Leadership, Management and Governance (LMG) Practices in Ethiopian Public Hospitals: 2018–and 2019

Abstract

Abstract
Background: Optimal Leadership, Management and Governance (LMG) practices are essential to ensure effective, efficient, and high-quality health service that contributes to good health conditions of the population. The aim of this study was to determine the level of LMG practices and identify factors associated with it at public hospitals in the years 2018 and 2019. A total of 250 hospitals (Tertiary hospitals, General hospitals, and Primary hospitals) were included in the study.
Methods: The study used hospital self-assessment reports which were reported in Districts Health Information System II (DHIS2) using quantitative national tools developed by the Ministry of Health. The data was collected by officers that have experience of working in hospitals (that means, those who were familiar with DHIS2) and whom we trained in how to use the data collection tools. The data was cleaned and analyzed using SPSS software. Descriptive statistics was used to measure level of LMG practices and cross-tabulation to identify factors associated with LMG practices.
Results: - The national mean score of LMG practices by hospital standard was 67% in 2018 and 65% in 2019. Overall mean scores were 52.6% and 52.1 for Tertiary hospitals. 72.8% and 69.3% for General hospitals and 65.2%, 67.2% for Primary hospitals, in 2018 and 2019, respectively. Out of the 250 public hospitals, studied, 49% had a well-functioning Health Development Army (HDA) is teams within the department/unit of a hospital. Only 50% of the public hospitals had evaluated the LMG practices of their Chief Executive Officers (CEOs) against the minimum standards set in EHSTG.
Conclusion: the entire variable in the assessment tools was a minimum standard to be fully complied with in all the public hospitals. The results of this study revealed that the LMG practices were below the minimum standard. Well-functioning health development army was missing in many of the hospitals, and this suggests that there remains a lot to improve in health service s delivery in public hospitals. Not evaluating hospital performance against annual plan was found to be a cause of misunderstanding the challenges and not targeting them in future direction to meet requirement. [Ethiop. J. Health Dev. 2021; 35(2):97-104]
Keywords: Leadership, Management and Governance practices; public hospitals; health service quality, Ethiopia