Strengthening management and leadership practices to increase health-service delivery in Kenya: an evidence-based approach

Human Resources for Health

Sammuel Cheburet¹  Peter Kibunga⁵  Nandita Thatte²  Joan Bragar³  Lily Murei⁶  Juan Carlos Alegre⁴  La Rue K Seims⁴ 

[1] Ministry of Health, Afya House, Cathedral Road, PO Box: 30016-00100, Nairobi, Kenya;Public Health Institute Global Health Fellow, US Agency for International Development, Office of Population and Reproductive Health, United States Agency for International Development, 1300 Pennsylvania Avenue, Washington, DC, 20523, USA;Management Sciences for Health, 784 Memorial Drive, Cambridge, MA, 02139, USA;Management Sciences for Health, 4301 North Fairfax Drive, Suite 400, Arlington, VA, 22203, USA;Management Sciences for Health, ACK Garden House, Block A, 6th Floor, First Ngong Road Avenue, off Bishops Road, PO Box 8700-00100, Nairobi, Kenya;Management Sciences for Health, Kenya (former), Box 61379, Nairobi, 00200, Kenya

关键词: Service delivery;    Management;    Leadership;    Kenya;    Institutional strengthening;    Health worker performance;   

Others  :  822690
DOI  :  10.1186/1478-4491-10-25

 received in 2011-09-01, accepted in 2012-07-04,  发布年份 2012

【 摘 要 】

Background

The purpose of the study was to test the hypothesis that strengthening health systems, through improved leadership and management skills of health teams, can contribute to an increase in health-service delivery outcomes. The study was conducted in six provinces in the Republic of Kenya.

Methods

The study used a non-randomized design comparing measures of key service delivery indicators addressed by health teams receiving leadership and management training (the intervention) against measures in comparison areas not receiving the intervention. Measurements were taken at three time periods: baseline, endline, and approximately six months post intervention. At the district level, health-service coverage was computed. At the facility level, the percentage change in the number of client visits was computed. The t-test was used to test for significance.

Results

Results showed significant increases in health-service coverage at the district level (p = <0.05) in the intervention teams compared to the comparison teams. Similarly, there were significant increases in the number of client visits at the facility level in the intervention group versus comparison facilities (P < 0.05).

Conclusions

Strengthening the leadership and management skills of health teams, through team-based approaches focused on selected challenges, contributed to improved health service delivery outcomes and these improvements were sustained at least for six months.

【 授权许可】

   
2012 Seims et al.; licensee BioMed Central Ltd.

【 图 表 】

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