Set 1: Short and concise

The set of 20 short readings are listed under the photograph.
If you seriously plan to undertake to read all of Set 1 for a new hospital manager ... ...

• General skills: Core management functions
  A Barometer of District Hospital Management
  Kwik-Skwiz #27, 2000, Health System Trust
  (4 pages, pdf 478KB)
  This Kwik-Skwiz:
  • Is aimed at management teams of health districts and of district hospitals
  • Raises issues about managing District Hospitals in the context of the District Health System
  • Provides a framework, criteria and indicators to assess how well the District Hospital is managed
• Service Delivery: Collaboration and new tools
  Team Players: Building the skills of local health care planners
  TEHIP, International Development Resource centre, Canada, 2004
  (4 pages, pdf 95KB)
  • Capacity building in team-work, planning, managing and implementing is needed for improved service delivery - then a little money can go a long way!
  • Members of management teams need to work together to solve problems, delegate and share responsibilities.
  • Tools are needed to understand the burden of disease and allocate resources
• General skills: Organising Work
  Organizing Work Better
  Global Health Technical Briefs, 2004, Maximizing Access and Quality (MAQ) USAID
  (2 pages, pdf 166KB)
  Increasingly, organizations must do more with the same or reduced resources. Simple changes in the way work is organized can help to serve clients better, offer more satisfying work to staff, operate more effectively and become more efficient. This 2 page summary of a 20 page report lists 9 elements of work organization at 3 levels of service delivery, and gives an example of each.
  
  Setting Priorities: The Basic List
  CIGNA Behavioural Health
  (1 page, pdf 36KB)
  A sheet for entering what has to be done and highlighting priorities
• General skills: Team meetings
  Meetings and Minutes - Making them More Effective
  Kwik-Sqwiz #28, 2001, Health Systems Trust
  (4 pages, pdf 191KB)
  Well-run meetings promote full participation in decision-making, drewing on the group's accumulated experience and expertise.
  This Kwik-Skwiz provides tips to improve:
  Preparation of meetings, participation in meetings, chairing meetings, effective minute taking

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• HR: Staff motivation
  Creating a positive work climate in health care organizations
  Global Health Technical Briefs, 2006, USAID
  (2 pages, 65KB)
  A positive work climate leads to and sustains employee motivation, high performance, and better results in health care. Good leadership and management practices contribute to a positive work climate. Three key features: clarity, support, challenge.
• HR - Supervision
  Supporting Staff Through Effective Supervision: How to Assess, Plan and Implement More Effective Clinic Supervision
  Kwik-Skwiz #15, 1998, Health Systems Trust
  (4 pages, pdf 635KB)
  The best supervisor provides support with skill, understanding and patience and without taking charge.
  This Kwik-Skwiz covers:
  Role of the clinic supervisor; qualities of an effective supervisor, effective use of clinic visits, keeping records of training that staff have received.
• HR - Staff absenteeism
  How to Monitor and Address Absenteeism in District Hospitals
  Kwik-Skwiz #25, 2000, Health Systems Trust
  (4 pages, pdf 604KB)
  This Kwik-Skwiz aims to help hospital managers:
  • Assess whether or not they have a problem with absenteeism
  • Understand management and staff issues leading to absenteeism
  • With a 5-step framework for addressing absenteeism
• Resources: Financial management
  Can Managing District Services Be Separated From Managing its Finances?
  Kwick-Skwiz #21, 1999, Health System Trust
  (4 pages, pdf 626KB)
  This Kwik-Skwiz aims to support managers understand:
  • Service management and financial management cycles and links between them
  • Sequencing of steps to integrate the cycles
  • Roles of management committees and financial administration staff
• Resources: Mobilizing resources
  Mobilizing Local Resources to Support Health Programs – Global Technical Brief
  2007, Management Sciences for Health, USAID Washington DC
  (2 pages, pdf 67 KB)
  Local resources can directly contribute to program implementation by complementing, strengthening, and extending existing resources. Assessing local resources, practical tips: think beyond money; build local skills; be cost-effective; keep records; focus on your mission.

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• Service delivery: Referral system
  Referral System Guidelines
  Department of Health - South Africa, 2003
  (3 pages, pdf 40KB)
  Close relations between all levels of the health system; seamless continuum of services for optimal care; referral integral to PHC; clear communication; referral on and referral back; 5 to 10% of clinic patients will be referred; sample referral form
• Drugs: stock cards
  Using Stock Cards to Improve Drug Management
  Kwik Skwiz #13, 1998, Health Systems Trust
  (4 pages, pdf 518KB)
  This KwikSkwiz deals with:
  • Reasons for using stock cards, how they work, example of a stock card,
  • Calculating re-order amounts, levels of stock to hold
  • Implementing a stock card system, what can go wrong,
  • Self test: what do you know about drug usage in your facility?
• Drugs - Indicators on use of drugs
  Collecting and Using Drug Use Indicators in Districts
  Kwik-Skwiz #19, 1999, Health Systems Trust
  (2 pages, pdf 998KB)
  Drugs are used rationally when clients "receive medications appropriate to their clinical needs, in doses that meet their individual requirements, for an adequate period of time and at the lowest cost to them and their community".
  This KwikSkwiz deals with:
  • measurement of drug use patterns and prescribing behaviour
  • structures which can be used to promote rational drug use at district level
  • and how to use drug measurement information (indicator data).
• Quality: Standards
  Hospital Policy for Afghanistan’s Health System
  2004, Islamic Transitional Government of Afghanistan, Ministry of Health
  (6 pages, pdf )
  Includes a list of standards for hospitals covering:
  • Responsibilities to the community
  • Patient Care
  • Leadership and management
  • Human resources management
  • Management systems
  • Hospital environment
• Waste Management - facility issues
  Health Care Waste Management - at a glance
  WHO and The World Bank, 2003
  (4 pages, pdf 75KB)
  Categories of waste; handling and disposal; waste management cycle; health worker safety; who is responsible for waste management; do's and don'ts
• Waste Management - clinical issues
  Waste Disposal in Clinical Procedures in a Resource Limited Health Care Facility
  WHO/EHT/CPR 2005
  (2 pages, pdf 33KB)
  15 key points for dealing with different types of waste
• Drugs: WHO Drugs - Essential medicines list - Reference Document
  Essential Medicines: WHO Model List
  2007
  (36 pages, pdf 423KB)
  The core list presents minimum medicine needs for a basic health care system, specifying the most efficacious, safe and cost-effective medicines for priority conditions.
  The complementary list presents essential medicines for priority diseases, for which specialized diagnostic or monitoring facilities, and/or specialist medical care, and/or specialist training are needed.
  The list is presented in clinical groupings with type and dosage. At the end of the document is an alphabetical listing of all the drugs with page references for the details.
• Quick references on Financial Management
  This link takes you to another page with a set of 8 readings - each is between 3 to 8 pages

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Set 2: A bit more in-depth

The role of the hospital

• The role of the hospital in a changing environment
  Martin McKee & Judith Healy, 2000, WHO, Bulletin of the World Health Organization, 2000, 78 (6)
  Summarizes the evidence underlying three hospital reform strategies: (i) behavioural interventions such as quality assurance programmes; (ii) changing organizational culture; and (iii) the use of financial incentives.
  (8 pages, pdf 211kb)
• Management of District Hospitals - Exploring Success
  ID Couper, JFM Hugo, 2005, Remote and Rural Health 5:433
  Success factors include: teams working together for a purpose; open communication and sharing information; management structures and processes to support teamwork and service delivery; being answerable to the community
  (19 pages, pdf 441kb)

Professional skills and social values

• Managing Self and Personal Skills
  2004, Management Standards Centre
  Brief notes on: setting objectives, communicating, planning, time management, evaluating, reviewing, learning, obtaining feedback, self-assessment, outcomes of performance; behaviours which underpin effective performance
  (3 pages, pdf 20kb)
• Poverty and health sector inequalities
  Adam Wagstaff, Commission on Macroeconomics and Health, 2003, WHO
  Poverty and ill-health intertwined; the poor tend to have worse health outcomes than the better-off; causality running in both directions: poverty breeds ill-health, and ill-health keeps poor people poor. evidence on inequalities in health; consequences
  (8 pages, pdf 271kb)

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Supply management

• Ensuring Secure and Reliable Supply And Distribution Systems in Developing Countries in the Context of HIV/AIDS and PMTCT
  Pharmaceuticals and Micronutrients Team, 2004, UNICEF
  Checklists for: coordinating supply management; equipment and consumables; reliable, cost-effectve procurment; storage and distribution; appropriate patient care;
  (9 pages, pdf 60kb)
• Lessons Learned In Managing Laboratory Supplies
  pdf, 205kb
  John Snow Inc., DELIVER, 2006, USAID
  Assessing laboratory capacity; stakeholder commitment and coordinating body to strengthen laboratory capacity; standardized laboratory systems are needed because of the large number of commodities to be managed; service statistics data can be used for quantification and procurement; the logistics system provides the base for laboratory services.
  (8 pages, pdf 201kb)

Managing human resources

• Improving Supervision: A Team Approach
  J. Benavente; C. Madden, 1993, Management Sciences for Health
  Developing a supervisory system; strengthening supervision: support staff, attend the work environment, educate staff, discuss problems with staff and work with them to find solutions; understand the needs and demands of clients; clinical, staff and management areas to supervise; giving feedback
  (18 pages, pdf 270kb)
• Performance management tool
  1998, Management Sciences for Health
  Performance planning and review system; developing performance objectives; developing job descriptions
  (19 pages, pdf 69kb)

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Service delivery

• Surgical Care at the District Hospital Chapter 1
  pdf, 166kb
  2003, WHO
  Chapter 1: Organization and Management of the District Surgical Service:
  Leadership, team skills, ethics, education, record keeping, evaluation, disaster planning; apply the medical skills of evaluation and planning to your work as a manager; respect the knowledge and expertise of senior hospital staff; every institution has a history and the legacy of what has happened and why things have worked or not worked is held in the memory of the employees; the pride people feel in their workplace and the services they offer is a valuable commodity and is the greatest resource of any health care facility.
  (24 pages, pdf 163KB)
• Preventing Nosocomial Infections
  Chapter from Infection Prevention Guidelines for Healthcare Facilities with Limited Resources, 2003, Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs
  This paper covers: 􀁸 The most common types of nosocomial infections
  􀁸 What impact nosocomial infections have on healthcare
  􀁸 How nosocomial infections increase the cost of healthcare
  􀁸 Why preventing nosocomial infections is important
  (6 pages, pdf 55KB)
• Aide-Memoire Surgical and Emergency Obstetrical Care at First Referral Level
  2003, WHO
  Notes on: personnel; education; facilities; equipment and instruments; supply system; quality system;
  (2 pages, pdf 66kb)
• Aide-Memoire for Diagnostic Imaging Services
  WHO
  Develop and maintain services; guidelines and regulations; national and local levels
  (2 pages, pdf 48kb)
• Ten Recommendations To Improve Use of Medicines In Developing Countries
  Ro Laing, Hv Hogerzeil and D Ross-Degnan, 2001, Health Policy and Planning 16(1): 13–20
  Simple methods to monitor drug use in a standardized way and to identify inefficiencies: standard treatment guidelines; essential drugs lists; pharmacy and therapeutics committees; problem-based basic professional training and targeted in-service trainining; focus groups; pharmacists give advice to consumers; educate the public; improve prescribing; monitor drug indicators carefully
  (8 pages, pdf 55kb)
• Referral and Network Development
  WHO Regional Office for South East Asia
  Rationale for the development of a referral system and networks; continuum of care; levels of care; case study
  (6 pages, pdf 60kb)
• Information Systems: The Key to Evidence-based Health Practice
  Roberto J. Rodrigues, 2000, WHO, Bulletin of the World Health Organization, 2000, 78: 1344–1351
  Health services and programme management decision-making; development, validation and use of a variety of sources of evidence and knowledge; opportunities and challenges; reference databases, contextual data, clinical data repositories, administrative data repositories, decision support software, and Internet-based interactive health information and communication
  (8 pages, pdf 289kb)

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Staff and patient safety

• Aide-Memoire For National Blood Programmes: Clinical Use of Blood
  2004, WHO
  Pre-requisites; national guidelines; education and training; hospital transfusion committees; monitoring and evaluation
  (2 pages, pdf 141kb)
• Mercury in Health Care
  2005, WHO
  Mercury is highly toxic, especially when metabolized into methyl mercury. Health-care facilities are one of the main sources of mercury release into the atmosphere because of emissions from the incineration of medical waste.
  (2 pages, pdg 33kb)
• Guiding principles to ensure injection device security
  2003, WHO
  Reuse of injection devices without sterilization is of concern as it may transmit hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV), accounting for 30%, 41% and 5% of new infections in 2000, respectively. This brief comments on forecasting, financing, procurement and management of necessary supplies.
  (2 pages, pdf 878kb)

Monitoring and evaluation

• Preparing a Performance Monitoring Plan
  Performance Monitoring and Evaluation TIPS # 7, 1996, USAID
  What is performance management?; why do it; elements; data collection; reporting; communicating results
  (4 pages, pdf 26kb)
• Establishing Performance Targets
  Performance Monitoring and Evaluation TIPS # 8, 1996, USAID
  What are performance targets?; why use them; information neede; approaches to setting and using targets
  (5 pages, pdf 39kb)
• Monitoring and Evaluation - online study course
  Global Health eLearning Centre, USAID
  Access to the online course requires registration, but it is free and provides access to several courses. The M&E course takes 1.5 to 2 hours and a certificate is awarded after passing the final exam.
  The course covers: • purposes and scope of M&E • difference between monitoring functions and evaluation functions • planning for M&E • conceptual frameworks, results frameworks, and logic models • M&E indicators and data sources • using information for decision-making
  (website)

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Set 3: Basic financial management reading

An Overview and Field Guide for District Management Teams
B. Engelbrecht, H. Jooste, G.Muller, T. Chababa and D. Muirhead, 2002, Department of Health, South Africa

This set of 8 guides (each around 3 to 8 pages):

• Aims to make concepts of financial management clear and accessible in order to help District Health Managers in their task.
• Gives an overview of financial management concepts, processes and techniques that can be used in the financial management of a district.
• Aims to make clear the different steps in the financial management cycle, analyses the task of district management and takes the manager step by step through the financial management cycle

Click each dimension on the framework to find resources on financial management containing that information. The readings can also be accessed below the framework

• Understanding the Regulatory Framework
  pdf, 86kb
  This section provides a brief overview of the Public Finance Management Act, the Treasury Regulations and the key role-players in the Financial Management arena.
• District Health Management
  pdf, 81kb
  This section describes the responsibilities of district management teams and outlines the district health management cycle. Special emphasis is placed on the District Health Plan as the starting point of the cycle. This section is the basis for further sections on financial management.
• Financial Management
  pdf, 33kb
  This section explains financial management, and forms the basis for the other sections that follow.
• Financial Planning
  pdf, 49kb
  This section covers the first process in the financial management cycle. It explains how to draw up a budget and to set targets to measure achievement.
• Allocating the Budget
  pdf, 39kb
  This section explains ways to allocate the received amount of money. Because the amount allocated is usually less than what was estimated, it is important to distribute resources according to set priorities.
• In-year Management: Operating, Monitoring and Safeguarding
  pdf, 36kb
  This section reflects the activities that happen throughout the financial year of operation. It emphasises the importance of internal controls and covers the management of revenue, expenditure, assets and losses.
• Evaluation and Reporting: Accounting for Performance
  pdf, 67kb
  This section describes possible ap p ro a ches to account for perfo rmance accord i n g to the key requirements of the Regulatory Framework.

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