PT - JOURNAL ARTICLE AU - Stephen Pope AU - Orvalho Augusto AU - Quinhas Fernandes AU - Sarah Gimbel AU - Isaías Ramiro AU - Dorlim Uetela AU - Stélio Tembe AU - Meredith Kimball AU - Mélia Manaca AU - C. Leigh Anderson AU - Sérgio Chicumbe AU - Kenneth Sherr TI - Primary Health Care Management Effectiveness as a Driver of Family Planning Service Readiness: A Cross-Sectional Analysis in Central Mozambique AID - 10.9745/GHSP-D-21-00706 DP - 2022 Sep 15 TA - Global Health: Science and Practice PG - e2100706 VI - 10 IP - Supplement 1 4099 - http://www.ghspjournal.org/content/10/Supplement_1/e2100706.short 4100 - http://www.ghspjournal.org/content/10/Supplement_1/e2100706.full SO - GLOB HEALTH SCI PRACT2022 Sep 15; 10 AB - Key FindingsAbout 74% of primary health care (PHC) facility managers surveyed did not receive any kind of formal management training, identifying a gap in building management capacity.Facility managers did not conduct routine staff performance reviews, making it challenging for managers to identify areas for performance improvements.Analysis of facilities included in this assessment revealed significant gaps in the quality and frequency of supervisory visits.Key ImplicationsValid and feasible indicators that are sensitive to PHC management practices and service readiness could improve the comparability and generalizability of PHC implementation research.Investments in management quality improvement and focused efforts to increase performance management practices in PHC settings are necessary for policy makers to support improved family planning service readiness.Introduction:The effectiveness of facility-level management is an important determinant of primary health care (PHC) reach and quality; however, the nature of the relationship between facility-level management and health system effectiveness lacks sufficient empirical grounding. We describe the association between management effectiveness and facility readiness to provide family planning services in central Mozambique.Methods:We linked data from the Ministry of Health’s 2018 Service Availability and Readiness Assessment and a second 2018 health facility survey that included the World Bank’s Service Delivery Indicators management module. Our analysis focused on 68 public sector PHC facilities in Manica, Sofala, Tete, and Zambézia provinces in which the 2 surveys overlapped. We used logistic quantile regression to model associations between management strength and family planning service readiness.Results:Of the 68 facility managers, 47 (69.1%) were first-time managers and (18) 26.5% had received formal management training. Managers indicated that 63.6% of their time was spent on management responsibilities, 63.2% of their employees had received a performance review in the year preceding the survey, and 12.5% of employee incentives were linked to performance evaluations. Adjusting for facility type and distance to the provincial capital, facility management effectiveness, and urban location were significantly associated with higher levels of readiness for family planning service delivery.Conclusions:We found that a higher degree of management effectiveness is independently associated with an increased likelihood of improved family planning service readiness. Furthermore, we describe barriers to effective PHC service management, including managers lacking formal training and spending a significant amount of time on nonmanagerial duties. Strengthening management capacity and reinforcing management practices at the PHC level are needed to improve health system readiness and outputs, which is essential for achieving global Sustainable Development Goals and universal health coverage targets.