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Table 4 Action points, observations and their status related to the ‘compete’ and ‘control’ functions of management from quarterly review meeting minutes

From: A participatory action research approach to strengthening health managers’ capacity at district level in Eastern Uganda

Management functions

Action points, observations and their status from quarterly review meetings and other project activities across the project implementation period

 

2013 (2 quarters)

2014 (2 quarters)

2015 (2 quarters)

Compete function:

client focus and managing execution of tasks to achieve results

The focus on improving the quality of maternal health services offered was initially observed to have been generally low; stakeholders, including managers, accepted the status quo and viewed the MANIFEST project as any other that will end without lasting effects

Improving confidence among stakeholders in the ability to cause change was observed; following up on commitments from stakeholders and being more responsible increased in 2014; however, a sense of dependency and need for more support in execution of tasks was still prevalent even through 2015; some stakeholders continued to lack a sense of clarity on their roles even in 2015

Building of staff houses, placenta pits, starting data centres and fencing off facility land, were noted as some of the achievements Discipline and monitoring of health worker availability was observed to have improved

Control function:

monitoring, planning, documentation and coordinating activities or projects

Reviewing of progress was observed to be missing; during the second review meetings in 2013, minutes from the previous meetings were generally not available and members had limited recall of any action points agreed upon; planning and coordination of activities was observed to have been heavily reliant on the MakSPH project team

A commitment to assign specific persons to take minutes was reaffirmed and followed through the year; members then started to review progress against their action points in every subsequent meeting. Teams to plan as well as focal persons for each of the project activity sets or components were formed; nonetheless it was observed that as prior planning of activities was often emphasised in meetings, this was implemented sporadically; MakSPH project team still played a central coordination role

Integration of project review meetings into mainstream meetings was started; review of maternal health issues was uplifted to council meetings at both sub-county and district levels

A quarterly District Health Management Team was the other avenue through which project activities were reviewed

Planning and coordination of activities was observed to have improved although still dependent on MakSPH project team to a large extent