Importance of strategic management in the implementation of private medicine retailer programmes: case studies from three districts in Kenya

 

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dc.contributor.author Abuya, Timothy en_ZA
dc.contributor.author Amin, Abdinasir en_ZA
dc.contributor.author Molyneux, Sassy en_ZA
dc.contributor.author Akhwale, Willis en_ZA
dc.contributor.author Marsh, Vicki en_ZA
dc.contributor.author Gilson, Lucy en_ZA
dc.date.accessioned 2015-11-11T11:55:24Z
dc.date.available 2015-11-11T11:55:24Z
dc.date.issued 2010 en_ZA
dc.identifier.citation Abuya, T., Amin, A., Molyneux, S., Akhwale, W., Marsh, V., & Gilson, L. (2010). Importance of strategic management in the implementation of private medicine retailer programmes: case studies from three districts in Kenya. BMC health services research, 10(Suppl 1), S7. en_ZA
dc.identifier.uri http://hdl.handle.net/11427/14864
dc.identifier.uri http://dx.doi.org/10.1186/1472-6963-10-S1-S7
dc.description.abstract BACKGROUND: The home-management of malaria strategy seeks to improve prompt and effective anti-malarial drug use through the informal sector, with a potential channel being the Private Medicine Retailers (PMRs). Previous evaluations of PMR programmes focused on their impact on retailer knowledge and practices, with limited evidence about the influence of implementation processes on the impacts at scale. This paper examines how the implementation processes of three PMR programmes in Kenya, each scaled up within a district, contributed to the outcomes observed. These were a Ministry of Health programme in Kwale district; and two programmes supported by non-governmental organizations in collaboration with government in Kisii Central and Bungoma districts. METHODS: The research methods included 24 focus group discussions with clients and PMRs, 19 in-depth interviews with implementing actors, document review and a diary of events. The data were analysed using the combination of a broad policy analysis framework and more specific scaling up/diffusion of innovations frameworks. RESULTS: The Kisii programme, a case study of successful implementation, was underpinned by good relationships between district health managers and a "resource team", supported by a memorandum of understanding which enabled successful implementation. It had flexible budgetary and decision making processes which were responsive to local contexts, and took account of local socio-economic activities. In contrast, the Kwale programme, which had implementation challenges, was characterised by a complex funding process, with lengthy timelines, that was tied to the government financial management system which constrained implementation Although there was a flexible funding system in Bungoma, a perceived lack of transparency in fund management, inadequate management of inter-organisational relationships, and inability to adapt and respond to changing circumstances led to implementation difficulties. CONCLUSIONS: For effective scaling up of PMR programmes, the provision of technical support and adequate resources are vital, but not sufficient on their own. An active strategy to manage relationships between implementing actors through effective communication mechanisms is essential. Successful outcomes may be realised if a strong and transparent management system, including management of financial resources, is put in place. This study provides evidence of the value of assessing implementation processes as part of impact evaluation for public health programmes. en_ZA
dc.language.iso eng en_ZA
dc.publisher BioMed Central Ltd en_ZA
dc.rights This is an Open Access article distributed under the terms of the Creative Commons Attribution License en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/2.0 en_ZA
dc.source BMC Health Services Research en_ZA
dc.source.uri http://www.biomedcentral.com/bmchealthservres/ en_ZA
dc.subject.other District Health System en_ZA
dc.subject.other Innovation Implementation en_ZA
dc.subject.other Bungoma District en_ZA
dc.subject.other Policy Analysis Framework en_ZA
dc.subject.other User Organization en_ZA
dc.subject.other Medicine Retailer en_ZA
dc.subject.other Implementation Process en_ZA
dc.subject.other Financial Management System en_ZA
dc.subject.other Training Prog en_ZA
dc.title Importance of strategic management in the implementation of private medicine retailer programmes: case studies from three districts in Kenya en_ZA
dc.type Journal Article en_ZA
dc.rights.holder 2010 Abuya et al; licensee BioMed Central Ltd. en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Health Economics Unit en_ZA
uct.type.filetype Text
uct.type.filetype Image


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This is an Open Access article distributed under the terms of the Creative Commons Attribution License Except where otherwise noted, this item's license is described as This is an Open Access article distributed under the terms of the Creative Commons Attribution License