These are the assumptions and hypotheses of the designers of the intervention and other stakeholders. Human resource management is organizing, coordinating, and managing employees within an organization to carry out an organization's mission, vision, and goals. 4. This article addresses innovation as a strategic instrument in human resource management capacity building in the age of globalization. Strategic management of the health workforce in developing countries: what have we learned? The factors related to the age gap, to the team relationships between medical and non-medical members of the teams, and to the relative power positions of members of the management teams all influence the functionality of the teams, and the degree to which non-medical team members will take up responsibilities. Hum Resource Dev Int (2005) 8(2):185205. Health Serv Manage Res (1998) 11(1):2448. In this paper, we develop a theoretical framework in the form of a refined program theory to understand how such a capacity-building program could bring about organizational change. endobj An overview of the organization and management of health services in Karnataka state and the policy context within which the intervention operated is summarized in File S2 in Supplementary Material. Cavalli A, Bamba SI, Traore MN, Boelaert M, Coulibaly Y, Polman K, et al. *Correspondence: N. S. Prashanth, Institute of Public Health, 250, 2 C Main, 2 C Cross, Girinagar I Phase, Bangalore 560 085, India e-mail: prashanthns@iphindia.org, http://www.frontiersin.org/Journal/10.3389/fpubh.2014.00089/abstract, http://www.mendeley.com/download/public/160002/6034808704/2e50d9be7b137c8126f34dacb27149c4008af420/dl.pdf, www.itg.be/itgtool_v2/PersonalPages/PersonalPage.asp?Persnr=1665&L=E, https://docs.google.com/file/d/0Bxp4UKSObSs9ODI5ZjYwNzktN2U4ZS00MTgyLTk0ZTAtZWQ2YTQzMTEyNzQ4/edit?hl=en_US, https://docs.google.com/a/iphindia.org/file/d/0B-h6Rqii7VzEdTYyaWtkMjZMbWs/edit, http://www.nird.org.in/Brgf/doc/Rural%20HealthMission_Document.pdf, http://libdoc.who.int/publications/9241561378.pdf, http://workspace.unpan.org/sites/internet/Documents/primary%20evaluation%20of%20service%20delivery.pdf, http://www.nytimes.com/2009/02/01/business/01unbox.html, https://docs.google.com/file/d/0Bxp4UKSObSs9ODlhNjQwNjctMGNlNC00MjhlLWJmY2QtMGVmN2I3YmY2YWE2/edit?hl=en_US, Creative Commons Attribution License (CC BY). % doi: 10.5195/hcs.2012.71, 2. The Indian governments flagship health program, the NRHM, is being implemented since 2005. How does capacity building of health managers work? Swanson RC, Bongiovanni A, Bradley E, Murugan V, Sundewall J, Betigeri A, et al. Health system barriers to access and use of magnesium sulfate for women with severe pre-eclampsia and eclampsia in Pakistan: evidence for policy and practice. They could be thought of as providing explanations of change seen at individual, institutional, and systems levels; however, Rowe et al. Health Policy Plan (2012) 27(Suppl 4):iv13. (2013), " Flexibility-oriented HRM systems, absorptive capacity, and market responsiveness and firm . Describe Human Resource Management in . The current understanding of context and mechanism in realist evaluation is summarized below (18). These theories explain organizational improvement through change in health worker behavior and practices, which they place across several levels: the team, the institution, and the larger health system environment within which they work. Context actors or other factors that occur in the setting where the intervention/policy was implemented, that occur independent of the intervention/policy, and affect the implementation of the intervention/policy. It enables you to map out your company's developmental path by identifying the priorities, gaps, and needs to be addressed. Over the last decade, there has been an increasing trend of decentralization of planning and implementation of health care to the district level. A realist evaluation study protocol. Tanner M. Strengthening district health systems. endstream The contextual analysis and review of literature have also indicated important factors individual mechanisms, institutional, and systemic factors (local context) which could be mapped on a CMO framework. Swasthya Karnataka Training in Tumkur. To ensure the vision and mission effectively represent and unite the organization, its necessary to undertake a process of outlining priorities and documenting them to form a strategic plan. It draws upon the assumptions that the implementers have made in designing and implementing the intervention. Kernick D. The demise of linearity in managing health services: a call for post normal health care. The same holds for DPMs at district level. Council for Health and Human Service Ministries (CHHSM) Follow Capacity building is an intervention that strengthens an organization's ability to fulfill its mission by promoting sound management, strong governance, and persistent rededication to achieving results. Stock building HRM practices Flow facilitating HRM practices: . Health Policy Plan (2009) 24(4):23952. Amsterdam: Elsevier (2003). A well-formulated program theory enables an understanding of how interventions could bring about improvements and an evaluation of the intervention. We discuss the application of program theory development in conducting a realist evaluation. Examples of capacity building initiatives. Also, potential mechanisms of change need to be identified. The IPT is readily available see the publication of the study protocol (15) reproduced in Figure 2. Pawson R, Sanjeev S. Theory-driven evaluation of public health programmes. % doi:10.1093/heapol/czs084, 9. After that, you can lay out the sequence of the goals and decide in what order they should be pursued. Available from: http://workspace.unpan.org/sites/internet/Documents/primary%20evaluation%20of%20service%20delivery.pdf, 57. endobj doi:10.1258/1355819021927782, 26. The "Human Resource Management for NGOs" here aims to make small and medium-sized NGOs understand and assess organizational behavior and functioning; manage organizations through planning, implementing and monitoring activities strategically; improve the performance of their staff; build effective management systems, policies and plans and impro. This strengthens leadership and resilience capacity, because it helps unite everyone on the same page, working towards common goals. In these 21 articles, the synthesis reports that " the mechanisms through which training produced changes were researched in . Capacity-building through training programs: what do we know? Buchan J. Studies pertaining to local health system managers, mostly doctors in the case of Indian districts, are scarce. We developed the program theory in a step-wise fashion based on guidance in literature (16, 17, 26). They also identified the new system of decentralized planning at the district level as an opportunity for the district health team to implement organizational change through improved annual action plans and better supervision practices. (1) Understand the intervention (initial program theory, IPT): we started with eliciting the IPT of the intervention. 16. Based on the review of theories that explain behavioral change in health services by Rowe et al. Sub-units could include hospitals, disease-control programs, or talukas (sub-districts). Capacity Building Dec. 1, 2009 0 likes 22,815 views Download Now Download to read offline Business Education Capacity building is a set of activities and decisions that strengthens an organization's operations and enables it to better achieve its MISSION. x=kj>]I$K~9&+;43#Qc| 4a7Y44o~?pZ=~}yvy\?q__RJ*=_yJ*J;{Ci){Y>_qn{\jBke]>/.vqqc37f?_`B=~5a>=,' ;m We present the results of the five steps described above, followed by a discussion of the results using the multipolar performance framework. While existing theories provide plausible explanatory mechanisms through which inputs and outcomes could be related, the systemic factors unrelated to the intervention that could affect the outcome of the intervention (the context) are very important to understand how the intervention worked. The mentors were either the teachers from the contact classes or experienced public health professionals. However, their contribution to improving these processes is dependent on their relative position within existing health management teams, which remain led by doctors. A PT could be conceptualized as a logical and ordered description of the relationships between the various constitutive elements of an intervention, and the plausible pathways through which they interact with the elements of the system to produce the expected outcome. Jacobs RL, Park Y. Biesma RG, Brugha R, Harmer A, Walsh A, Spicer N, Walt G. The effects of global health initiatives on country health systems: a review of the evidence from HIV/AIDS control. Capacity building is an investment, and as with any investment it's important that it's targeted so it can deliver results. doi:10.1002/jid.965, 56. Bates R. A critical analysis of evaluation practice: the Kirkpatrick model and the principle of beneficence. They would visit the participants at their workplace, discuss topics raised in the contact classes, and offer to demonstrate or help implement the acquired knowledge and/or skills in the participants workplace. Accepted: 07 July 2014; Published online: 25 July 2014. Hum Resour Health (2004) 2(6):17. The United Nations defines capacity-building as a process whereby an organization strengthens its skills, instincts, abilities, techniques, and resources to thrive in a rapidly-changing civil society. Ltd., Australia). Human Resource Management (HRM) 3. Capacity building 10. They stress the importance of understanding what works for whom, and under what conditions (66, 67). These plausible explanatory CMO configurations need to be tested using program data to understand which of the many possible organizational change mechanisms is operating in the Indian district setting. The steps followed are described below and summarized in Table 1. It is generally accepted that human resources capacity building as a concept is closely related to education, training and human resource development. Available from: http://www.nird.org.in/Brgf/doc/Rural%20HealthMission_Document.pdf, 34. Reproduced from the study protocol (15). doi:10.1016/S0140-6736(05)67028-6, 35. -fO)RIA1T&AuN Lancet (2008) 371(9613):66874. Some of these programs have dual reporting lines: they report to the district health officer (DHO) as well as to dedicated disease-control program managers at the state level. Bangalore: Institute of Public Health (2012). 30. In Figure 3, we represented the refined program theory of the intervention. The relationship between decision-spaces available to health managers and their organizational commitment has been investigated. The program implementers specifically targeted these enlarged management teams. You may not have realized it, but you are probably already applying capacity-building programs and initiatives. Evidence-Based Public Health: Effectiveness and Efficiency. Review and evaluate. Keywords: capacity-building, realist evaluation, district health management, theory-driven research, health managers, health manpower, human resources for health, local health system, Citation: Prashanth NS, Marchal B, Kegels G and Criel B (2014) Evaluation of capacity-building program of district health managers in India: a contextualized theoretical framework. Bennett S, Agyepong IA, Sheikh K, Hanson K, Ssengooba F, Gilson L. Building the field of health policy and systems research: an agenda for action. Driving toward theory in program evaluation: more models to choose from. Evaluating healthcare interventions: answering the how question. Context matters: interpreting impact findings in child survival evaluations. Recent years have shown us the importance of sustainable development in the operations of businesses and nonprofit organizations. The local health system at the district level is an important organizational unit for management of health services. 20 0 obj Local health systems at taluka and district level can be conceptualized as complex adaptive systems, a network of inter-related and inter-dependent organizations, which are relatively similar, yet dynamically interacting with each other and their environment. Figure 5. For example, mentoring visits targeted teams and not individual participants. A great way to initiate capacity building in your business is to assess your systems, identify any inefficiencies, and fix them. However, our program theory shows that in the present Indian district context, improved organizational performance would also need better contextual alignment (perceived decision-spaces of health managers and BPMs) and operational alignment (decreasing the social distance between doctors as leaders of health management teams and their other members, improved teamwork among the members of the team including the young program managers). Programs introduce new resources into a dynamic system. Well look at the whole concept in more detail in this article. note that: little is known about how well the theories predict health worker practices or success of interventions. Furthermore, most studies included in their review concern healthcare workers. This includes recruiting, hiring, training, compensating, retaining, and motivating employees. (3) Identify contextual factors: we reviewed government reports and program documents related to performance of district health services (full list of documents in File S3 in Supplementary Material). The implication of the team assumption on the performance of taluka and district participants therefore needs to be critically examined. Training Needs Assessment for District Health Managers. 4, pp. Figure 7. . World Health Organization. Thank you! 5QD3==F1}Q\6JcAFI}QJ'$>YO51(d5T}QA0*3YF%}QYcTUyF5}Q]_`D"#/6jKF}QW_f;Fxh2F}j*D-}7Fho6Z[7vh4ZSg}FmFH7F~4:a#bt5ent7zGF~L?n4z'I~Z?c?4g9c1bM. Program theory of the intervention after incorporating the assumptions of the implementers. In India and many other low- and middle-income countries (LMICs), doctors are usually in charge of the management of local health systems. Rowe A, Desavigny D, Lanata C, Victora C. How can we achieve and maintain high-quality performance of health workers in low-resource settings? It helps us by indicating where to look for contextual factors that could affect individual learning and its application within the participants organization. This guide is here to help take the sting out of the process. Am Psychol (1982) 37:12247. Am J Eval (2010) 31(3):36381. This framework is an adaptation of a conceptual framework designed for analyzing the performance of healthcare organizations proposed by Sicotte et al. The tool is aimed at Customs Administrations' Top Management, Modernization Units/Teams and HRM Senior Managers. ICscpQ&#WmNl)SY#R4UzGHtL%y Vm?~1j??Z#|y#G(0mJw#]E.8_|(JEQVT|QED5;l#|S As we have seen, this starts with a capacity assessment: taking stock of the current situation, and identifying priority areas for improvement. When you visit websites, they may store or retrieve data in your browser. The intervention involved training of health managers on public health management topics through a mix of classroom teaching and mentoring at their workplace. When everyone within the organization has access to lifelong learning, your organization becomes more resilient with a greater capacity for innovation and growth. The available and perceived decision-spaces of health managers are another factor. We had hypothesized that, in addition to organizational and environmental factors, such a positive organizational change could be linked to individual attributes of the participant, like the organizational commitment of the individual and the confidence that the individual places in his ability to produce such a change (15). PLoS One (2013) 8(3):e59158. doi:10.1258/hsmr.2007.007015, 43. The program documents and interview transcripts were imported into NVivo 10 (QSR International Pvt. Wherever health managers perceive this to be an opportunity, capacity-building programs may find fertile grounds and they can contribute to change planning practices. 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