Management for health services delivery

List of management functions

Key management functions for health service delivery include the following:

  • Policy and Planning
    • Local policy development (adjusting national policies to be applicable to the district, and/or developing additional local policies)
    • Strategic (medium-term) planning & setting priorities for the district
    • Financial forecasting for the district
    • District operational (annual or shorter period) planning

  • Financial Planning and Management
    • Budget development - capital or investment, for the district
    • Budget development - recurrent or operational, for the district
    • Budget allocation to services and activities within the district
    • Publication of district annual health plan and budget for public information
    • Monitoring district health expenditure against budget
    • Adjustment between budget lines during the year
    • Setting fees for health services and drugs in the district (if applicable)
    • Organising community health insurance in the district
    • Collection of fees and/or insurance premiums in the district
    • Setting criteria for subsidies or exemption from fees in the district
    • Decisions on use of health income to the district
    • Audit of district health finances and functions

  • Human Resources Planning and Management
    • Deciding the number and mix of staff required for health facilities and services in the district
    • Long-term health workforce planning for the district
    • Hiring and firing staff in the district
    • Setting staff salaries and allowances for the district
    • Deployment of staff to clinical, outreach and public health services and activities within the district
    • Development of health staff job descriptions for the district
    • Performance assessment of health staff in the district
    • Training needs assessment for health staff in the district
    • In-service education for health staff in the district
    • Career planning for health staff in the district
    • Setting and awarding district health staff incentives - financial
    • Setting and awarding district health staff incentives - non-financial

  • Governance and Accountability
    • Establishment of health services governance or management structures in the district
    • Deciding on inclusion of community members in district health management structures
    • Interaction with the community - seeking information on and responding to community health needs
    • Ensuring the community has information on costs of health services, delivery options and available resources
    • Reporting local health priorities to national authorities
    • Intersectoral collaboration in the district
    • Negotiating donor support to health services in the district
    • Defining the role of the private sector in district health
    • Monitoring donor activity in health in the district
    • Enforcing health legislation, regulation and standards in the district
    • Assessment of constraints to district health performance

  • Planning and Management of Service Provision
    • Development of essential packages of health services for the district
    • Development of essential list of drugs for the district
    • Development of clinical & public health protocols for the district
    • Development of performance standards for the district
    • Establishment of mechanisms for referral and control of access to services in the district
    • Procurement of drugs for the district
    • Procurement of equipment for the district
    • Health facility development in the district
    • Health facility maintenance in the district
    • Equipment and vehicle maintenance in the district
    • Contracting health services in the district
    • Undertaking research on operational or clinical topics of concern to the district
    • Dissemination of relevant health research and best practices in the district

  • Managing performance through information
    • Maintaining coverage, integrity, timeliness and quality of routing information on health services provision
    • Monitoring of performance standards in the district
    • Monitoring patient throughput and statistics in the district
    • Monitoring health service utilization by poor and vulnerable groups in the district
    • Monitoring adverse patient events in the district
    • Monitoring patient satisfaction in the district
    • Monitoring population health indicators in the district
    • Monitoring referrals to and from services in the district
    • Monitoring drug use and availability in the district
    • Monitoring drug quality in the district
    • Surveillance for rapid response to disease outbreak
    • Aggregation of data from facilities and feedback to facilities
    • Assessment of effective coverage of services
    • Reporting on district health performance to national government
    • Reporting on district health performance to stakeholders
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