Evaluation of a Capacity-Building Programme of District Health Managers in India: A Contextualised Theoretical Framework

Prashanth, N S; Marchal, Bruno; Macq, Jean; Kegels, Guy; Criel, Bart

doi:10.2139/ssrn.2451132

Cited by 1 publication

(7 citation statements)

References 40 publications

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“…In low-income countries, health managers in the public sector are often medical, clinical or nursing personnel assigned to this as an extra role. They have to balance between clinical and managerial work which is often complex and difficult [11]. In terms of numbers and distribution, duly qualified health managers are in short supply and concentrated in urban settings and in the private sector [12].…”

Section: Introductionmentioning

confidence: 99%

“…Management competencies are typically described in relation to the term “capacity”, which refers to individual attributes that enable or hinder managers’ performance [18, 19]. According to the literature, managers at the district level are more likely than those at the national level to lack the necessary skills, attitudes and behaviors needed to perform management duties [11, 20]. Several approaches have been advanced and implemented to strengthen managers’ competencies including formal training, on-the job training, action learning and non-formal training [21].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, such support systems require competent personnel to run them [7]. In low-income countries, while these systems are readily available, their capacity is often low, at sub national levels these support systems are weakest [6, 11, 24]. …”

Section: Introductionmentioning

confidence: 99%

“…Regular meetings, support supervision and mentoring, incentives, organizational support structures and adequate levels of autonomy are some of the examples of an enabling environment advanced by the WHO framework. The creation of such an environment has been reported as essential for building strong management of health systems [7, 11]. While this is widely documented, less attention has been directed towards effective approaches for achieving an enabling environment [11].…”

Section: Introductionmentioning

confidence: 99%

“…The creation of such an environment has been reported as essential for building strong management of health systems [7, 11]. While this is widely documented, less attention has been directed towards effective approaches for achieving an enabling environment [11]. …”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Building a competent health manager at district level: a grounded theory study from Eastern Uganda

Tetui

Hurtig

Ekirpa-Kiracho

et al. 2016

BMC Health Serv Res

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Background: Health systems in low-income countries are often characterized by poor health outcomes. While many reasons have been advanced to explain the persistently poor outcomes, management of the system has been found to play a key role. According to a WHO framework, the management of health systems is central to its ability to deliver needed health services. In this study, we examined how district managers in a rural setting in Uganda perceived existing approaches to strengthening management so as to provide a pragmatic and synergistic model for improving management capacity building. Methods: Twenty-two interviews were conducted with district level administrative and political managers, district level health managers and health facility managers to understand their perceptions and definitions of management and capacity building. Kathy Charmaz's constructive approach to grounded theory informed the data analysis process. Results: An interative, dynamic and complex model with three sub-process of building a competent health manager was developed. A competent manager was understood as one who knew his/her roles, was well informed and was empowered to execute management functions. Professionalizing health managers which was viewed as the foundation, the use of engaging learning approaches as the inside contents and having a supportive work environment the frame of the model were the sub-processes involved in the model. The sub-processes were interconnected although the respondents agreed that having a supportive work environment was more time and effort intensive relative to the other two sub-processes. Conclusions: The model developed in our study makes four central contributions to enhance the WHO framework and the existing literature. First, it emphasizes management capacity building as an iterative, dynamic and complex process rather than a set of characteristics of competent managers. Second, our model suggests the need for professionalization of health managers at different levels of the health system. Third, our model underscores the benefits that could be accrued from the use of engaging learning approaches through prolonged and sustained processes that act in synergy. Lastly, our model postulates that different resource investments and a varied range of stakeholders could be required at each of the sub-processes.

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Section: Introductionmentioning

confidence: 99%