Technical Director, BASICS and Principal Technical Advisor, Center for Health Services, Management Sciences for Health.
A tool for assessing management capacity at the decentralized level in a fragile state
Article first published online: 28 OCT 2011
Copyright © 2011 John Wiley & Sons, Ltd.
The International Journal of Health Planning and Management
Volume 27, Issue 4, pages 276–294, October/December 2012
How to Cite
Newbrander, W., Peercy, C., Shepherd-Banigan, M. and Vergeer, P. (2012), A tool for assessing management capacity at the decentralized level in a fragile state. Int. J. Health Plann. Mgmt., 27: 276–294. doi: 10.1002/hpm.1108
- Issue published online: 5 NOV 2012
- Article first published online: 28 OCT 2011
- health system strengthening;
- fragile states;
- management assessment;
- capacity building
Fragile states need assessment of decentralized management capabilities, not just of the central level, to design capacity-building efforts focused on improving management. Improving the management capacity of health departments at the provincial or district level is just as critical as strengthening the central ministry in fragile states if a health system that effectively addresses the real health needs of the population is to be formed. This paper describes a management capacity assessment tool developed for use in fragile states. It uses a framework that describes six critical management areas: oversight and coordination; human resources; resource management; health financing; community involvement; and health information management. These core areas of health system management are assessed with regard to capacity in three core management functions: the capacity to plan, to implement, and to monitor and evaluate. The tool was applied to assess the management capacity of six counties in Liberia. The results helped differentiate the level of capacity of the different counties and clarify the actions required to strengthen the health system in the periphery. The assessment also allowed the prioritizing of county health offices with regard to the level of capacity building required to improve management. The tool also identified successes that can inform the design of future health programs in other county health offices. The tool can be applied to other challenging country situations to assess management capacity, which will help focus technical assistance to the health sector in fragile states. Copyright © 2011 John Wiley & Sons, Ltd.