More Information on Management
The actions and decisions of health managers influence many things, for example: where facilities are located, when they are open, how they are staffed, funded and equipped, the range of services provided including support services and outreach activities, use of treatment protocols and guidelines, use of quality systems, and referral mechanisms between different services and at different levels of the system. How to scale up from a pilot project to district or national coverage also entails a wide range of management issues and decisions.
In many developing countries, people who have the responsibility to manage service delivery often may not have any, or very much, management training. Training to be a doctor, a nurse or a pharmacist, usually does not include how to manage finances, or staff, or how to institute major changes. Increasing management capacity involves not only building individual management competency, but also, having enough managers in the right places, providing an enabling work environment, and ensuring that managers have suitable functioning management systems to help them to do their job. Thus, focusing primarily on sending managers away for management training will probably not have a significant impact on improving service delivery and health outcomes, if the other aspects of building management capacity are not also improved.