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Management practices in facilities providing HIV services to key populations in Kenya and Malawi: A descriptive analysis of management in community-based organizations

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Listed:
  • Andrea Salas-Ortiz
  • Marjorie Opuni
  • Alejandra Rodríguez-Atristain
  • José Luis Figeroa
  • Jorge Eduardo Sánchez-Morales
  • Agatha Kapatuka Bula
  • Barbara Nyambura
  • Sergio Bautista-Arredondo

Abstract

HIV services for key populations (KP) at higher risk of HIV infection are often delivered by community-based organizations. To achieve HIV epidemic control, countries need to scale up HIV services for KP. Little is known about the management practices of community-based organizations delivering health services. We explored the management practices and facility characteristics of community-based health facilities providing HIV services to key populations as part of the LINKAGES program in Kenya and Malawi. We collected information on management practices from 45 facilities called drop-in centers (DICs) during US Government FY 2019, adapting the World Management Survey to the HIV community-based health service delivery context. We constructed management domain scores for each facility. We then analyzed the statistical correlations between management domains (performance monitoring, people management, financial management, and community engagement) and facility characteristics (e.g., number of staff, organization maturity, service scale) using ordinary least square models. The lowest mean management domain scores were found for people management in Kenya (38.3) and financial management in Malawi (25.7). The highest mean scores in both countries were for performance monitoring (80.9 in Kenya and 82.2 in Malawi). Within each management domain, there was significant variation across DICs, with the widest ranges in scores (0 to 100) observed for financial management and community involvement. The DIC characteristics we considered explained only a small proportion of the variation in management domain scores across DICs. Community-based health facilities providing HIV services to KP can achieve high levels of management in a context where they receive adequate levels of above-facility support and oversight—even if they deliver complex services, rely heavily on temporary workers and community volunteers, and face significant financial constraints. The variation in scores suggests that some facilities may require more above-facility support and oversight than others.

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  • Andrea Salas-Ortiz & Marjorie Opuni & Alejandra Rodríguez-Atristain & José Luis Figeroa & Jorge Eduardo Sánchez-Morales & Agatha Kapatuka Bula & Barbara Nyambura & Sergio Bautista-Arredondo, 2024. "Management practices in facilities providing HIV services to key populations in Kenya and Malawi: A descriptive analysis of management in community-based organizations," PLOS Global Public Health, Public Library of Science, vol. 4(3), pages 1-15, March.
  • Handle: RePEc:plo:pgph00:0002813
    DOI: 10.1371/journal.pgph.0002813
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    References listed on IDEAS

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    3. Nicholas Bloom & Carol Propper & Stephan Seiler & John Van Reenen, 2015. "The Impact of Competition on Management Quality: Evidence from Public Hospitals," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 82(2), pages 457-489.
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    5. Nicholas Bloom & Renata Lemos & Raffaella Sadun & Daniela Scur & John Van Reenen, 2014. "The New Empirical Economics of Management," NBER Working Papers 20102, National Bureau of Economic Research, Inc.
    6. Nicholas Bloom & Renata Lemos & Raffaella Sadun & Daniela Scur & John Van Reenen, 2016. "International Data on Measuring Management Practices," American Economic Review, American Economic Association, vol. 106(5), pages 152-156, May.
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