Enhancing Leadership, Management, And Governance Competencies For Performance Improvements At Primary Health Care Entities In Ethiopia: A Before And After Study

Abstract

ObjectivesLeadership, management, and governance (LMG) interventions play a significant role in improving management systems, enhancing work climate, and creating responsive health systems. This study aimed to determine the change that occur in the performance of primary healthcare entities and compare the outputs of block and segmented LMG trainings and the intervention as a whole after implementation for one full year.ResultsTwo hundred and ninety-three LMG trained and 333 non-trained health workers participated with a response rate of 100 percent and 87 percent, respectively. Of those who attended the didactics sessions, 235 (80.9%) scored 70% or more on post-test exams. In addition, the assessment on the practical exercises after implementing the leadership projects revealed that the majority, 252 (86%) scored 80% or more on their desired measurable results. As a result of the LMG trainings, management systems, work climate, and responsiveness of the health system to new challenges were significantly improved (p<0.001). Owing to the leadership projects, within the 136 health facilities, an additional 2,290.3 units of health service coverage was gained. A comparison of the trainees revealed that more block (79.1%), than segmented I (65.02%) and segmented II (62.0%) LMG trainings were successfully completed. Therefore, providing block LMG trainings for more health workers and managers working at primary healthcare entities is 53 recommended as it willaccelera te the implementation of prioritized health sector interventions.