Health Service Administration
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Health Service Administration

Working Group objectives:

Outline management and organizational strategies to improve the efficiency, effectiveness and equity of health service delivery.

Table 8 Health Service Administration




Human Resource Development and Management

Poor selection and recruitment process

Lack of orientation system for staff

No performance based culture/ reward system

Ill-defined job description

No system of discipline

Weak continuing education programme










Centralization of Authority

This produces problems of:

unclear line of authority

lack of accountability

lack of empowerment

non-adherence to systems and procedure


lack of sense of ownership

absence of team concept

by health professional through out the private and public sector.








Develop a comprehensive human resource and management plan



























Decentralization of authority

Review policy guidelines of Public Service Commission for effective ness (selection and recruitment)

Leadership development within health institutions

Establish a performance based culture and rewarding system for health managers and employees

Establish a system of discipline by instituting financial penalties for lack of accountablity on the job

Cultivate a positive work ethics amongst health staff

A system of continuing education should be established according to needs within institutions




In order to address problems associated with centralization one should;

Concentrate on line authority in the organizational structure of health institution-

flatten organizational structure to increase


empower all levels of staff through committee participation

revisit systems and procedures for consensus and standardization

encourage effective resource sharing to achieve sense of ownership amongst staff

and adopt a multi-disciplinary approach to health care administration


Operational Guidelines

The following problems have been identified with health institutions:

- Inadequate strategic planning


- Lack of a sense of direction in institutions

- Overburdened secondary health care services


- lack of communication between centralized authority and the community



The health care environment is plagued with regulatory problems some of these are as follows:

Non adherence to standards and procedures through out public and private sector institutions

Inadequate mechanisms for licensing of health institutions

Absence of Ethics Committee in medical institutions

Non-functional Boards at health institutions on the Island



Develop a clear vision for the health service





















Strengthen the legislative and regulatory frame work of the health sector

Some measures to alleviate these problems include;

- Strategic Planning for health services

- Formulating mission statement for institutions

- Building new Polyclinics to absorb secondary services



- Increasing community

participation in the decision

making process of health






Some measure to strengthen the regulatory environment would encompass the formation of Statutory Bodies ie.

Standards Committee in health institutions

Ministry of Health centered Quality Assurance, Licensing Committee and Ethics Committee.

In order to provide comprehensive quality care to the public, there must be the immediate activation of management authority for Health Boards at the main hospitals on the Island eg. Victoria Hospital

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