Management of human resources for health in health districts in Uganda: A decision space

Mansour, Wesam, Aryaija‐Karemani, Adelaine, Martineau, Tim ORCID: https://orcid.org/0000-0003-4833-3149, Namakula, Justine, Mubiri, Paul, Ssengooba, Freddie and Raven, Joanna ORCID: https://orcid.org/0000-0002-4112-6959 (2021) 'Management of human resources for health in health districts in Uganda: A decision space'. The International Journal of Health Planning and Management, Vol 37, Issue 2, pp. 770-789.

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Abstract

Background: Decentralisation has been adopted by many governments to strengthen national systems, including the health system. Decision space is used to describe the decision‐making power devolved to local government. Human resource Management (HRM) is a challenging area that District Health Management Teams (DHMT) need some control over its functions to develop innovative ways of improving health services. The study aims to examine the use of DHMTs' reported decision space for HRM functions in Uganda. Methods: Mixed methods approach was used to examine the DHMTs' reported decision space for HRM functions in three districts in Uganda, which included self‐assessment questionnaires and focus group discussions (FGDs). Results: The decision space available for the DHMTs varied across districts, with Bunyangabu and Ntoroko DHMTs reporting having more control than Kabarole. All DHMTs reported full control over the functions of performance management, monitoring policy implementation, forecasting staffing needs, staff deployment, and identifying capacity needs. However, they reported narrow decision space for developing job descriptions, resources mobilisation, and organising training; and no control over modifying staffing norms, setting salaries and developing an HR information system (HRIS). Nevertheless, DHMTs tried to overcome their limitations by adjusting HR policies locally, better utilising available resources and adapting the HRIS to local needs. Conclusions: Decentralisation provides a critical opportunity to strengthen HRM in low‐and‐middle‐income countries. Examining decision space for HRM functions can help identify areas where district health managers can change or improve their actions. In Uganda, decentralisation helped the DHMTs be more responsive to the local workforce needs and analysing decision space helped identify areas for improvement in HRM. There are some limitations and more power over HRM functions and strong management competencies would help them become more resourceful.

Item Type:	Article
Subjects:	W General Medicine. Health Professions > Health Services. Patients and Patient Advocacy > W 84 Health services. Delivery of health care WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WA Public Health > Health Administration and Organization > WA 540 National and state health administration
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1002/hpm.3359
SWORD Depositor:	JISC Pubrouter
Depositing User:	Stacy Murtagh
Date Deposited:	04 Nov 2021 12:53
Last Modified:	06 Apr 2022 14:07
URI:	https://archive.lstmed.ac.uk/id/eprint/19265

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