The seminar topic, “Decentralization and Health Office Core Functions” is important for every public health professional because you all have a role to play in your own offices’ success and the successes of others within the complex web that is the health sector in your country.
Day 4: Data use and planning for improving functional performance
- Applying the standards, prioritizing functions and tasks, and developing performance improvement action plans.
Welcome to Day 4 and the end of the seminar! We want to applaud you for being with us for all 4 days. Congratulations!
Yesterday we discussed how you prepare for and facilitate the first part of the process – developing a list of your office’s/team’s core functions and their related tasks along with the performance standards.
Today we will look at applying the standards, prioritizing functions and tasks, and developing performance improvement action plans.
The methodology for the second two steps is as follows:
- In plenary, review the functions and standards versus current performance by completing the Function and Task Performance Assessment which you can find under Resources for Day 4.
- Prioritize the functions that you and your office/team to determine which functions to address first using the form found under Resources for Day 4, which also includes the action plan and an example.
- Develop an action plan for performance improvements in these operating areas.
When you prepare to do the Function and Task Performance Assessment, you might imagine that the process of identifying unsatisfactory task and function performance would be relatively straightforward. In fact, most groups find that those tasks dedicated to the periodic formulation and preparation of important plans, budgets and reports are the least difficult to assess as they relate principally to timely completion, acceptance and decision-making by the destination offices.
However, many groups find other tasks and functions, such as those that are continuously performed and must adhere to standards of technical quality and timely action or response, are more difficult to assess. Functions and tasks in this category might include: notifications, investigation and control of disease outbreaks; inspection of water supplies, excreta disposal facilities, eating establishments and drug vendors, production; and conduct of health education materials and efforts, and issuing citations and arrests for illegal health-related behavior and conduct.
The effectiveness and outcomes of group processes and coordination efforts, such as the management and conduct of provincial or district health committees and councils, coordination of joint action with NGOs and communities, and negotiation and joint planning with donor projects are even more difficult to assess.
Further, when teams assess themselves there may be a tendency to gloss over important gaps in performance or deficiencies in expected results and/or play the “blame game.” Also, in working through this process, there may be a tendency to use current performance as the standard. If this happens, your office needs to assess how this standard will hurt or help you in achieving your core functions. How will you challenge yourselves to stretch and reach even higher standards?
In listing the tasks related to a few core functions and proposing standards for them, you may have become aware that there are many, many tasks your local health office must undertake leading to better performance. You will need to prioritize.
Most of you are probably familiar with action planning, but in this case it may require some creativity to develop new ways to attain the standards and achieving success. It is important to begin improving performance on highest priority functions first since your team will not be able to address all of the functions at the same.
To be successful in implementing the methodology and sustaining change in your office or on your team, you must have an enabling environment that focuses on what you can do as a team building on each person’s strengths and what they can do best to support your success. This means that you also need to examine your own commitment; what you will contribute as an individual? The only way that you will see the changes you desire is each of you to take responsibility and hold each other accountable. It’s a good time now to think about how you will do this.
As we close Day 4 of the seminar, we ask that you respond to the questions on the Forum and we will continue the interactive dialogue over the weekend as we have over the past three days. We will also send you a final seminar summary on Monday.
Finally, we request that you complete the evaluations as we would like your thoughts on this seminar and the content so we can improve it in the future.
Discussion Questions for Day 4
- Give examples of unsatisfactory task performance related to a few of the tasks and standards defined so far and which ones the office team and higher level offices might prioritize for performance improvement.
- What ideas do you have for performance improvement interventions that your team could implement to address these gaps?
- Do you feel this methodology can be useful in your office? How?
- Day 4 Final Summary
Greetings to all those who attended the seminar or reviewed the content and especially to the post-ers – Ngugi and Felipe – who were totally dedicated to the process and conversation as well as Eddah, who also posted interesting comments.
The four days of the seminar went by way too quickly. In fact, our sense is that we could have used a few more days to cover the material completely and allow more time for clarifications and exploration!
Before you go, please complete the seminar evaluation at https://www.surveymonkey.com/s/CEEME1-2015 and check out the additional, extensive resources posted on the site.
We have just a few more comments, elaborations, and food for thought before we close:
- Functions –
- Public health governance and enforcement of regulations. There is growing interest in the nature of this function which includes the rational and timely formulation of new policy and regulations and then their implementation and enforcement. This growth in interest ties back to the title of the seminar which focuses on decentralization. For example, it is critical that sub-national offices be properly prepared to play their roles as their responsibilities expand from their own health offices to the monitoring and oversight of private organizations and individuals. Felipe, many thanks for bringing this up in the seminar.
- Monitoring and evaluation of health trends and service performance. Increasingly, highly cost-effective preventive, case-finding, and case management services will fall to the government to ensure that full coverage is achieved. Gaps in coverage frequently occur in geographic areas and population groups who need it most, but have least access. Full and accurate monitoring of these trends is an essential public health function that must be maintained and improved.
- Disease surveillance and outbreak identification and control. These are also important monitoring functions and tasks and must remain under close scrutiny by local health offices as the contributors and responders in this system vary across the country and frequently include government officials, and volunteers. Accurate application of standard case definitions and fulfillment of standard notification procedures must be a continuing subject of increasing concern.
- Coordination and collaboration was a strong theme throughout the seminar. This must occur across all public sectors in order to have the necessary impact on multi-sectoral services and opportunities for health promotion and protection, such as schools, markets, public works projects, communications, and law enforcement. You identified this in your comments and we’d like to leave you with the question “how will you define the health office function and tasks addressing cross-sectoral cooperation?”
- Core functions and tasks at all levels of the health sector was another theme throughout the course. We need to take account of the roles and responsibilities at other levels in the health sector, not just in the local public health offices. Sharing the process throughout the health sector would indeed expand the benefits.
In conclusion we just want to thank you for your participation and interest in the seminar. We also encourage you to get in touch with us using the CEEME seminar site to add more of your thoughts, or post them on the Meeting Space. We will still be here to answer any questions you may have.
It has been a great pleasure having you in the seminar.
Steve and Susan
- Functions –
- Seminar Evaluation