Roles, responsibilities and matrix management
Interview with Dr Shin Young-soo, WHO's Regional Director for the Western Pacific
Dr Shin Young-soo took up the position of the World Health Organization's Regional Director for the Western Pacific on 1 February 2009. Dr Shin is the first Regional Director for the Western Pacific to be appointed from outside WHO.
Dr Anne Marie Worning, former Executive Director, Director-General’s office, has long experience of management and planning. Dr Worning has worked in senior positions in WHO’s Regional offices in the Easter Mediterranean Region and Europe and in Headquarters.
Dr Anne Marie Worning: Dr Shin, you were part of the initial task force that looked at the roles and responsibilities of the Organization. Can you please explain why you thought it was so important to look at what the different levels of the Organization should do?
Dr Shin Young-soo: It is very simple: every organization should have a terms of reference or a mission statement that outlines what each level of that organization should do. This should be the basis of resource planning and should drive estimation of budget split. We are now at a junction of WHO reform and there are a lot of issues to handle including reforming the budget and planning process.
We realized that we lacked a document that could guide us on defining what each level should do. We also found that there were different understandings and interpretations by managers and even senior leaders on their respective role and responsibilities.
We have never had a discussion clarifying the roles and responsibilities and that is why the task force got started. Why wasn’t this done before? I think, basically that if we look backwards into our 65-year old history, it is just recently that we have started being serious about the "one-WHO". We recently implemented GSM in all regions, asking for accountability and transparency of all levels of the Organization.
Traditionally, based on the decisions by the Member States at the World Health Assembly and the Executive Board we just proportionally distributed our assessed contributions. On top of that, we had the assessed contributions arriving, to specific technical areas, so we tried to make that work. Since we didn’t have a systematic approach the six Regional offices and Headquarters have grown spontaneously and more or less independently.
Dr Anne Marie Worning: Dr Shin you came from the outside and you talk a lot about systematic approaches and rigorous frameworks. Did it shock you to come to WHO and see that we have so little articulated division of labor?
Dr Shin Young-soo: Well, that is quite true, I was previously the Director-General of an outside organization and I worked with WHO in many different capacities over a long period of time. I thought I knew WHO very well, but when I became the Regional Director I felt overwhelmed. The Organization has such a complexity. Personally, I have substantial experience in managing organizations but this organization is the most complex. I think it may be one of the most complex Organizations that exists.
Dr Anne Marie Worning: A little along the same lines – you came from an environment where effectiveness and efficiency were in focus. I know that you feel strongly about matrix management. Can you please tell us why you think it is important that matrix management is introduced in WHO?
Dr Shin Young-soo: WHO has explicit responsibility in leading the work in global health that is then translated into activities at country level with the envisioned outcome of improving the health status of the population. We need all components of the Organization working towards this. Since we are a decentralized organization, we didn’t have proper accountability and a division of labor describing who is doing what, and where. For example, in Headquarters we have an excellent human resources pool with wonderful technical experts but how these contribute to the country level work is not explicitly described.
From my own experience of matrix management, we decide on the programmatic deliverables that cut horizontally across the three levels of the organization and then use the vertical structures as implementers. This would be a better mechanism for all three levels to work together. Ideally, the Headquarter Directors need to be responsible for their areas all the way down to the country office.
We need to clarify how these technical experts are implementing their agenda and I think this will be easier through matrix management. We will need several rounds of refinement and adjustments and also behavioral changes among staff to achieve this. Matrix management will allow for a better monitoring and assessment of the situation through this whole collective mechanism.
The programme Directors must be held accountable for the resources and the result at each level and in each country. This process should be conducted with full transparency. This is something that we don’t see now and this is far from current practice. A lot of work lies ahead. I think that all senior management are agreeing that it needs a careful process, consensus based, with step-by-step implementation. We also need to develop an explicit code of conduct for matrix management as well as monitoring and evaluation mechanisms.
Dr Anne Marie Worning: Dr Shin, you talk enthusiastically about matrix management. We have tried this in WHO in the past through different mechanism with mixed success. Do you think that we can achieve what you have eluded to?
Dr Shin Young-soo: My outset is neither a positive nor a negative one. I don't think "this will not work". I think it is clear that every component of the Organization needs to understand the implications and that it is not an easy undertaking. We are moving away from how we used to lead this organization for the past 65 years. So it is an enormous challenge – but not an impossible challenge.
Dr Anne Marie Worning: Last question: you have been the Regional Director promoting the category networks study that I had the pleasure to be involved in. What has been the most interesting finding in the study for you, now we have the preliminary results?
Dr Shin Young-soo: I think of all the components of the study the most interesting was to get the views of our technical staff members. We have the most intellectually excellent staff working for this Organization – recruited from all over the world. They have to have their own viewpoints and we were able to listen to these when doing the study. I was very pleased to see a diversity of opinions.
Also, I see that there is a need to go on and continue to develop our work further. There is a lack of communication along with a lack of clear division of responsibilities. We have done solid work with the fact finding and it creates a foundation to bring this work forward. The next step will be to develop an overall architecture for how to incorporate the concept of matrix management in our work.