Thatte Nandita, Choi Yoonjoung
Office of Population and Reproductive Health, Bureau for Global Health, US Agency for International Development, 1300 Pennsylvania Avenue, NW, Room 3.6.146, Washington, DC 20004, USA
Office of Population and Reproductive Health, Bureau for Global Health, US Agency for International Development, 1300 Pennsylvania Avenue, NW, Room 3.6.146, Washington, DC 20004, USA.
Health Policy Plan. 2015 Apr;30(3):356-67. doi: 10.1093/heapol/czu019. Epub 2014 Apr 15.
Human resource (HR) management is a priority for health systems strengthening in developing countries, yet few studies have empirically examined associations with service quality. The purpose of this study was to assess the relationship between HR management and family planning (FP) service quality.
Data came from the 2010 Kenya Service Provision Assessment, a nationally representative health facility assessment. In total, 912 FP consultations from 301 facilities were analysed. Four indices were created to measure quality on reproductive history taking, physical examination, sexually transmitted infections prevention and pill/injectable specific counselling. HR management variables included training in the past year, any and supportive (i.e. with feedback, technical updates and discussion) in-person supervision in the past 6 months and having a written job description. Multivariate linear regression analyses were conducted to estimate coefficients of HR management variables on each of the four quality indices, adjusting for background characteristics of clients, provider and facilities.
The level of service quality ranged from 16 to 53 out of a maximum score of 100 across the indices. Fifty-two per cent of consultations were done by providers who received supportive in-person supervision in the previous 6 months. In 23% and 38% of consultations, the provider was trained in the past year and had a written job description, respectively. Multivariate analyses indicated that having a written job description was associated with higher service quality in history taking, physical examination and the pill/injectable specific counselling. Other HR management variables were not significantly associated with service quality.
Having a written job description was significantly associated with higher service quality and may be a useful tool for strengthening management practices. The details of such job descriptions and the quality of other management indicators should be explored to better understand the relationship between HR management and FP service quality.
人力资源管理是发展中国家卫生系统加强建设的优先事项，但很少有研究实证检验其与服务质量的关联。本研究的目的是评估人力资源管理与计划生育服务质量之间的关系。
数据来自2010年肯尼亚服务提供评估，这是一项具有全国代表性的卫生设施评估。总共分析了来自301个设施的912次计划生育咨询。创建了四个指标来衡量生殖史采集、体格检查、性传播感染预防以及避孕药/注射剂特定咨询方面的质量。人力资源管理变量包括过去一年的培训、过去6个月内的任何形式和支持性（即有反馈、技术更新和讨论）的现场监督以及有书面工作描述。进行多变量线性回归分析以估计人力资源管理变量在四个质量指标上的系数，并对客户、提供者和设施的背景特征进行调整。
各指标的服务质量水平在满分100分中从16分到53分不等。52%的咨询是由在过去6个月内接受支持性现场监督的提供者进行的。在23%和38%的咨询中，提供者分别在过去一年接受过培训并有书面工作描述。多变量分析表明，有书面工作描述与在病史采集、体格检查以及避孕药/注射剂特定咨询方面更高的服务质量相关。其他人力资源管理变量与服务质量无显著关联。
有书面工作描述与更高的服务质量显著相关，可能是加强管理实践的有用工具。应探索此类工作描述的细节以及其他管理指标的质量，以更好地理解人力资源管理与计划生育服务质量之间的关系。
