Organizational change--key to capacity building and effective health promotion

Abstract

Contemporary health promotion is now a well-defined discipline with a strong (albeit diverse) theoretical base, proven technologies (based on program planning) for addressing complex social problems, processes to guide practice and a body of evidence of efficacy and increasingly, effectiveness. Health promotion has evolved principally within the health sector where it is frequently considered optional rather than core business. To maximize effectiveness, quality health promotion technologies and practices need to be adopted as core business by the health sector and by organizations in other sectors. It has proven difficult to develop the infrastructure, workforce and resource base needed to ensure the routine introduction of high-quality health promotion into organizations. Recognizing these problems, this paper explores the use of organizational theory and practice in building the capacity of organizations to design, deliver and evaluate health promotion effectively and efficiently. The paper argues that organizational change is an essential but under-recognized function for the sustainability of health promotion practice and a necessary component of capacity-building frameworks. The interdependence of quality health promotion with organizational change is discussed in this paper through three case studies. While each focused on different aspects of health promotion development, the centrality of organizational change in each of them was striking. This paper draws out elements of organizational change to demonstrate that health promotion specialists and practitioners, wherever they are located, should be building organizational change into both their practice and capacity-building frameworks because without it, effectiveness and sustainability are at risk.

Reorientation of health services: enablers and barriers faced by organisations when increasing health promotion capacity

“…However, the enablers and barriers identified were common across the studies and despite these limitations there are several key findings that 21,22,25 -access to expertise, workforce development and training 21,22,25 -recruitment of skilled staff 21,22,25 -priority given to health promotion approaches. 25,26 Influence on the organisation's ethos and practice: -aligning health promotion with the organisation's vision, values and priorities 20,27,28 -long term commitment to health promotion 26,29 -culture of collaboration 27,31 -sound knowledge of health promotion 30 -build on previous initiatives 25 -identify further funding 30 -embedding health promotion activities into planning and reporting, including quality improvement processes. 22 -proactive approach to staff development and succession planning 33 -support joint work with key stakeholders 33 External partnerships -access to external partners (key stakeholders including community members) to work on health promotion approaches 18,[25][26][27] can be explored further: management support, leadership, external specialist assistance, skilled staff, partnership work, resource allocation, and the challenge of competing work priorities in health organisations.…”

“…To increase organisational health promotion capacity, management support, 18,20-33 a skilled and knowledgeable workforce, [34][35][36][37][38] external specialist assistance, 18,24,32,34,35 resource allocation, 20,22,27,31 leadership 26,27,29,31,33,39,40 and access to external partners to work on health promotion approaches 21,[25][26][27] were the most commonly reported enablers. Management support was reported in two ways: first, the line manager's influence on work practice; and second, the influence of the organisation's ethos and practice.…”

“…The most common reported barriers for an organisation aiming to increase health promotion capacity were: lack of management support; 20,26,37,38 lack of dedicated health promotion staff; 25,26,30,41 Articles for full text evaluation (n = 125)…”

“…17 The framework acknowledges the interdependency between the components and has guided health promotion capacity building work, particularly in Australia, since the early 2000s. 20 The health promotion capacity building framework 17 identified areas that can be strengthened to embed health promotion within an organisation. However, when reorientating health services it is important to understand the challenges of implementing change into practice.…”

A Phenomenological Analysis of Managerial Capability in SMEs in Nigeria

“…Augustine (2013) posited that for Firm Growth to be actualised, failing organisations should reconsider the capabilities of managers and insist on change where there are deficiencies irrespective of the complexities involved in change process. Confirming the complexities in change process, Heward et al (2007) observed that the planning of change becomes complex with many contingencies, steps and sub steps. In some cases, organisations may go through cycles of change without proper planning and implementation or worst still skip one or more steps of the action plan that may have been erroneously perceived as trivial.…”