A hospital-management training programme in South Africa

Abstract

Background. The South African (SA) National Department of Health (NDoH) has identified the training of managers of public hospitals as key to improving efficiency in health-service delivery. As a part of that process, the NDoH, together with the universities of KwaZulu-Natal (UKZN) and the Witwatersrand (Wits) and the government of France, has launched a Master’s programme to train hospital managers. Its development began in 2003, and was initially based on the French hospital-management training programme. The aim was to make it a prerequisite for appointment as a senior hospital manager in the near future, although this was not achieved. The programme also aims to realise the NDoH’s policies of revitalisation and decentralisation of hospital management, by empowering managers and equipping them to effectively address the challenges of providing equitable and efficient health-service delivery. The aims of the Master’s course in hospital management are five-fold: (i) to develop uniform standards for the training of hospital managers; (ii) to develop leadership and managerial capacity among prospective and current hospital managers; (iii) to apply these competencies to critical research, intervention, evaluation and policy-development efforts in hospital management; (iv) to train adequate numbers of hospital managers for SA; and (v) to develop hospital management as a recognised profession among health and other professionals in SA. The programme was launched in 2006, and 150 students (chief executive officers (CEOs) of public hospitals) were enrolled during the 4-year duration of the programme. They were selected by the Training Unit for Hospital Managers of South Africa (the collaboration unit created by the abovementioned partners) based on selection criteria that it developed. An evaluation was carried out to assess the programme.

Objectives. To do a baseline audit of the current skills and competency levels of students enrolled in the Master of Public Health (MPH) in hospital management programme, and to assess the functioning of the hospitals they have been managing.

Methods. A cross-sectional study design was used. The study participants were the specific cohort of students (n=47) from public hospitals in SA who were enrolled in 2006 and 2007 at Wits in the MPH in hospital management programme. A structured questionnaire was distributed to the participants, and 41 out of the 47 students (30 first-year and 11 second-year students) completed it.

Results. The majority of the participants in the programme had been working in the public-health sector for a long time, and had acquired substantial practical experience. All of them had professional qualifications, as well as some management training or qualifications. Most of them had attended numerous management-related short courses. They suggested that the programme should be offered in such a way as to reinforce and consolidate their existing knowledge. They proposed that the NDoH should explore the possibility of recognition of prior learning. The participants supported the idea of continuing the current structure of the programme, and recommended the incorporation of soft skills such as the development of leadership, emotional intelligence and conflict-management skills. The participants preferred classroom teaching, case studies and experiential learning, and least supported the distance-based teaching methodology.

Conclusion. The findings from this study assisted the two universities and the NDoH to refine the programme currently offered, and confirmed that its strategy to professionalise hospital-management training was on the right track.