Using the integration of human resource management strategies at district level to improve workforce performance: analysis of workplan designs in three African countries
Abstract Background There is a worldwide shortage of health workers against WHO recommended staffing levels to achieve Universal Health Coverage. To improve the performance of the existing health workforce a set of integrated human resources (HR) strategies are needed to address the root causes of t...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | Human Resources for Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12960-023-00838-0 |
| _version_ | 1797769408649625600 |
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| author | Tim Martineau Wesam Mansour Marjolein Dieleman Patricia Akweongo Samuel Amon Kingsley Chikaphupha Paul Mubiri Joanna Raven |
| author_facet | Tim Martineau Wesam Mansour Marjolein Dieleman Patricia Akweongo Samuel Amon Kingsley Chikaphupha Paul Mubiri Joanna Raven |
| author_sort | Tim Martineau |
| collection | DOAJ |
| description | Abstract Background There is a worldwide shortage of health workers against WHO recommended staffing levels to achieve Universal Health Coverage. To improve the performance of the existing health workforce a set of integrated human resources (HR) strategies are needed to address the root causes of these shortages. The PERFORM2Scale project uses an action research approach to support district level management teams to develop appropriate workplans to address service delivery and workforce-related problems using a set of integrated human resources strategies. This paper provides evidence of the feasibility of supporting managers at district level to design appropriate integrated workplans to address these problems. Methods The study used content analysis of documents including problem trees and 43 workplans developed by 28 district health management teams (DHMT) across three countries between 2018 and 2021 to identify how appropriate basic planning principles and the use of integrated human resource and health systems strategies were used in the design of the workplans developed. Four categories of HR strategies were used for the analysis (availability, direction, competencies, rewards and sanctions) and the relationship between HR and wider health systems strategies was also examined. Results About half (49%) of the DHMTs selected service-delivery problems while others selected workforce performance (46%) or general management (5%) problems, yet all workplans addressed health workforce-related causes through integrated workplans. Most DHMTs used a combination of strategies for improving direction and competencies. The use of strategies to improve availability and the use of rewards and sanctions was more common amongst DHMTs in Ghana; this may be related to availability of decision-space in these areas. Other planning considerations such as link between problem and strategy, inclusion of gender and use of indicators were evident in the design of the workplans. Conclusions The study has demonstrated that, with appropriate support using an action research approach, DHMTs are able to design workplans which include integrated HR strategies. This process will help districts to address workforce and other service delivery problems as well as improving ‘health workforce literacy' of DHMT members which will benefit the country more broadly if and when any of the team members is promoted. |
| first_indexed | 2024-03-12T21:08:36Z |
| format | Article |
| id | doaj.art-015c178489fb475285150e46ed5377a2 |
| institution | Directory Open Access Journal |
| issn | 1478-4491 |
| language | English |
| last_indexed | 2024-03-12T21:08:36Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Human Resources for Health |
| spelling | doaj.art-015c178489fb475285150e46ed5377a22023-07-30T11:17:13ZengBMCHuman Resources for Health1478-44912023-07-012111910.1186/s12960-023-00838-0Using the integration of human resource management strategies at district level to improve workforce performance: analysis of workplan designs in three African countriesTim Martineau0Wesam Mansour1Marjolein Dieleman2Patricia Akweongo3Samuel Amon4Kingsley Chikaphupha5Paul Mubiri6Joanna Raven7Liverpool School of Tropical MedicineLiverpool School of Tropical MedicineKIT Royal Tropical InstituteDepartment of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, University of GhanaDepartment of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, University of GhanaResearch for Equity and Community Health (REACH) TrustMakerere University School of Public HealthLiverpool School of Tropical MedicineAbstract Background There is a worldwide shortage of health workers against WHO recommended staffing levels to achieve Universal Health Coverage. To improve the performance of the existing health workforce a set of integrated human resources (HR) strategies are needed to address the root causes of these shortages. The PERFORM2Scale project uses an action research approach to support district level management teams to develop appropriate workplans to address service delivery and workforce-related problems using a set of integrated human resources strategies. This paper provides evidence of the feasibility of supporting managers at district level to design appropriate integrated workplans to address these problems. Methods The study used content analysis of documents including problem trees and 43 workplans developed by 28 district health management teams (DHMT) across three countries between 2018 and 2021 to identify how appropriate basic planning principles and the use of integrated human resource and health systems strategies were used in the design of the workplans developed. Four categories of HR strategies were used for the analysis (availability, direction, competencies, rewards and sanctions) and the relationship between HR and wider health systems strategies was also examined. Results About half (49%) of the DHMTs selected service-delivery problems while others selected workforce performance (46%) or general management (5%) problems, yet all workplans addressed health workforce-related causes through integrated workplans. Most DHMTs used a combination of strategies for improving direction and competencies. The use of strategies to improve availability and the use of rewards and sanctions was more common amongst DHMTs in Ghana; this may be related to availability of decision-space in these areas. Other planning considerations such as link between problem and strategy, inclusion of gender and use of indicators were evident in the design of the workplans. Conclusions The study has demonstrated that, with appropriate support using an action research approach, DHMTs are able to design workplans which include integrated HR strategies. This process will help districts to address workforce and other service delivery problems as well as improving ‘health workforce literacy' of DHMT members which will benefit the country more broadly if and when any of the team members is promoted.https://doi.org/10.1186/s12960-023-00838-0Health workforceHuman resource managementDistrict planningWorkforce performance |
| spellingShingle | Tim Martineau Wesam Mansour Marjolein Dieleman Patricia Akweongo Samuel Amon Kingsley Chikaphupha Paul Mubiri Joanna Raven Using the integration of human resource management strategies at district level to improve workforce performance: analysis of workplan designs in three African countries Human Resources for Health Health workforce Human resource management District planning Workforce performance |
| title | Using the integration of human resource management strategies at district level to improve workforce performance: analysis of workplan designs in three African countries |
| title_full | Using the integration of human resource management strategies at district level to improve workforce performance: analysis of workplan designs in three African countries |
| title_fullStr | Using the integration of human resource management strategies at district level to improve workforce performance: analysis of workplan designs in three African countries |
| title_full_unstemmed | Using the integration of human resource management strategies at district level to improve workforce performance: analysis of workplan designs in three African countries |
| title_short | Using the integration of human resource management strategies at district level to improve workforce performance: analysis of workplan designs in three African countries |
| title_sort | using the integration of human resource management strategies at district level to improve workforce performance analysis of workplan designs in three african countries |
| topic | Health workforce Human resource management District planning Workforce performance |
| url | https://doi.org/10.1186/s12960-023-00838-0 |
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