Abstract
Zimbabwe’s health service delivery has attracted media attention for three successive decades due to failure by public hospitals to deliver effective service with the blame leveled against the hospital management boards (HMB). Responding to the criticism, the Ministry of Health introduced reforms on public hospital governance practices towards ensuring an effective health delivery system. This was done by improving the structural capacity of hospitals to deal with the increasing demand for health services (Moyo, 2016; Sikipa, Osifo-Dawodu, Kokwaro, & Rice, 2019). Thus, the study sought to determine the standard functional structures within HMBs of Zimbabwe’s 6 central hospitals. To achieve this, the study used a mixed research design in which 66 board members responded to the questionnaire while 9 purposively selected board members were interviewed, respectively. The study revealed that public hospitals require standard functional structures in order to be effective. These include a functional board that has sub-committees, a policy to evaluate the performance of CEOs, and the board itself. Frequency of board meetings, setting of agendas, succession planning, and alignment of goals with interests of various stakeholders. Implementing such functional structures enhances would standard functional structures for hospital management boards in central hospitals
Highlights
On the foot of attaining political independence in 1980, Zimbabwe focused on improving the provision of primary health care services across all provinces to close the gap created by the colonial government
The study revealed that public hospitals require standard functional structures in order to be effective. These include a functional board that has sub-committees, a policy to evaluate the performance of CEOs, and the board itself
The standard functional structures for hospital management boards can be identified through various indicators like a functional board, the existence of board sub-committees, policy to evaluate the performance of CEO and the board itself, frequency of board meetings and setting of agendas, succession planning, and alignment of goals with interests of various stakeholders
Summary
On the foot of attaining political independence in 1980, Zimbabwe focused on improving the provision of primary health care services across all provinces to close the gap created by the colonial government. The government decided to establish hospital management boards (HMB) to oversee the leadership and management of public hospitals including the 6 large hospitals referred to as central hospitals in Zimbabwe As if this was not enough, public hospitals continue to experience service delivery challenges at an alarming scale with the board of directors criticized for failing to put in place standard functional structures to improve hospital performance and functionality (Mazikana, 2019). Many countries around the world have introduced effective strategies and techniques to ensure that public hospitals are better prepared or equipped to match the growing demand as the population increases. In addition to lack of autonomy, and inability to fund raise, HMB suffer from policy inconsistency (De Geyndt, 2017)
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