| dc.description.abstract |
This study, a cross-sectional census survey with a case control analysis, assesses various determinants of functionality of District Health Management Teams (DHMTs) in Addis Ababa. The questionnaire survey component was carried out among 16 DHMTs from December, 1992 to February, 1993. The objectives of the study were to describe the work of the various health teams and classify them as functional or nonfunctional. The findings revealed that eight of the DHMTs were performing 60% or more of the activities mentioned in their job description, this being the cut-off point for determining functionality. The criterion for functionality was then further strengthened, limiting functionality to those teams who performed 64% of their required activities, leaving seven in this category. comparing these with the five nonfunctional teams (~ 56% of their required activities) various associations between structural team characteristics and internal team interaction processes were found. DHMT functionality was positively associated with the academic qualifications of the team leader (OR=14.1 with 95% CI 14-259), with the presence of job descriptions for the team members (OR=4.0 with 95% CI 3.8-57.3), with the size of the team (OR=10 with 95% CI 9.98-128.82), and with the presence of research activities (OR=5 with 95% CI 4.1-106.4). Among the team ... eo ' N' .. i<m'r" .. ".·hn' ...... ·( ...... -:!U '" U(& .. a:r=t · '*~ ,- , "'M'b: 'S_' It ., ,. > $ , vi interaction process that were found to be important to functionality (at P<O.05) were the clarity of objectives, knowledge of each others roles, analysis of experience, good communications, a feeling of belonging, and respect for differences. These findings demonstrate the importance of structural and interaction processes for the appropriate development of health management teams and the further strengthening of the district health care system. |
|