors among managers employed by Amanuel Mental Specialized Hospital in Addis Ababa, Ethiopia. Methods: An institutional-based cross-sectional study was employed from 01 August to 01 September/2023. Six key informant interviews (KIIs) and 80 healthcare managers in total were undertaken. A complete census was used for quantitative data and purposive sampling for the qualitative approach. A binary logistic regression model was fitted to identify the factors associated with healthcare leadership effectiveness. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) and p-value less than 0.05 during multivariable logistic regression was used to declare the factors associated with the outcome variable. Results: In this study, 30% (95% CI: 20 -40) of the participants had effective healthcare leadership practices. Responsibility and accountability (AOR = 8.022; 95% CI; 7.582, 9.923), resolving problems and conflicts (AOR = 5.813; 95% CI; 4.240, 13.679), use resources in the right way (AOR = 2.968, 95% CI; 1.623, 4.145) were positively associated with effective healthcare leadership. Conclusions: The prevalence of effective leadership among managers in Amanuel Mental Specialized Hospital was low. Responsibility and accountability, using resources in the right way, and resolving problems and conflict were the factors affecting healthcare leadership effectiveness. It is recommended that the topic should be investigated further, including the perspectives of the workforce on successful leadership.

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Section: Introductionmentioning

confidence: 99%

Level of leadership effectiveness and associated factors among managers in Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, 2023. A mixed-methods study

Ayenew,

Liyew,

Azale

et al. 2024

Preprint

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Five lessons from a mid-level health manager intervention to increase uptake of tuberculosis prevention therapy in Uganda: ‘it is a completely different thing to implement what you know.’

Johnson-Peretz,

Christian,

Akatukwasa

et al. 2024

Global Health Action

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Background Leadership skills are essential for middle-level healthcare manager efficacy. Capacity-building efforts may attempt behavioural change by filling ‘knowledge gaps’ while neglecting a sustainable application of that knowledge. Sustainable application of that knowledge, or implementation know-how, must resonate with local cultural patterns. When it is neglected, root issues like unclear decision-making space and local authority to interpret policy during implementation remain unaddressed. Particularly in decentralized healthcare systems, the impact can appear in implementation challenges, subjective decision-making, poor teamwork, and an absence of disseminating best practices. Objectives The SEARCH-IPT trial led a series of mini-collaborative meetings, which provided business leadership and management training for an intervention group of mid-level healthcare system managers in rural Eastern, East-Central, and Southwestern Uganda to see whether this would increase uptake of isoniazid-prevention therapy (IPT) for people living with HIV (PLHIV) in intervention districts. IPT is known to reduce active tuberculosis (TB), a leading cause of death among PLHIV, by 40–60%. Methods We performed a thematic analysis of six focus-group discussions from this intervention (held in May 2019, January 2020, September 2021) and 23 key informant interviews with control group participants (between February and August 2019 and September and December 2020). Results Analysis revealed five implementation skill sets District Health Officers (DHOs) and District Tuberculosis and Leprosy Supervisors (DTLSs) deployed to achieve sustainable implementation and realize their decision-making space. The five practices were as follows: data-based decision-making, root-cause analysis, quality assurance, evidence-based empowerment, and sharing best practices with colleagues. Conclusion These practices reached beyond outcome measures to address root problems around the DHO’s range of authority and elicit buy-in from district health workers. For successful capacity building at the mid-manager level, focusing on core practices as part of competency is objectively implementable and measurable at the system level and does not rely on DHO self-assessments.

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Continuing professional development training needs for primary care doctors in central Uganda

Namatovu,

Buwembo,

Nakigudde

et al. 2023

African Journal of Primary Health Care & Family Medicine

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Acceptability and feasibility of inter-related activities to improve agency among African district health managers: A four-country study

Cited by 3 publications

References 35 publications

Level of leadership effectiveness and associated factors among managers in Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, 2023. A mixed-methods study

Level of leadership effectiveness and associated factors among managers in Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, 2023. A mixed-methods study

Five lessons from a mid-level health manager intervention to increase uptake of tuberculosis prevention therapy in Uganda: ‘it is a completely different thing to implement what you know.’

Continuing professional development training needs for primary care doctors in central Uganda

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