Contribution of performance management processes to health facility performance outputs in Namayingo district

Abstract

Performance management system was introduced by the Ministry of public of Uganda in 2007. It was rolled out in the health sector by the Uganda Capacity Programme (UCP) with the goal of improving performance through enhancement of management of an individual’s performance. Whereas some health facilities have better health facility performance outputs, others experience poor health facility performance outputs. The purpose of this study was to establish the contributions of performance management processes to health facility performance outputs. The study was cross sectional, employing both qualitative and quantitative approaches. In qualitative design, facility managers of H/C III and H/C IV were interviewed and the responses recorded with audio recorder as well as documentation on paper. Quantitative approach involved use of researcher developed self-administered questionnaire given to health workers at the selected health centre IV, III and IIs. Data were analyzed with descriptive and analytical statistical tests. Health centre IV and IIIs conduct performance planning, planning reviewing, performance feedback, performance appraisal and performance rewarding (performance management processes) though poorly. Health facilities implementing performance management processes were performing better than those without. Most health facilities had high standard unit of output and the staff productivity at health centre IIs was higher than at health centre IIIs. A Correlation of performance appraisal with standard unit of out showed no significant relationship. The study findings revealed that other factors influencing health facility performance apart from performance management were; leadership and management, medical supplies, understaffing. Performance management processes are implemented poorly at selected health facilities. The facilities showed a performance disparity as reflected by the standard unit of output. There was knowledge gap among the facility managers in the context of performance management that needs attention if the performance of the facilities is to be revamped. Staffing and improvement in working conditions should be given attention. Recommendations: Facility managers should be supported by District Health Officer (DHO) for training in performance management/ improvement, strengthen use of Health Management Information Systems (HMIS) data at health facilities; improve on staffing and working conditions.