Summary Background This study aims to assess the levels of management competencies of primary health care (PHC) managers in Timor‐Leste. Timor‐Leste is a young country. It has made important improvements in reconstructing its health system since its independence in 2002. However, most managers still learn through their failures, and few studies have described the perceptions of managers in Timor‐Leste. Methods This study used quantitative methods, using a cross‐sectional survey involving a structured self‐administered questionnaire. The Cochran formula was used in calculating the sample size. The sample included 183 PHC managers in Timor‐Leste. Stratified random sampling was adopted to conduct the survey. The researcher used confirmatory factor analysis (CFA) to confirm the validity and reliability of the tools and create new dimensions. The data were analyzed using the frequency and percentage. Results This study was initially designed to include seven dimensions, but after confirming it using the CFA, it was reduced to six dimensions. The result of CFA was used. This study found that PHC managers in Timor‐Leste had rated themselves “not competent” in knowing the organization, professionalism in the workplace, problem solving on financial management, and effective leadership and only “competent” in managing human resources and communicating effectively. Conclusion This study determined that policy makers and stakeholders must give more attention to knowing the organization, professionalism in the workplace, problem solving on financial management, and effective leadership. Managers need to be competent and have various skills to perform managerial functions effectively and efficiently.

Objective This study aims to identify the required management competencies, current competency levels, and strategies for improving the management competencies of Bhutanese primary health care (PHC) managers. Methods A quantitative method with a cross-sectional survey using self-administered questionnaires. This study recruited 339 PHC managers across Bhutan. The data were analyzed using statistical software. Results This study identified three competency domains and seven key sub-domain competencies. People domain was perceived to be the highest required competency with a mean score of 4.2376, followed by execution (4.1851), and the transformation (4.0501) domains. For the seven key sub-domains, the communication sub-domain (4.3220) was perceived as the highest required competency, followed by professionalism (4.2967), managing change (4.1776), relationship building (4.1686), analytical thinking (4.1091), leadership (4.0980), and innovative thinking (3.9794). The current competency levels of PHC managers in domains and sub-domain competencies were the people domain (3.7322), execution (3.6471), and the transformation (3.5554). For the sub-domains, communication (3.8092), professionalism (3.7939), relationship building (3.6603), analytical thinking (3.6396), leadership (3.5805), managing change (3.5723), and innovative thinking (3.4543). Conclusion Findings of Bhutan health managers’ competencies are consistent with the findings of other international contexts. This study suggests that agencies responsible for health system need to focus more on the competencies defined by the study to positively influence health leadership and management development interventions.

Village health workers (VHWs) are the first contact extending vital health services to unreached and underserved communities in Bhutan. VHWs truly embody the principles of primary health care and are effective catalysts in promoting community health. This study identifies and confirms factors motivating VHWs to remain in the health care system. This is a quantitative study with a cross-sectional survey design. Two-stage cluster sampling was used with VHWs from 12 districts representing 3 regions of Bhutan. Data were collected using pretested semistructured questionnaires. Confirmatory factor analysis was used for data analysis. Findings reveal a 4-factor model of motivations among VHWs that includes social, personal, job related, and organizational factors. Among these, the social factor most significantly motivates VHWs to remain in the health care system. VHW motivation can be further fostered by providing a holistic combination of financial and nonfinancial incentives that recognize intrinsic needs and empower innate altruism.

Background: Bhutan achieved over 95% of health coverage through its primary health care network and geared towards achieving and ensuring Universal Health Coverage. About 62.2% of the Bhutanese people are rural dwellers, living in villages. Village health workers (VHWs) are essential for primary health care delivery at the community level in order to bridge the gap between the health care system and the communities. However, increasing numbers of VHWs leaving the health care system remain a challenge for Bhutan. This study intends to find existing problems of motivation and retention among VHWs in Bhutan and to devise appropriate strategies for making effective policy interventions.Methods: This quantitative study with a cross-sectional survey design aims to determine demotivating factors.One stage cluster sampling technique was applied for VHWs from 12 districts in three regions. Data were collected by the trained enumerators using a pre-tested semi-structured questionnaire.Results: The Confirmatory factor analysis identified and confirmed a four-factor model of demotivation among VHWs in Bhutan. Among the four factors, the social factor was the main factor for VHWs leaving the health care system. However, the holistic combination of both financial and non-financial motivator needs to be taken into consideration. The content analysis revealed six areas of

Objectives: The majority (80%) of stroke survivors in Bangladesh have lived with either minor or major physical, emotional, and cognitive disabilities. Due to patients’ poor perceived experience in healthcare services, participation in rehabilitation care has become a significant challenge for them. Consequently, it increases the burden of stroke disability. Therefore, this study aimed to measure the gaps in post-stroke outpatients’ rehabilitation Service Quality (SQ) and factors related to these gaps. Methods: A cross-sectional descriptive study was administered on 311 post-stroke outpatients who were selected by stratified sampling method from 5 divisional centers of a rehabilitation hospital. Data collection tools consisted of the following: a demographic information form and a modified Service Quality (SERVQUAL) questionnaire. Cronbach’s alpha coefficient was applied to analyze the internal consistency. Besides, Pearson’s (r) correlation test was applied to examine the correlation coefficient between the explored items. The obtained data were analyzed by descriptive statistics, Paired Samples t-test, and Eta-statistic (δ) of the Analysis of Variance (ANOVA). Results: Patients’ expectations were rated higher than the perceptions in all dimensions of rehabilitation SQ and indicated a significant gap (t=-29.604, P<0.001). Patients’ occupation (δ=0.189), family status (δ=0.289), pre-stroke daily activities (δ=0.235), and post-stroke disability (δ=0.286) indicated a significant relationship with the gaps in rehabilitation SQ. Discussion: Post-stroke rehabilitation SQ gaps are required to be addressed by considering the factors related to these gaps. Most importantly, the rehabilitation hospital must integrate the continuous quality improvement monitoring systems to enhance SQ as well as patients’ participation in rehabilitation care programs.