Table of Contents
Chapters
- Understanding the Concept
- Evidence-Based Practices
- Adaptability
- Links with Other Services
- Minimizing Paperwork
- Physical Factors
- Service Hours and Scheduling
- Client Flow
- Division of Labor and Job Design
- Social Factors
- Implementing the Concept
- Bibliography
This issue was prepared in collaboration with the Maximizing Access and Quality (MAQ) Initiative of the United States Agency for International Development's Office of Population and Reproductive Health. The MAQ Initiative supports research and evidence-based interventions to promote access and quality of reproductive health and family planning services.
Published by the INFO Project, Center for Communication Programs, The Johns Hopkins University Bloomberg School of Public Health, 111 Market Place, Suite 310, Baltimore, Maryland 21202, USA.
Volume XXXII, Number 1,
Winter 2004
Series Q, Number 2
Maximizing Access to Quality
| Personnel | |
9 |
Social Factors |
People are a health care organization’s most valuable resource. When providers are motivated and perceive that their work benefits clients, they can deliver better services (49). When managers enable their staff to obtain and maintain the skills and support that they need to be productive, they also help to meet clients’ needs (63).
Principles of Social Factors
Principles in Action Uganda: Improving SupervisionIn 2001 and 2002 the Uganda Family Life Education Program (FLEP) sought to improve supervision and performance appraisal at FLEP clinics in the Busoga region. These efforts were part of a larger project to improve human resources management. FLEP first encouraged supervisors and providers to communicate more often and reviewed and updated staff salaries. Next, FLEP updated its personnel policy and procedures manual and distributed it to management and supervisory staff in its 49 health facilities. Job descriptions and personnel files also were updated to provide staff with clear performance expectations. FLEP also addressed the supervision process. Clinic supervisors were given a day’s training on how to use a newly developed performance appraisal checklist, communicate better with employees, and provide feedback. Approximately eight months later, in an evaluation, the staff reported increased satisfaction with many supervisory practices. For instance, staff responses to the statements, “I get clear feedback from my supervisor about how well I am performing my job” and “My supervisor applies personnel policy and practice fairly to me” improved to an average score of four on a scale of one to five, compared with a score of just one beforehand (84). |
Provide leadership and motivation. Leadership is vital to performance. Leaders inspire people through their own positive behavior, ethics, and values and thus serve as role models. Their shared vision provides staff with purpose and direction in their work.
Managers who are leaders motivate staff and encourage them to take responsibility for solving problems and improving services. They improve morale and performance by giving encouraging feedback and helping staff to see how their jobs benefit clients and enable the organization to achieve its goals. They also organize people to work together collaboratively and effectively.
To perform well, staff members need to know how they are doing compared with expectations for their job. Managers can clarify what is expected by preparing and distributing guidelines and by writing job descriptions and discussing them with staff (11, 47, 62) (see box, at left). Feedback on job performance can come not only from supervisors’ evaluations but also from clients’ comments and from self- and peer-assessments (9, 71).
Develop staff potential. Program staff are more satisfied and perform better when they know that the organization is committed to their personal and professional development (84). The organization can encourage staff to improve their skills and their performance continually through training and job aids (57). Skills training can even empower staff to make decisions without the need for guidance from supervisors (13, 31). Managers also can provide rewards and recognition for good performance (62).
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At a Ugandan family planning facility, staff members discuss responsibilities. Leaders play a key role in encouraging and enabling staff to take responsibility for improving services. |
Enable positive human relationships. Health care providers need to be able to interact and communicate well with their clients, as well as with their supervisors and co-workers. When clients and providers communicate openly, share information, and ask and answer questions freely, clients are more satisfied and understand and recall information better (28, 56, 118). Staff members who are able to communicate openly with their supervisors and co-workers can do their jobs better (49, 71).
Promoting amicable and constructive staff relationships is vital to teamwork and other problem-solving approaches. In a health center in Brazil, for instance, the entire staff was encouraged to participate in an effort to improve infection prevention—not just the professional staff but also the support staff, including the janitor. In fact, it was the janitor who told managers that the water cistern serving the clinic had never been cleaned and thus posed a health threat (64).
