Abstract
BackgroundThere is increasing evidence that good district management practices can improve health system performance and conversely, that poor and inefficient management practices have detrimental effects. The aim of the present study was to identify factors contributing to inefficient management practices of district health managers and ways to improve their overall efficiency.MethodsNineteen semi-structured interviews were conducted with district health managers in three districts of the Eastern Region in Ghana. The 19 interviews conducted comprised 90 % of the managerial workforce in these districts in 2013. A thematic analysis was carried out using the WHO’s leadership and management strengthening framework to structure the results.ResultsKey factors for inefficient district health management practices were identified to be: human resource shortages, inadequate planning and communication skills, financial constraints, and a narrow decision space that constrains the authority of district health managers and their ability to influence decision-making. Strategies that may improve managerial efficiency at both an individual and organizational level included improvements to planning, communication, and time management skills, and ensuring the timely release of district funds.ConclusionsFilling District Health Management Team vacancies, developing leadership and management skills of district health managers, ensuring a better flow of district funds, and delegating more authority to the districts seems to be a promising intervention package, which may result in better and more efficient management practices and stronger health system performance.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1271-3) contains supplementary material, which is available to authorized users.
Highlights
There is increasing evidence that good district management practices can improve health system performance and that poor and inefficient management practices have detrimental effects
Respondents emphasised that the District Health Administration (DHA) had repeatedly sent letters to the Regional Health Administration (RHA) of the Eastern Region requesting for staff to fill their vacancies
By the end of the data collection period, the RHA had not been in the position to fill any of the District health management team (DHMT) staff vacancies in the districts
Summary
There is increasing evidence that good district management practices can improve health system performance and that poor and inefficient management practices have detrimental effects. As in other district health systems in low- and middleincome countries (LMICs), district health managers in Ghana form the link between the strategic levels (national and regional levels) and operational levels (district and sub-district levels), and are responsible for managing all areas of health service delivery at the district and sub-district levels [5]. They are organised into District Health Management Teams (DHMTs) and members of the teams are composed of administrative, technical and operational managers. DHAs report to, and are supervised by, their respective Regional Health Administration (RHA), which is in turn accountable to the central administration at national level
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
