Institutional Capacity Assessment of the aids control Program Uganda

Download 191.49 Kb.

Page	4/9
Date	19.01.2017
Size	191.49 Kb.
	#8707

1 2 3 4 5 6 7 8 9

3.1 Staffing and Human resources management
3.2 Governance and leadership

Results

The results of the self-rated capacity of the STDs/HIV/AIDS Control Program in the 15 domains of the assessment are presented in this section. The consensus scores range from 20% for HIV/AIDS mainstreaming to 75% for Governance & Leadership and Record keeping, cash & banking respectively (figure II). Only 3 domains, Staffing and human resources, HIV/AIDS mainstreaming and financial planning & budgeting, fall below the 50% mark. While 4 domains scored 50% each, 8 domains scored above the 50% mark.

Figure II Summary of consensus Score (%) for domains

The mean (%) scores for the 3 categories namely, systems and infrastructure management, technical areas management and functions, roles and responsibilities, show that ACP is seen to be in the range of 50s in all 3 areas (Figure III). Systems & infrastructure is shown to be the lowest with a mean score of 50.8% while functions roles and responsibilities at 59.2%, has the highest mean score. The detail description of the scores, reasons for consensus ranking, indicators of strength and areas for improvement are presented below.

Fig III % Mean Score for 3 categories of assessment

3.1 Staffing and Human resources management

Human resources management is the function within an organization, department or unit which focuses on recruitment, management and providing direction for the people who work in the organization. ACP capacity in human resources was assessed through 16 questions which covered, adequacy and appropriateness of staffing, the recruitment process, use of job descriptions, personnel policies, performance management and training. ACP scores in relation to a model system is presented below.
Individual score range: 19% – 60%

Group consensus score: 38%

Table 4: Staffing and Human resources Management

Reasons for consensus ranking	Strength	Summary Indicators of needed improvement	Recommendation
There is reasonable number of staff and good gender representation in ACP No formal orientation or training plans * Non use of any formal policy documents for HR * Dissatisfaction amongst staff on different incentive structures which affects attitude to work	Good number of staff (over 100) and a good proportion of these are women. Good degree of technical competence in staff of key technical positions Clear system for hiring, new staffs exist.	Over 70 percent of ACP staff was reported to be ‘support staff’ and this raises the question of appropriateness of the staff mix Many, especially non-technical staff, do not have formal job descriptions Absence of any effective performance management system though promotion interview conducted routinely Absence of organized orientation, training and appraisals Uncoordinated incentives schemes for different categories of staff	Conduct an indepth review of HR needs of ACP, including unit’s structure, job analysis for different positions training needs etc Develop and implement a customized HR policy and plan which covers hiring, performance mgt, training, handling of grievances, benefits etc Develop a job description for each position Harmonize incentive schemes for different staff categories to reward performance Conduct a major re-orientation for staff of ACP to address performance and other issues

Participants believe that ACP has a relatively weak staffing and HR management system as compared to a model system. The consensus of 38% shows that ACP is showing some results in this area. Some of the points mentioned for this score include the fact that ACP has a good number of staff most of which are women. However, it was also noted that majority of the staff (at least 70%) are ‘support staff’ meaning that only about 30% of the current ACP staff are engaged in technical work related to its mandate. There is no consensus amongst staff on whether the number of technical staff is adequate to cover all that ACP is supposed to do. It was also noted that current human resources system and thinking in the ministry of health tends to focus on staffing units based on established government norms and this often hasn’t coped with HRH needs for HIV/AIDS. As a bridge, partners’ projects have tended to fund specific staffing positions to man the different projects implemented collaboratively with ACP. Though this has helped address shortages in the short run, it has also introduced additional human resource management challenges. These include issues of allegiance and control of ‘project staff’ who receive their salaries from partners and the different incentive schemes for different categories of staff in ACP. It is now important to link staffing support for projects to HR plans in ACP where this exists. As a first step, a review of the HR needs of ACP is recommended.

3.2 Governance and leadership

This assessment considered the governance and leadership from two perspectives. First is the organization and relative position of the ACP within the Ministry of Health which enables it to play its role, and second is the capacity of ACP to discharge its mandate as it relates to management and leadership of the health sector response. Participants responded individually and then discussed collectively the 18 questions which explored these issues. A summary of the scores and discussion is presented in the table below.
Individual score range: 52% – 93%

Group consensus score: 75%

Table 5: Governance and Leadership

Reasons for consensus ranking

Strengths

Summary Indicators of needed improvement

Recommendation

* ACP has a defined role.
* There is gender balance at the top management level.
* ACP has limited positional authority to directly engage with policy level stakeholders eg HPAC

* Role of ACP clearly defined in strategic plans, and national health policy documents
* Women are well represented at the top of ACP management.
* ACP knows and relates well with many stakeholders. Meetings are convened often.

* ACP organogram does not include all staff positions

* Knowledge of policy and HIV/ADS is poor especially amongst non technical staff

* There is still some misunderstanding on the roles of the ACP and UAC especially in partners coordination. ACP/UAC relationship not well understood.

* ACP has limited positional authority in MOH to influence policy changes eg in HPAC

* Internal accountability mechanisms are weak often fueling poor public image.

* ACP does not hold stakeholders accountable.

* Review ACP structure to reflect role in the response (see HR Mgt above)

* Organise ACP/UAC meetings to clarify TOR/roles and responsibilities

* ACP should set up Internal and external accountability mechanisms.

* A training plan should be implemented to address knowledge and skill gaps in all staff but especially among non-technical staff

* The level of authority of ACP management should be reviewed with a view to determining what is appropriate for ACP role in the response

Many participants believe that ACP is systematically achieving in terms of governance and leadership. Policies that document ACP’s mandate are cited so also are guidelines put forward by ACP to guide its work in coordinating the health sector response. Some of the other reasons mentioned for a consensus score of 75% are, irregular stakeholders meetings, poor internal and external accountability and inadequate understanding of the multi-sectoral response and ACP’s role in relation to the UAC. There was a general feeling that the position of the ACP within the ministry of health and the level of authority it has, may have limited its effectiveness in influencing policies and relating with some stakeholders. Financial control, external communications and active role at HPAC are cited as examples of areas where ACP may be currently limited in terms of authority. A responsibility-authority review for ACP should explore this matter indepth in order to determine an appropriate level of authority for ACP mandate. TOR clarification for UAC-ACP is recommended to address current misunderstanding or potential overlap in roles.

Download 191.49 Kb.

Share with your friends:

1 2 3 4 5 6 7 8 9