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Open Access Research article

District health executives in Midlands province, Zimbabwe: are they performing as expected?

Mary Muchekeza1*, Anderson Chimusoro2, Notion T Gombe1, Mufuta Tshimanga1 and Gerald Shambira1

Author affiliations

1 Field Epidemiology Training Program, University of Zimbabwe, P O Box A178, Avondale, Harare, Zimbabwe

2 Provincial Medical Directorate, Midlands Province, Ministry of Health and Child Welfare, Harare, Zimbabwe

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Citation and License

BMC Health Services Research 2012, 12:335  doi:10.1186/1472-6963-12-335

Published: 22 September 2012

Abstract

Background

The cornerstone of the health system in Zimbabwe, the district health system has been under the responsibility of the district health executive since 1984. Preliminary information obtained from some provincial health managers in Midlands Province suggested a poor performance by most district health executives. We therefore investigated the reasons for this poor performance.

Methods

A descriptive cross sectional study was conducted. Structured interviewer administered questionnaires were used to obtain information from district health managers of five randomly selected districts in the province. Checklists were used to assess resource availability, staffing levels and proxy indicators to effective district health executive function. Data were analysed using Epi Info statistical package.

Results

Thirty district health managers were interviewed. Almost half of the participants could not list at least five functions of district health executives. Twenty nine managers reported having inadequate management skills requiring training. District health executives failed to meet their targets on expected activities in the year 2010 such as conducting monthly district health executive meetings, conducting quarterly supervision to health centres and submitting quarterly district health reports to the provincial level.

Conclusion

Poor knowledge on expected functions could have resulted in poor performance. Without adequate management training district health managers are likely to underperform their duties. DHE guidelines were therefore distributed to all districts. Management trainings were conducted to all district health executives throughout the country from November 2011.

Keywords:
District health executives; Performance; Midlands Province