scholarly journals Leadership and management competencies required for Bhutanese primary health care managers in reforming the district health system

2019 ◽  
Vol Volume 11 ◽  
pp. 13-21 ◽  
Author(s):  
Kinley Dorji ◽  
Phudit Tejativaddhana ◽  
Taweesak Siripornpibul ◽  
Mary Cruickshank ◽  
David Briggs
2019 ◽  
Vol 35 (2) ◽  
pp. 520-531 ◽  
Author(s):  
Alipio Gusmão Lopes ◽  
Kanida Narattharaksa ◽  
Taweesak Siripornpibul ◽  
David Briggs

2020 ◽  
Author(s):  
Tobias Abelsson ◽  
Helena Morténius ◽  
Ann-Kristin Karlsson ◽  
Stefan Bergman ◽  
Amir Baigi

Abstract Background: The vast availability of and demand for evidence in modern primary health care forces clinical decisions to be made based on condensed evidence in the form of policies and guidelines. Primary health care managers play a key role in implementing these governing documents. Thus, the aim of this article was to investigate the use and availability of evidence-based practice resources from the perspective of first-line primary health care managers.Methods: The study utilized a quantitative method based on a national survey of primary health care managers. The study population was recruited nationally from Sweden and consisted of 186 respondents. The data were analysed using empirically constructed themes and validated using factor analysis. To determine the statistical significance in making comparisons, the chi-square test was utilized. Associations between variables were calculated using Spearman’s correlation. All tests were two-sided, and the significance level was set to 0.05.Results: A majority (97%) of managers stated there was an impact of guidelines and policy documents on primary health care; 84% of managers could see a direct influence in daily practices. Most of the managers (70%) stated that some adaptation had to be made when new evidence was introduced. The managers emphasised the importance of keeping themselves updated and open to new information about work routines (96%). Conclusions: Evidence-based practice has a fundamental impact on Swedish primary health care. The study illustrated a nearly unanimous response about evidence influencing daily practice. The emphasis on the importance of all staff members keeping their professional knowledge up to date can be seen as a direct result of this. An information-dense organization such as a primary health care organization would have much to gain from cooperation with regional information resources such as clinical libraries.Trial registration: Not applicable.


Author(s):  
Andrew R. Liebenberg ◽  
Johan F. Coetzee ◽  
Hofmeyr H. Conradie ◽  
Johan F. Coetzee

Background: Burnout among doctors negatively affects health systems and, ultimately,patient care.Aim: To determine the prevalence of burnout among doctors working in the district health system in the Overberg and Cape Winelands districts of the Western Cape Province and to compare the findings with those of previous South African studies.Setting: Rural district hospitals.Methods: During 2013, a validated questionnaire (Maslach Burnout Inventory) was sent to 42 doctors working in the district health system within the referral area of the Worcester Hospital, consisting of the Overberg health district and the eastern half of the Cape Winelands.Results: Response rate was 85.7%. Clinically significant burnout was found among 81% of respondents. High levels of burnout on all three subscales were present in 31% of participants.Burnout rates were similar to those of a previous study conducted among doctors working in the Cape Town Metropolitan Municipality primary health care facilities. Scores for emotional exhaustion (EE) and depersonalisation (DP) were greater than those of a national survey;however, the score for personal accomplishment (PA) was greater. EE and PA scores weresimilar to that of a study of junior doctors working in the Red Cross Children’s Hospital;however, EE was smaller.Conclusion: This study demonstrates high burnout rates among doctors working at district level hospitals, similar to the prevalence thereof in the Cape Town Metropolitan primary health care facilities. Health services planning should include strategies to address and prevent burnout of which adequate staffing and improved work environment are of prime importance.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Binyam Fekadu Desta ◽  
Azeb Abitew ◽  
Ismael Ali Beshir ◽  
Mesele Damte Argaw ◽  
Sualiha Abdlkader

Abstract Background Primary health care (PHC) in Ethiopia serves as the main entry point for preventive, promotive and curative health services. The district health office is responsible for the planning, implementation and evaluation of all district health activities. In addition, district health offices manage service delivery facilities working on provision of PHC – primary hospitals, health centers and health posts. As the leader of the health care system tier, district health management must ensure direction, alignment and commitment within teams and organizations and make sure that achievements are consistent with the vision, values and strategy of the organization. USAID Transform: Primary Health Care provides diverse support to improve district health manager competencies including in-service trainings followed by planning and implementation of performance improvement projects and on-the-job mentoring and support. Methods This study was conducted to compare district level capacity and performances between leadership, management and governance (LMG) and non-LMG districts. Project outcome monitoring data that shows the performance of districts was collected from 284 districts from January to December 2019. The study was carried out using a comparative-cross sectional study design, which assessed and compared district health office level indicators. Districts were classified into two categories: LMG and non-LMG districts. The study compared data from 94 LMG and 190 non-LMG districts. Propensity score matching was used to control the effect of differences between LMG and non-LMG districts. Results Results of the independent samples t-test revealed that LMG districts scored better average performances of 61.8 ± 121.45 standard deviation (SD) compared to non-LMG districts 56.89 ± 110.39 SD, with t (282243) = − 3.407317 and p < 0.001, two-tailed. The difference of 4.9 percentage unit in the average performance indicated a statistically significant difference between the LMG and non-LMG districts. Conclusion District level leadership development program contributes to improving district capacity, structure and management practices, and quality of care.


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