Every day, health service leaders face challenges like working with limited resources while delivering results, managing change, and keeping staff motivated. Decentralisation adds to these challenges, as many health workers have both clinical and managerial responsibilities.
However, little attention is paid to leadership and management skills during their health training.
Communities, donors, local politicians and opinion leaders are demanding accountability and results, which is achievable with simple leadership and management skills.
In partnership with the districts, who select the candidates, the Makerere University School of Public Health is training health workers in three areas: planning and management of health services, improving management of logistics and improving management of labor and newborn care.
A six-month distance health services management certificate course, targeting district and health facility managers, caters for the first two thematic areas, the focus for this article. In the first phase, 30 health service delivery personnel were drawn from the three study districts (10 from each), and another 30 are attending the second phase of training. The results have been tremendous, with beneficiaries already registering significant improvements back at their work places.
Stephen Otukor, a clinical officer in Pallisa district, said that the financial management skills he acquired during the training are invaluable.
Before the training, spending and finances were not streamlined. Now all his staff know how his clinic's financial resources are used.
"The other good thing is that when we collect the data nowadays, we analyse it, and we utilize it," adds Stephen. "This has helped us in decision making. For instance, if we plot a graph and find problems, we trace the root causes of why. We then find solutions to the challenges."For Edith Bogere, a senior nursing officer with Kamuli district, turning support supervision into a blame game and police-like interrogation had failed to solve a long-standing problem. But, while still on the course, Edith decided to employ her new skills by suggesting the involvement of the in-charge of the health centre and the staff to find solutions.
"The in-charge gave us her views, and one of them was to change a midwife that was there to another health facility and get her another one or two. And the district health management team respected her opinion. We have since seen deliveries increasing in this facility, even the OPD attendance is improving. When you compare the HMIS report 105 of Bupadhengo now and those before, you see a marked improvement. This is simply because we were able to change our approach to supervision and problem solving."And in the case of Anek Santurinah, a midwife in Pallisa, time management was a problem. "Things like phone calls and visitors who came unnecessarily would take my time. I would sometimes attend to these visitors and ignore clients. But this changed after the training."
By the end of the study, each of the three districts will have had 30 key personnel trained in health services management.
By Kakaire Ayub Kirunda, FHS Uganda Policy Influence and Research Uptake Officer
[Editor's note: This article is the first in a series of updates from the FHS Uganda team that were also compiled in their recent Showcase.]