Developing Public Health Management Training Capacity in Nicaragua

McEwan, Elena; Conway, Mary J.; Bull, David; Malison, Michael D.

doi:10.2105/ajph.91.10.1586

Cited by 19 publications

(12 citation statements)

References 1 publication

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“…Although carried out in a different context, a Turkish study on problem-solving abilities of hospital nursing managers highlighted several shortfalls (27, 51). Nursing managers in Nicaragua (52), Uganda (53), Liberia (44), and the Gambia (54) who have effective problem-solving skills contribute to health systems strengthening and improve quality of care (51). Hence, continuing professional development programmes should include problem-solving skills for PHC nursing managers.…”

Section: Discussionmentioning

confidence: 99%

An evaluation of the competencies of primary health care clinic nursing managers in two South African provinces

Munyewende

Levin

Rispel

2016

Global Health Action

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BackgroundManagerial competencies to enhance individual and organisational performance have gained currency in global efforts to strengthen health systems. Competent managers are essential in the implementation of primary health care (PHC) reforms that aim to achieve universal health coverage.ObjectiveTo evaluate the competencies of PHC clinic nursing managers in two South African provinces.DesignA cross-sectional study was conducted in two South African provinces. Using stratified random sampling, 111 PHC clinic nursing managers were selected. All supervisors (n=104) and subordinate nurses (n=383) were invited to participate in the survey on the day of data collection. Following informed consent, the nursing managers, their supervisors, and subordinate nurses completed a 40-item, 360-degree competency assessment questionnaire, with six domains: communication, leadership and management, staff management, financial management, planning and priority setting, and problem-solving. Standard deviations, medians, and inter-quartile ranges (IQRs) were computed separately for PHC nursing managers, supervisors, and subordinate nurses for competencies in the six domains. The Tinsley and Weiss index was used to assess agreement between each of the three possible pairs of raters.ResultsA 95.4% response rate was obtained, with 105 nursing managers in Gauteng and Free State completing the questionnaires. There was a lack of agreement about nursing managers’ competencies among the three groups of raters. Overall, clinic nursing managers rated themselves high on the five domains of communication (8.6), leadership and management (8.67), staff management (8.75), planning and priority setting (8.6), and problem-solving (8.83). The exception was financial management with a median score of 7.94 (IQR 6.33–9.11). Compared to the PHC clinic managers, the supervisors and subordinate nurses gave PHC nursing managers lower ratings on all six competency domains, with the lowest rating for financial management (supervisor median rating 6.56; subordinate median rating 7.31).ConclusionThe financial management competencies of PHC clinic nursing managers need to be prioritised in continuing professional development programmes.

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Section: Discussionmentioning

confidence: 99%

An evaluation of the competencies of primary health care clinic nursing managers in two South African provinces

Munyewende

Levin

Rispel

2016

Global Health Action

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“…There is also minimization of work-place disruptions since the face-to-face sessions are short (not more than 2 weeks). Similar approaches have been used to strengthen health workforce capacity in several countries including The Gambia [16], Nicaragua [17] and Liberia [18]. …”

Section: Discussionmentioning

confidence: 99%

Strengthening health workforce capacity through work-based training

Matovu

Wanyenze

Mawemuko

et al. 2013

BMC Int Health Hum Rights

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BackgroundAlthough much attention has been given to increasing the number of health workers, less focus has been directed at developing models of training that address real-life workplace needs. Makerere University School of Public Health (MakSPH) with funding support from the Centers for Disease Control and Prevention (CDC) developed an eight-month modular, in-service work-based training program aimed at strengthening the capacity for monitoring and evaluation (M&E) and continuous quality improvement (CQI) in health service delivery.MethodsThis capacity building program, initiated in 2008, is offered to in-service health professionals working in Uganda. The purpose of the training is to strengthen the capacity to provide quality health services through hands-on training that allows for skills building with minimum work disruptions while encouraging greater involvement of other institutional staff to enhance continuity and sustainability. The hands-on training uses practical gaps and challenges at the workplace through a highly participatory process. Trainees work with other staff to design and implement ‘projects’ meant to address work-related priority problems, working closely with mentors. Trainees’ knowledge and skills are enhanced through short courses offered at specific intervals throughout the course.ResultsOverall, 143 trainees were admitted between 2008 and 2011. Of these, 120 (84%) from 66 institutions completed the training successfully. Of the trainees, 37% were Social Scientists, 34% were Medical/Nursing/Clinical Officers, 5.8% were Statisticians, while 23% belonged to other professions. Majority of the trainees (80%) were employed by Non-Government Organizations while 20% worked with the public health sector. Trainees implemented 66 projects which addressed issues such as improving access to health care services; reducing waiting time for patients; strengthening M&E systems; and improving data collection and reporting. The projects implemented aimed to improve trainees’ skills and competencies in M&E and CQI and the design of the projects was such that they could share these skills with other staff, with minimal interruptions of their work.ConclusionsThe modular, work-based training model strengthens the capacity of the health workforce through hands-on, real-life experiences in the work-setting and improves institutional capacity, thereby providing a practical example of health systems strengthening through health workforce capacity building.

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“…Strong systems are essential to achieving improved clinical outcomes because they are able to holistically and equitably respond to a population's healthcare needs through coordinated efforts of people, institutions, and resources (8,9). The complex, multifaceted, and highly contextual nature of health systems poses challenges for their quantitative evaluation; as such, the World Health Organization (WHO) has increasingly emphasized the need for innovative techniques for program monitoring using system-wide approaches (10)(11)(12) (21). However, many of these SDSMAS administrative personnel are clinicians without formal training for such managerial duties, but were brought to their current roles as a result of the dearth in HRs stemming from both external and internal brain drain across the Mozambican health sector (23).…”

Section: Introductionmentioning

confidence: 99%

Implementation of a health management mentoring program: year-1 evaluation of its impact on health system strengthening in Zambézia Province, Mozambique

Edwards

Moisés²,

Nzaramba³

et al. 2015

Int J Health Policy Manag

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Background: Avante Zambézia is an initiative of a Non-Governmental Organization (NGO), Friends in Global Health, LLC (FGH) and the Vanderbilt Institute for Global Health (VIGH) to provide technical assistance to the Mozambican Ministry of Health (MoH) in rural Zambézia Province. Avante Zambézia developed a district level Health Management Mentorship (HMM) program to strengthen health systems in ten of Zambézia's 17 districts. Our objective was to preliminarily analyze changes in four domains of health system capacity after the HMM's first year: accounting, Human Resources (HRs), Monitoring and Evaluation (M&E), and transportation management. Methods: Quantitative metrics were developed in each domain. During district visits for weeklong, on-site mentoring, the health management mentoring teams documented each indicator as a success ratio percentage. We analyzed data using linear regressions of each indicator's mean success ratio across all districts submitting a report over time. Results: Of the four domains, district performance in the accounting domain was the strongest and most sustained. Linear regressions of mean monthly compliance for HR objectives indicated improvement in three of six mean success ratios. The M&E capacity domain showed the least overall improvement. The one indicator analyzed for transportation management suggested progress. Conclusion: Our outcome evaluation demonstrates improvement in health system performance during a HMM initiative. Evaluating which elements of our mentoring program are succeeding in strengthening district level health systems is vital in preparing to transition fiscal and managerial responsibility to local authorities. Implications for policy makers• Health worker shortages and weak health systems threaten to undermine the ability to attain key health goals. • A strategy to deploy teams of mentors to build capacity by equipping district health managers with skills in planning, priority setting, and problem solving across eight target health management domains was implemented with some early success. • Mutual trust stemming from an open and collaborative relationship with provincial and district health authorities was key to program success. •In following best practice guidelines in global health by involving local stakeholders, our interventions were designed to target areas of joint priority and need, which encourages both relevance and sustainability of the program. This is particularly important as President's Emergency Plan for AIDS Relief (PEPFAR) seeks to fully transition authority to local entities, though we recognize that such a process can have precarious consequences if done too quickly or too cheaply. Implications for publicA health management mentoring initiative was implemented as part of a larger President's Emergency Plan for AIDS Relief-funded (PEPFARfunded) HIV care and treatment scale-up program, based on assumptions that improvements in overall system performance will eventually result in better clinical outcomes for patients. Our result...

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Developing Public Health Management Training Capacity in Nicaragua

Cited by 19 publications

References 1 publication

An evaluation of the competencies of primary health care clinic nursing managers in two South African provinces

An evaluation of the competencies of primary health care clinic nursing managers in two South African provinces

Strengthening health workforce capacity through work-based training

Implementation of a health management mentoring program: year-1 evaluation of its impact on health system strengthening in Zambézia Province, Mozambique

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