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What Do District Health Managers in Ghana Use Their Working Time for? A Case Study of Three Districts

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  • Marc Bonenberger
  • Moses Aikins
  • Patricia Akweongo
  • Xavier Bosch-Capblanch
  • Kaspar Wyss

Abstract

Background: Ineffective district health management potentially impacts on health system performance and service delivery. However, little is known about district health managing practices and time allocation in resource-constrained health systems. Therefore, a time use study was conducted in order to understand current time use practices of district health managers in Ghana. Methods: All 21 district health managers working in three districts of the Eastern Region were included in the study and followed for a period of three months. Daily retrospective interviews about their time use were conducted, covering 1182 person-days of observation. Total time use of the sample population was assessed as well as time use stratified by managerial position. Differences of time use over time were also evaluated. Results: District health managers used most of their working time for data management (16.6%), attending workshops (12.3%), financial management (8.7%), training of staff (7.1%), drug and supply management (5.0%), and travelling (9.6%). The study found significant variations of time use across the managerial cadres as well as high weekly variations of time use impulsed mainly by a national vertical program. Conclusions: District health managers in Ghana use substantial amounts of their working time in only few activities and vertical programs greatly influence their time use. Our findings suggest that efficiency gains are possible for district health managers. However, these are unlikely to be achieved without improvements within the general health system, as inefficiencies seem to be largely caused by external factors.

Suggested Citation

  • Marc Bonenberger & Moses Aikins & Patricia Akweongo & Xavier Bosch-Capblanch & Kaspar Wyss, 2015. "What Do District Health Managers in Ghana Use Their Working Time for? A Case Study of Three Districts," PLOS ONE, Public Library of Science, vol. 10(6), pages 1-15, June.
    • Handle: RePEc:plo:pone00:0130633
    DOI: 10.1371/journal.pone.0130633
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    References listed on IDEAS

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    1. Valeria Oliveira-Cruz & Christoph Kurowski & Anne Mills, 2003. "Delivery of priority health services: searching for synergies within the vertical versus horizontal debate," Journal of International Development, John Wiley & Sons, Ltd., vol. 15(1), pages 67-86.
    2. Smith, Duane L. & Bryant, John H., 1988. "Building the infrastructure for primary health care: An overview of vertical and integrated approaches," Social Science & Medicine, Elsevier, vol. 26(9), pages 909-917, January.
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    1. Anne Christine Stender Heerdegen & Moses Aikins & Samuel Amon & Samuel Agyei Agyemang & Kaspar Wyss, 2020. "Managerial capacity among district health managers and its association with district performance: A comparative descriptive study of six districts in the Eastern Region of Ghana," PLOS ONE, Public Library of Science, vol. 15(1), pages 1-18, January.

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