Transforming capacity-strengthening in an era of sustainable development

Heerdegen, Anne Christine Stender

doi:10.1007/s00038-020-01490-4

Cited by 2 publications

(2 citation statements)

References 8 publications

(12 reference statements)

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“…Which form of governance, leadership, and management is preferable in any given context is highly susceptible to socio-political and cultural norms, and speaks to the need to consider ‘the reciprocal influence actors have upon one another’s interests and priorities, and the enabling environment within the health-eco system’ [ 25 ]. Whereas governance strengthening efforts tend to take place at a national level, investment in leadership and management for health are frequently concentrated at a district (i.e., within district health management teams; DHMTs) or sub-district level (i.e., within large, district-based, referral hospitals), with the assumption that improvements will ‘trickle-down’ to primary health facilities [ 26 – 28 ]. Consequently, there is a dearth of research focused on health facility based leadership and management– despite its proximal influence within primary care settings and decentralized health systems [ 29 ].…”

Section: Introductionmentioning

confidence: 99%

A new scale to assess health-facility level management: the development and validation of the facility management scale in Ghana, Uganda, and Malawi

Mubiri,

Ssengooba,

O’Byrne

et al. 2024

BMC Health Serv Res

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Background The increased recognition of governance, leadership, and management as determinants of health system performance has prompted calls for research focusing on the nature, quality, and measurement of this key health system building block. In low- or middle-income contexts (LMIC), where facility-level management and performance remain a challenge, valid tools to measure management have the potential to boost performance and accelerate improvements. We, therefore, sought to develop a Facility-level Management Scale (FMS) and test its reliability in the psychometric properties in three African contexts. Methods The FMS was administered to 881 health workers in; Ghana (n = 287; 32.6%), Malawi (n = 66; 7.5%) and Uganda (n = 528; 59.9%). Half of the sample data was randomly subjected to exploratory factor analysis (EFA) and Monte Carlo Parallel Component Analysis to explore the FMS’ latent structure. The construct validity of this structure was then tested on the remaining half of the sample using confirmatory factor analysis (CFA). The FMS’ convergent and divergent validity, as well as internal consistency, were also tested. Results Findings from the EFA and Monte Carlo PCA suggested the retention of three factors (labelled ‘Supportive Management’, ‘Resource Management’ and ‘Time management’). The 3-factor solution explained 51% of the variance in perceived facility management. These results were supported by the results of the CFA (N = 381; χ2 = 256.8, df = 61, p < 0.001; CFI = 0.94; TLI = 0.92; RMSEA [95% CI] = 0.065 [0.057–0.074]; SRMR = 0.047). Conclusion The FMS is an open-access, short, easy-to-administer scale that can be used to assess how health workers perceive facility-level management in LMICs. When used as a regular monitoring tool, the FMS can identify key strengths or challenges pertaining to time, resources, and supportive management functions at the health facility level.

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Section: Introductionmentioning

confidence: 99%

A new scale to assess health-facility level management: the development and validation of the facility management scale in Ghana, Uganda, and Malawi

Mubiri,

Ssengooba,

O’Byrne

et al. 2024

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…Which form of leadership and management is preferable in any given context is highly susceptible to socio-political and cultural norms, and speaks to the need to consider 'the reciprocal in uence actors have upon one another's interests and priorities, and the enabling environment within the health-eco system' [22]. Within LMICs, investment in leadership and management for health are frequently concentrated at a district (i.e., within district health management teams; DHMTs) or sub-district level (i.e., within large, district-based, referral hospitals), with the assumption that improvements will 'trickle-down' to primary health facilities [23][24][25]. Consequently, there is a dearth of research focused on health facility based leadership and management -despite its proximal in uence within primary care settings and decentralized health systems [26].…”

Section: Introductionmentioning

confidence: 99%

A new scale to assess health-facility level management: The development and validation of the Facility Management Scale in Ghana, Uganda, and Malawi

Mubiri,

Ssengooba,

O’Byrne

et al. 2023

Preprint

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Background The increased recognition of leadership and management as a determinant of health system performance has prompted calls for research focusing on the nature, quality, and measurement of this key health system building block. In low- or middle-income contexts (LMIC), where facility-level management and performance remain a challenge, valid tools to measure leadership and management have the potential to boost performance improvements. We, therefore, sought to develop a Facility-level Management Scale (FMS) and test its reliability in the psychometric properties in three African contexts. Methods The FMS was administered to 881 health workers in; Ghana (n = 287; 32.6%), Malawi (n = 66; 7.5%) and Uganda (n = 528; 59.9%). Half of the sample was randomly subjected to exploratory factor analysis (EFA) and Monte Carlo Parallel Component Analysis to first explore the FMS’ latent structure. The construct validity of this structure was then tested on the remaining half of the sample using confirmatory factor analysis (CFA). The FMS’ convergent and divergent validity, as well as internal consistency, were also tested. Results Findings from the EFA and Monte Carlo PCA suggested the retention of three factors (labelled ‘Supportive Management’, ‘Resource Management’ and ‘Time management’). The 3-factor solution explained 51% of the variance in perceived facility management. These results were supported by the results of the CFA (N = 381; χ2 = 256.8, df = 61, p < .001; CFI = .94; TLI = .92; RMSEA [95% CI] = 0.065 [.057–.074]; SRMR = .047). Conclusion The FMS is an open-access, short, easy-to-administer scale that can be used to measure health workers’ perceptions of facility-level management in LMICs. When used as a regular monitoring tool, the FMS can identify key strengths or challenges pertaining to time, resources, and supportive management functions at the health facility level.

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Transforming capacity-strengthening in an era of sustainable development

Abstract: This Editorial is part of the series ''Young Researcher Editorial'', a training project of the Swiss School of Public Health.

Cited by 2 publications

References 8 publications

A new scale to assess health-facility level management: the development and validation of the facility management scale in Ghana, Uganda, and Malawi

A new scale to assess health-facility level management: the development and validation of the facility management scale in Ghana, Uganda, and Malawi

A new scale to assess health-facility level management: The development and validation of the Facility Management Scale in Ghana, Uganda, and Malawi

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