Abstract
BackgroundThe performance management concept is relatively new to the Ugandan health sector. Uganda has been implementing health sector reforms for nearly two decades. The reforms included the introduction of the results-oriented management in the public sector and the decentralisation of the management of health care workers from central to local governments. This study examined the implementation of performance management of health care workers in order to propose strategies for improvement.MethodsThe study was a descriptive survey carried out in the Kumi, Mbale, Sironko and Tororo districts and utilising mixed research methodology. A self-administered questionnaire was used to collect quantitative data from the health care workers. A semi-structured interview guide was used to collect qualitative data from the health service managers. The sample for the quantitative method was selected using stratified random sampling. Purposive sampling was used to select health service managers. Quantitative data were analysed using Statistical Package for Social Sciences (version 18.0). Qualitative data were categorised according to the themes and analysed manually.ResultsThe findings show that to some extent performance management is implemented in the health sector; however, there were loopholes in its implementation. There were inadequacies in setting performance targets and performance management planning was hardly done. Although many health care workers had job descriptions, the performance indicators and standards were not clearly defined and known to all workers and managers. Additionally the schedules for performance assessments were not always adhered to. There were limited prospects for career progression, inadequate performance feedback and poor rewarding mechanisms.ConclusionsPerformance management of health care workers is inadequately done in the districts. Performance management is a key component of attempts to improve health sector outcomes. As a result of this study, suggestions to enhance health sector performance management in the districts have been put forward. The authors are optimistic that if these suggestions are implemented, the performance of health care workers is likely to improve.
Highlights
The performance management concept is relatively new to the Ugandan health sector
Among the reforms implemented is the decentralisation of responsibility for delivery of health services and management of health care workers from the central Ministry of Health (MoH) to the local governments
Performance management tools serve to improve the performance of health care workers and assist in setting, communicating and internalising the organizational goals [18]
Summary
The performance management concept is relatively new to the Ugandan health sector. Uganda has been implementing health sector reforms for nearly two decades. The reforms included the introduction of the results-oriented management in the public sector and the decentralisation of the management of health care workers from central to local governments. Uganda has implemented health sector reforms for nearly two decades to improve access and strengthen health care systems. Among the reforms implemented is the decentralisation of responsibility for delivery of health services and management of health care workers from the central Ministry of Health (MoH) to the local governments. Human resource management challenges have been reported in Uganda Among these challenges is weak performance management of health care workers. The value for money audit for the health sector programmes that was carried out in Uganda in the year 2006 revealed a number of weaknesses in performance management of health care workers in the districts. Many district and health facility managers were not utilising the existing health management information systems (HMIS) to report performance [9]
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