Chelagat Tecla, Rice James, Onyango Joseph, Kokwaro Gilbert
Strathmore University Business School, Institute of Healthcare Management, Nairobi, Kenya.
Front Public Health. 2021 Feb 26;8:550796. doi: 10.3389/fpubh.2020.550796. eCollection 2020.
The provision of health care services in Kenya was devolved from the national government to the counties in 2013. Evidence suggests that health system performance in Kenya remains poor. The main issue is poor leadership resulting in poor health system performance. However, most training in Kenya focuses on "leaders" (individual) development as opposed to "leadership" training (development of groups from an organization). The purpose of that study was to explore the impact of leadership training on health system performance in selected counties in Kenya. A quasi-experimental time-series design was employed. Pretest, posttest control-group design was utilized to find out whether the leadership development program positively contributed to the improvement of health system performance indicators compared with the non-trained managers. Questionnaires were administered to 31 trained health managers from the public, private for-profit, and private not-for-profit health institutions within the same counties. The pretest and posttest means for all the six health system (HS) pillar indicators of the treatment group were higher than those of the control group. The regression method to estimate the DID structural model used to calculate the "fact" and "counterfactual" revealed that training had a positive impact on the intended outcome on the service delivery, information, leadership and governance, human resources, finance, and medical products with impact value ≥1 (57.2). The study findings support both hypotheses that trained health care management teams had a significant difference in the implementation status of priority projects and, hence, had a significant impact on health system performance indicators compared with non-trained managers.
2013年，肯尼亚的医疗保健服务提供职责从国家政府下放到了各县。有证据表明，肯尼亚的卫生系统绩效仍然很差。主要问题是领导力薄弱导致卫生系统绩效不佳。然而，肯尼亚的大多数培训都侧重于“领导者”（个人）的发展，而不是“领导力”培训（组织中团队的发展）。该研究的目的是探讨领导力培训对肯尼亚部分县卫生系统绩效的影响。采用了准实验时间序列设计。利用前测、后测对照组设计来确定与未接受培训的管理人员相比，领导力发展计划是否对卫生系统绩效指标的改善有积极贡献。对同一县内公立、私立营利性和私立非营利性卫生机构的31名接受培训的卫生管理人员进行了问卷调查。治疗组所有六个卫生系统（HS）支柱指标的前测和后测均值均高于对照组。用于计算“事实”和“反事实”的估计双重差分（DID）结构模型的回归方法显示，培训对服务提供、信息、领导力与治理、人力资源、财务和医疗产品等预期结果有积极影响，影响值≥1（57.2）。研究结果支持了两个假设，即与未接受培训的管理人员相比，接受培训的医疗保健管理团队在优先项目的实施状况方面存在显著差异，因此对卫生系统绩效指标有显著影响。
