Evaluation of the district health management fellowship training programme: a case study in Iran

Abstract

ObjectiveTo evaluate the district health management fellowship training programme in the north-west of Iran.Data sources/study settingThe programme was introduced to build the managerial capacity of district health managers in Iran. Eighty-nine heads of units in the province’s health centre, district health managers and the health deputies of the district health centres in the north-west provinces of Iran had registered for the district health management fellowship training programme in Tabriz in 2015–2016.Study designThis was an educational evaluation study to evaluate training courses to measure participants' reactions and learning and, to a lesser extent, application of training to their job and the organisational impact.Data collection/extraction methodsValid and reliable questionnaires were used to assess learning techniques and views towards the fellowship, and self-assessment of health managers’ knowledge and skills. Also, pretest and post-test examinations were conducted in each course and a portfolio was provided to the trainees to be completed in their work settings.Principal findingsAbout 63% of the participants were medical doctors and 42.3% of them had over 20 years of experience. Learning by practice (scored 18.37 out of 20) and access to publications (17.27) were the most useful methods of training in health planning and management from the participants’ perspective. Moreover, meeting peers from other districts and the academic credibility of teachers were the most important features of the current programme. Based on the managers’ self-assessment, they were most skilful in quality improvement, managing, planning and evaluation of the district. The results of the post-test analysis on data collected from district health managers showed the highest scores in managing the district (77 out of 100) and planning and evaluation (69) of the courses.ConclusionThe results of this study indicated that training courses, methods and improvement in managers' knowledge about the health system and the skills necessary to manage their organisation were acceptable.

Managerial capacity among district health managers and its association with district performance: A comparative descriptive study of six districts in the Eastern Region of Ghana

“…In Ghana, the District Directors of Health Services who lead the DHMTs, are strongly encouraged to undergo a certified management training course at the Ghana Institute of Management and Public Administration to prepare them for their role [44]. Thus, Ghana seems to be advancing in terms of competent DHMs compared to other countries, where DHMs often are described as clinical staff that have been promoted to management positions with little or no structured management training [12,30,43,45,46]. However, there is still improvement potential; more than one third of DHMs in this study had less than one year of management experience before entering their current role, and the majority had a bachelor degree or lower as highest educational qualification.…”

“…Filerman suggest that essential management competencies are learned most effectively if the training takes place where the managers' work, within the team and it addresses existing challenges [22]. Gholipour et al describes that the academic credibility of the instructors are important, and that meeting and sharing experiences with peers from other districts also can be an effective approach to strengthen district management [45].…”

“…Management capacity is a complex concept to measure. This study measured it through a selfadministered survey, which is an approach that has been used in other studies [45,[58][59][60][61]. The self-assessment methodology is founded on the concept of self-efficacy that posits that individuals who feels greater confidence in their ability to perform is more likely to successfully perform [30].…”

How Does District Health Management Emerge Within a Complex Health System? Insights for Capacity Strengthening in Ghana

“…Since the 1980s, management strengthening interventions (MSIs) have had a predominant focus on strengthening the DHMs' individual competencies rather than the system capacity (13)(14)(15)(16). Individual competencies among DHMs are indeed critical for them to carry out their job in an effective and efficient way (3,13,14,(17)(18)(19)(20)(21)(22)(23)(24)(25). Nevertheless, it has been posed that leadership and management within complex adaptive systems, such as the district health system, need to be considered as more than the act of individuals, and rather as something that emerges through an interplay of many interacting forces (26).…”

Effectiveness of training and educational programs for hospital managers: A systematic review

“…This could be due to the date of the reviewed studies or weaknesses in health information systems, or in managers' abilities to use these methods. 65 Indeed, a study by Beanland et al concluded that using communication technologies (e.g., the Internet) was an effective training method in health systems. 66 Ensuring that the training program design is attractive and functional is an effective strategy to encourage participant involvement, and to improve program quality.…”