Management capacity of primary healthcare facilities in low- and middle-income countries: A scoping review

Abstract

How health facilities are managed determines their performance and health service delivery. Management capacity of health facilities comprises the competency of managers at the individual level and the management support and work environment in their institutions. Evidence shows this management capacity influences service delivery and performance of the facility. For LMICs, there are evidence gaps as existing evidence is scarce, varied in the assessment of management capacity of PHC facilities and report a measurement gap due to the scarcity of assessment tools contextualised to the LMIC PHC setting. Our review aims to address these gaps by mapping and summarising the existing literature on management capacity of PHC facilities in LMICs, its components and performance across these components, providing evidence on what needs to be improved for better service delivery. We used Arksey and O`Malley`s scoping review methodology. We searched PubMed, Scopus, Web of Science and Google Scholar and hand-checked reference lists. We synthesized findings using a thematic approach. We included 21 articles out of the 3867 articles gotten. Individual capacity consisted of managerial competencies grouped into seven groups: (1) communication and information management, (2) financial management and planning, (3) human resource, supportive and performance management, (4) community stakeholder and engagement, (5) target setting and problem solving, (6) leadership and (7) situational analysis. Institutional capacity included functional support systems grouped into; (1) availability of resources, (2) support to undertake duties and (3) clear roles and responsibilities. Gaps were prevalent across individual and institutional capacities. There were deficiencies in the managerial competencies of the managers and the functional support systems were not adequate. These negatively affected facility service delivery and performance. There is still a scarcity of studies hence more research is needed. Furthermore, interventions such as training and supportive supervision should be considered in improving the managerial competencies of managers.