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

Human Resources for Health

Research

La Rue K Seims¹  Juan Carlos Alegre¹  Joan Bragar²  Peter Kibunga³  Lily Murei⁴  Sammuel Cheburet⁵  Nandita Thatte⁶ 

[1] Management Sciences for Health, 4301 North Fairfax Drive, Suite 400, 22203, Arlington, VA, USA;Management Sciences for Health, 784 Memorial Drive, 02139, Cambridge, MA, USA;Management Sciences for Health, ACK Garden House, PO Box 8700-00100, Block A, 6th Floor, First Ngong Road Avenue, off Bishops Road, Nairobi, Kenya;Management Sciences for Health, Box 61379, Kenya (former), 00200, Nairobi, Kenya;Ministry of Health, Afya House, PO Box: 30016-00100, Cathedral Road, 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, 20523, Washington, DC, USA;

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

DOI  :  10.1186/1478-4491-10-25

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

来源: Springer

【 摘 要 】

BackgroundThe 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.MethodsThe 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.ResultsResults 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).ConclusionsStrengthening 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】

CC BY   
© Seims et al.; licensee BioMed Central Ltd. 2012