Many countries in Sub-Saharan Africa have undergone a process of decentralising health system planning and management, shifting authority to varying degrees from central government to local districts. There are gaps in research on health worker performance at the district level. To strengthen the evidence base, PERFORM – a research consortium of three European and three African universities – has applied action research using a holistic “systems approach” to explore how improving management skills can enhance workforce performance at district level. The project aimed to boost the capacity of health managers in three districts in Ghana, Tanzania and Uganda to identify health workforce related problems themselves, understand the systemic factors affecting performance (including uneven distribution of health workers, inappropriate allocation of tasks and lack of training, management and support) and apply and monitor strategies.

By Kate Hawkins and Sarah Hyde

Read the brief.