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  Public health workers’ experiences and perceptions of supervision in medicines management
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 Ophav:
Hessilt, Mette1, Forfatter
Westergaard, Stine1, Forfatter
Holme Hansen, Ebba2, Vejleder
Tilknytninger:
1Det Farmaceutiske Fakultet, Københavns Universitet, København, Danmark, diskurs:7016              
2Institut for Farmakologi og Farmakoterapi, Det Farmaceutiske Fakultet, Københavns Universitet, København, Danmark, diskurs:7018              
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Indhold

Ukontrollerede emneord: Africa, health workers perception and experiences, supervision, motivation
 Abstract: Aim
The aim of the study was to explore the experiences and perceptions about medicines management among health workers who work at public health facilities level III and IV in Uganda.
Background
After the implementation of a new supervision strategy, SPARS, public health facilities perform differently with respect to improvement of medicines management. SPARS assesses medicines management in five areas; dispensing and prescription quality, stock- and storage management and ordering & reporting. The performance of health facilities depends on activities, performance and motivation of health workers which is why it is interesting to look at what experiences and perceptions health workers have with SPARS and which factors may influence on performance and motivation of the health workers, according to themselves.
Literature review
It was found that performance of health facilities depends on the motivation and performance of the health workers. Factors such as low salary, drug availability and support by managers were found influencing.
Theoretical perspectives
The theoretical perspectives applied were Leavitt’s model with Scott Morton’s modifications of changes occurring in an organization, a conceptual framework of factors influencing on health worker motivation by Franco et al. and social cognitive career theory by Lent, Hackett and Brown. These three models were chosen for covering all the fields of the study.
Methods
The study was based on qualitative methods. 20 interviews with health workers from four public health facilities level III and four health facilities level IV in the Eastern and the Central regions of Uganda were conducted. Sampling of health facilities was based on performance assessed in SPARS. The four best and poorest performing facilities were included. Observations from the health facilities were also included. Two focus group discussions were conducted with 10 supervisors of SPARS, South Western region. The framework for the analysis was open coding. Method- and researcher triangulation were utilized in the study.
Results Health workers had many roles and responsibilities regarding medicines management. Supervision was perceived as positive and provided health worker with new knowledge and skills. Health workers and supervisors pointed out following factors as being either motivating or demotivating for their performance: Health facility conditions, leadership support, number of staff besides workload, salary, behaviour of the supervisor, rewards, drug availability and staff accommodations.
Discussion
The applied theoretical perspectives were found useful. The validity and reliability of the study is perceived as being good. The findings can be generalized to other parts of Uganda and to developing countries with similar structures of the health care system.
Conclusion
Health workers perceive and experience supervision as positive. Supervision provides the health workers with new knowledge and skills. Several factors such as behaviour of supervisor, health facility conditions and rewards are pointed out by health workers and supervisors as influence motivation and performance of the health workers.
 Abstract: Formål
Formålet med studiet var at undersøge hvilke erfaringer og opfattelser sundhedsarbejdere på offentlige sundhedsklinikker (niveau III og IV) i Uganda har med håndtering af medicin.
Baggrund
Efter implementering af en ny supervisions strategi, SPARS, forbedrer offentlige sundhedsklinikker deres performance i håndtering af medicin forskelligt. SPARS vurderer håndtering af medicin indenfor 5 områder; dispensing and prescription quality, stock- and storage management og ordering & reporting. Sundhedsklinikkernes performance er afhængig sundhedsarbejdernes aktiviteter, performance og motivation, hvorfor det er interessant at undersøge, hvilke erfaringer og opfattelser sundhedsarbejdere har med SPARS og hvilke faktorer, der ifølge dem selv, kan være motiverende.
Litteratur
Det blev fundet at sundhedsklinikkernes performance er afhængig af sundhedsarbejdernes motivation og performance. Faktorer såsom lav løn, tilgængelighed af medicin og ledelsessupport blev fundet værende influerede.
Teoretisk perspektiv
Den anvendte teoretiske ramme var Leavitt’s model med Scott Mortons modifikationer af forandringer i en organisation, en begrebsramme af faktorer, der påvirker sundhedsarbejders motivation af Franco et al., og social kognitiv karriere teori af Lent, Hackett og Brown. Disse tre modeller blev valgt for at dække alle områder i studiet.
Metode Studiet er baseret på kvalitative metoder. 20 interviews med sundhedsarbejdere fra fire offentlige niveau III og fire niveau IV sundhedsklinikker i den Østlige og den Centrale regioner i Uganda blev udført. Udvælgelsen af sundhedsklinikker var baseret på performance vurderet i SPARS. De fire bedst og dårligst præsterende sundhedsklinikker blev inkluderet. Observationer fra sundhedsklinikkerne blev også inkluderet. To fokusgruppe diskussioner blev udført med 10 SPARS supervisors fra den Syd- vestlige region. Åben kodning blev brugt som ramme for analysen. Metode- og forsker triangulering blev anvendt i studiet.
Resultater
Sundhedsarbejderne havde mange roller indenfor håndtering af medicin. Supervision blev opfattet som værende positivt og udstyrede sundhedsarbejdere med ny viden og færdigheder. Sundhedsarbejder og supervisorer påpegede følgende faktorer værende motiverende eller demotiverende for deres performance: Sundhedsklinikkens tilstand, ledelses support, antallet af sundhedsarbejder i forhold til arbejdsbyrden, løn, supervisorens adfærd, anerkendelse, lægemiddel tilgængelighed og personale indkvartering.
Diskussion
De anvendte teoretiske rammer blev fundet brugbare. Studiets validitet og reliabilitet blev opfattet som værende god. Resultaterne kan generaliseres til resten af Uganda og til andre udviklingslande med lignende strukturer i deres sundhedssystem.
Konklusion
Sundhedsarbejderne opfatter supervision som værende positivt. Supervision giver sundheds-arbejderne ny viden og færdigheder. Adskillige faktorer såsom supervisorens adfærd, sundhedsklinikkens tilstand og anerkendelse påpeges af sundhedsarbejdere og supervisors som værende influerende på sundhedsarbejderes motivation og performance.
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Tilgængelighed:
Offentlig
Mime-type / størrelse:
application/pdf / 2MB
Copyright dato:
2012
Copyright information:
De fulde rettigheder til dette materiale tilhører forfatteren.
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Basal

Bogmærk denne post: https://diskurs.kb.dk/item/diskurs:31800:4
 Type: Speciale
Alternativ titel: a qualitative study from Uganda
Alternativ titel: offentlige sundhedsarbejderes erfaringer og opfattelser af supervision i medicinhåndtering
Alternativ titel: et kvalitativt studie fra Uganda
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Detaljer

Sprog: English - eng
 Datoer: 2012-08-09
 Sider: ix, 90 s.
 Publiceringsinfo: København : Københavns Universitet
 Indholdsfortegnelse: -
 Note: Farmaceut cand. pharm.
 Type: Speciale
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