Providing quality access to healthcare is one of the pertinent goals every nation’s government strives to achieve. Inherently, a healthy nation is a wealthy nation. However, health care institutions continue to be plagued by organizational challenges such as management and governance, which in large extent have impeded proper performance of health care systems. How can a nation ensure that health institutions are properly governed in both structure and functioning? Exploring these dynamics of governance and leadership in the healthcare industry, were: Prof. Gerry McGivern from Warwick Business School, who took the audience through The challenges facing Clinician/Manager Hybrids, Dr. Sassy Molyneux; KWTRP & Oxford University, tackling pertinent issues regarding Governance and Accountability in Health Care settings in Kenya, and Dr Pratap Kumar, IHM Strathmore who delved into Social Entrepreneurship and its role in meeting health care needs during the Governance and Leadership in Healthcare seminar at Strathmore Business School on 21st of July this year.
Dr. Pratap Kumar, founder of the social enterprise; Health-E-Net, caught a captivated audience as he took them through the cogwheels of working with telemedicine. His start-up, described by many as a revolution to telemedicine and social entrepreneurship, addresses limitations such as: making access to quality diagnosis easier, through a network of qualified specialists from all over the world without disclosing the patient’s bio-data such as name, race or residence.
He also took the audience through some of the indicators to look out for in order to maximize on social entrepreneurship as an interventions for health care systems, giving prominence to: Choosing interactive interventions widely agreed to be valuable, strong leadership and governance interventions, active engagement of a range of implementers and of the target community, tailoring the scale-up approach to the local situation and lastly incorporating research into various interventions.
Governance is one of the central building blocks in quality healthcare and health systems. Bringing this home, Dr. Sassy Molyneux addressed the underlining factors of Governance and accountability. “Putting in place strong governance ties in health care institutions and systems can boost the quality of health care and ethical practice,” she told.
Accountability on the other hand, should ensure answerability between the actors on delegated tasks, with the score card being, employing simple methods to evaluate results. She drew examples from community based accountability, where community groups voiced their concerns with an aim of keeping the institution accountable. The importance of such an intervention, she explained, is to give room for members of the public to voice their views regarding healthcare systems. From research, reports issued from community accountability interventions, have proved that community involvement in holding health care institutions accountable have yielded fruits in improving health care delivery services, up-grading accountability outcomes , collective action towards a particular problem yields a general feeling of communal participation towards the common good and lastly, people are more supportive of health services, if involved in decisions about how services are delivered. However, what can easily be proven is taken-up, other than what can be difficult to demonstrate progress. Documentation of numbers and procedural records may not necessarily be a show of transparency.
Dr. Gerry McGivern delved into challenges facing Clinician/Manager Hybrids. He described hybrid managers as people who are trained in medicine; but moved into managerial roles. Historically, “professional administrators” have had to conform to professional norms. Hybrid managers play a key role in implementing evidence based service improvement. For the longest time; doctors managed doctors, however as time went by and the profession evolved, professional autonomy and collegial self-regulation started. He took the audience through the various clusters of hybrid managers, with the impact of management style, being weighed against efficiency of governance. In his conclusion: Willing managers were good at challenging “poor” out dated and unrealistic system of governance, where as clinicians who took up managerial role on the basis of role claiming, were passively involved in meeting governance obligations effectively.