Can action research strengthen district health management and improve health workforce performance? A research protocol

Mshelia, Comfort; Huss, Reinhard; Mirzoev, Tolib; Elsey, Helen; Baine, Sebastian Olikira; Aikins, Moses; Kamuzora, Peter; Bosch‐Capblanch, Xavier; Raven, Joanna; Wyss, Kaspar; Green, A; Martineau, Tim

doi:10.1136/bmjopen-2013-003625

Cited by 15 publications

(11 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…the care they receive, staff expertise and availability of supplies [3,25,26]) and to complain when their experiences do not align with their expectations. Second, is the ability of the health system to adequately analyse, respond to, and utilise patient feedback – for example in health service quality improvement (QI) [5,9,25] or improving human resource management processes (HRM) [9,18,27,28]. A key lesson from recent reviews is the need for patient complaints to be a part of an integrated system that ensures patient feedback is responded to [8,29,30] and always acted upon [8,9,25,31].…”

Section: Introductionmentioning

confidence: 99%

Key strategies to improve systems for managing patient complaints within health facilities – what can we learn from the existing literature?

Mirzoev

Kane

2018

Global Health Action

View full text Add to dashboard Cite

Background: Information from patient complaints – a widely accepted measure of patient satisfaction with services – can inform improvements in service quality, and contribute towards overall health systems performance. While analyses of data from patient complaints received much emphasis, there is limited published literature on key interventions to improve complaint management systems. Objectives: The objectives are two-fold: first, to synthesise existing evidence and provide practical options to inform future policy and practice and, second, to identify key outstanding gaps in the existing literature to inform agenda for future research. Methods: We report results of review of the existing literature. Peer-reviewed published literature was searched in OVID Medline, OVID Global Health and PubMed. In addition, relevant citations from the reviewed articles were followed up, and we also report grey literature from the UK and the Netherlands. Results: Effective interventions can improve collection of complaints (e.g. establishing easy-to-use channels and raising patients’ awareness of these), analysis of complaint data (e.g. creating structures and spaces for analysis and learning from complaints data), and subsequent action (e.g. timely feedback to complainants and integrating learning from complaints into service quality improvement). No one single measure can be sufficient, and any intervention to improve patient complaint management system must include different components, which need to be feasible, effective, scalable, and sustainable within local context. Conclusions: Effective interventions to strengthen patient complaints systems need to be: comprehensive, integrated within existing systems, context-specific and cognizant of the information asymmetry and the unequal power relations between the key actors. Four gaps in the published literature represent an agenda for future research: limited understanding of contexts of effective interventions, absence of system-wide approaches, lack of evidence from low- and middle-income countries and absence of focused empirical assessments of behaviour of staff who manage patient complaints.

show abstract

Section: Introductionmentioning

confidence: 99%

Key strategies to improve systems for managing patient complaints within health facilities – what can we learn from the existing literature?

Mirzoev

Kane

2018

Global Health Action

View full text Add to dashboard Cite

show abstract

“…Management is the process by which different resources are organised to achieve a set goal, in this case, the sustainable provision of quality health services to the population [ 7 ]. Health management could broker human relations and linkages within and between the different components of the health system [ 8 , 9 ]. Health managers, through their various actions, have the potential to promote linkages amongst the different components of the health system, thus creating synergy among them [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Elements for harnessing participatory action research to strengthen health managers’ capacity: a critical interpretative synthesis

Tetui

Zulu

Hurtig

et al. 2018

Health Res Policy Sys

View full text Add to dashboard Cite

BackgroundHealth managers play a key role in ensuring that health services are responsive to the needs of the population. Participatory action research (PAR) is one of the approaches that have been used to strengthen managers’ capacity. However, collated knowledge on elements for harnessing PAR to strengthen managers’ capacity is missing. This paper bridges this gap by reviewing existing literature on the subject matter.MethodsA critical interpretive synthesis method was used to interrogate eight selected articles. These articles reported the use of PAR to strengthen health managers’ capacity. The critical interpretive synthesis method’s approach to analysis guided the synthesis. Here, the authors interpretively made connections and linkages between different elements identified in the literature. Finally, the Atun et al. (Heal Pol Plann, 25:104–111, 2010) framework on integration was used to model the elements synthesised in the literature into five main domains.ResultsFive elements with intricate bi-directional interactions were identified in the literature reviewed. These included a shared purpose, skilled facilitation and psychological safety, activity integration into organisational procedures, organisational support, and external supportive monitoring. A shared purpose of the managers’ capacity strengthening initiative created commitment and motivation to learn. This purpose was built upon a set of facilitation skills that included promoting participation, self-efficacy and reflection, thereby creating a safe psychological space within which the managers interacted and learnt from each other and their actions. Additionally, an integrated intervention strengthened local capacity and harnessed organisational support for learning. Finally, supportive monitoring from external partners, such as researchers, ensured quality, building of local capacity and professional safety networks essential for continued learning.ConclusionsThe five elements identified in this synthesis provide a basis upon which the use of PAR can be harnessed, not only to strengthen health managers’ capacity, but also to foster other health systems strengthening initiatives involving implementation research. In addition, the findings demonstrated the intricate and complex relations between the elements, which further affirms the need for a systems thinking approach to tackling health systems challenges.

show abstract

“…This study was carried out within the framework of PERFORM, a HRM intervention program, which aims at identifying ways of strengthening decentralized district management to improve health workforce performance in sub-Saharan Africa [ 17 ]. The aim of the present study was to identify factors contributing to inefficient management practices of district health managers, coping strategies to alleviate such factors, and ways to improve overall efficiency of district level managers.…”

Section: Introductionmentioning

confidence: 99%

Factors influencing the work efficiency of district health managers in low-resource settings: a qualitative study in Ghana

Bonenberger

Aikins

Akweongo

et al. 2015

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundThere is increasing evidence that good district management practices can improve health system performance and conversely, that poor and inefficient management practices have detrimental effects. The aim of the present study was to identify factors contributing to inefficient management practices of district health managers and ways to improve their overall efficiency.MethodsNineteen semi-structured interviews were conducted with district health managers in three districts of the Eastern Region in Ghana. The 19 interviews conducted comprised 90 % of the managerial workforce in these districts in 2013. A thematic analysis was carried out using the WHO’s leadership and management strengthening framework to structure the results.ResultsKey factors for inefficient district health management practices were identified to be: human resource shortages, inadequate planning and communication skills, financial constraints, and a narrow decision space that constrains the authority of district health managers and their ability to influence decision-making. Strategies that may improve managerial efficiency at both an individual and organizational level included improvements to planning, communication, and time management skills, and ensuring the timely release of district funds.ConclusionsFilling District Health Management Team vacancies, developing leadership and management skills of district health managers, ensuring a better flow of district funds, and delegating more authority to the districts seems to be a promising intervention package, which may result in better and more efficient management practices and stronger health system performance.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1271-3) contains supplementary material, which is available to authorized users.

show abstract

Can action research strengthen district health management and improve health workforce performance? A research protocol

Cited by 15 publications

References 15 publications

Key strategies to improve systems for managing patient complaints within health facilities – what can we learn from the existing literature?

Key strategies to improve systems for managing patient complaints within health facilities – what can we learn from the existing literature?

Elements for harnessing participatory action research to strengthen health managers’ capacity: a critical interpretative synthesis

Factors influencing the work efficiency of district health managers in low-resource settings: a qualitative study in Ghana

Contact Info

Product

Resources

About