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Supporting decentralised management to improve health workforce performance in Ghana, Uganda and Tanzania

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Innovative approach to improve health workforce performance in sub-Saharan Africa

The chronic shortage of effective health workers in Africa is a key obstacle to improving healthcare and saving lives. To improve performance in the region, an EU initiative worked to enhance health services

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The EU-funded PERFORM (Supporting decentralised management to improve health workforce performance in Ghana, Uganda and Tanzania) project addressed the workforce deficit in the region. Overall, the aim was to identify which areas within decentralised management structures in Ghana, Tanzania and Uganda can be improved using available resources. Project partners employed an action-based approach to support district health management teams (DHMTs) in three districts per country. DHMTs carried out a situation analysis of their respective health systems, paying particular attention to workforce performance and service delivery issues. They identified problem areas in need of improvement, and developed and planned suitable human resource and health systems strategies to improve workforce performance. With continued guidance and assistance, DHMTs learned to monitor the implementation of their strategies, and to assess the procedures and outcomes on workforce performance and health systems overall. The benefits of some strategies became evident before the project finished. In addition, DHMTs came to realise the importance of monitoring the effects of their strategies and took steps to modify them as needed. They also made better use of existing human resources and HS management processes. PERFORM contributed to the knowledge of how management at district level can be reinforced and how health workforce performance can be further developed in sub-Saharan Africa. Key health actors now have at their disposal a new set of skills and competencies which they can continue to hone towards developing and evaluating interventions for the enhancement of health systems.


Health workforce performance, Africa, health services, PERFORM, district health management teams

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