Dimensions influencing the performance of District Health Executives (DHES) in Mashonaland East Province

Abstract

The District Health Executives are performing their work below expectation. The objectives of the study were to: find out the role of supervision on the work performance of DHEs; establish the influence of management development on the work performance of DHEs; determine the role of teamwork on the work performance of DHEs; find out how conditions of service impact on the work performance of DHEs; establish the gaps in the literature and conceptualize a framework that explains the work performance of DHEs, all in Mashonaland East Province The qualitative methodology was used. Research participants (totalling fifteen) from three hospitals and from the Provincial Medical Director (PMD)’s office were selected, using a non - probability sampling method called purposive sampling, to participate in the interview. Participants were selected for their experience of five years and above, and for their willingness to share their opinions, feelings, knowledge and experiences openly and honestly. Semi–structured interview – pretested before collecting data – were used to collect primary data DHE members, PHE members and other key participants. Objectivity was guaranteed creating rapport with participants. Data was transcribed immediately after an interview. The main research findings were that supervision was done in an authoritarian and reactive way; most DHE members do not have management skills as their professional curricula do not cover management courses; DHEs lack the autonomy to make relevant and contextual decisions; some DHE members have lost the legitimacy to give their subordinates instructions due to untenable relations with their juniors; certain existing arrangements (like administration of disease control programmes, unstable DHEs, unfair treatment of DHE members) militated against teamwork; inadequate remuneration for DHE members, and; failure on the part of supervisors to acknowledge and value the differences in individual salary grades and length of experience, and failure to acknowledge excellent work: all these were identified as dimensions that influence the work performance of DHEs. DHE members need to undergo management development courses to acquire management knowledge and skills, to be able to supervise effectively, to be professional and earn integrity, 6 and to acquire team building skills; should be given appropriate autonomy to make local decisions and resources to perform well. Integrity and autonomy need further research.