Improving Health Staff Performance Using Standardized Performance Management Systems in Bunyangabu District Health Facilities in Western Uganda

Abstract

Introduction: The performance management concept is not new but has undergone a relatively slow development in the Ugandan health sector and lacks documented proof of practice. Performance management is a continuous process of identifying, measuring and developing the performance of individuals and aligning performance with the strategic goals of the organization.Aim of the study: The study aimed to improve the performance of health workers through established performance management practices in health facilities of Bunyangabu district in order to inform and benchmark interventions.Methodology: A before and after study design was employed to conduct this study. Both qualitative and quantitative research methods were used to collect data from selected health facilities in Bunyangabu district, interventions which included, training, support supervision and mentor-ship were used. Pre and post intervention data was collected and analyzed using excel, stata, and epi info computer software.Findings: The baseline analysis showed that up to 25% of the health managers were not aware of the recommended performance management practices,  45% able to set performance targets, 20% had job descriptions, 30%had conducted appraisals and only 15% knew about the rewards and sanctions.  85% could not state  the vision or mission of the organizations.The interventions applied during the study including training in performance management improved the level of awareness among participants from 75% to 95% in six months, knowledge on target setting from 15-80%, knowledge on Job description from 20-62%, knowledge in performance appraisal from 30-70%, and knowledge in rewards and sanctions from 15 – 70%. The raise in knowledge was associated with an  improvement in key health service delivery indicators; staff attendance 62-88%, eMTCT retention on ART 79-88%, PNC at 6weeks 26-53%, HTS linkage 89-97%, and ART coverage 92.5 – 99.7%.The study of associations indicated that the performance management was associated with health facility performance as follows performance planning (r=.757; P = 0.001), performance monitoring (r=.692) ; P=0.001), and functional rewards and sanctions committees  (r=.66843); P=0.000).Conclusion: The study concludes that there is a knowledge gap among health facility managers  about performance management.The study also concludes that inclusion of performance management in routine support supervision is associated with improved quality of health services and Continuous monitoring and  mentor-ships influence performance among health workers.

Keywords: health staff, individual performance management, standardized staff performance management systems, accredited facilities, performance planning, performance monitoring, performance appraisal, rewards and sanctions

DOI: 10.7176/PPAR/13-3-04

Publication date: April 30^th 2023