Health management improvement

PES covers the period 5/83-11/84 and is based on an attached special evaluation (XD-AAR-070-A). A Bureau of Management and Methods has been established within the MOH to implement administrative improvements, but (with only 3 staff members plus contract TA) is much reduced from the unit envisioned, and its post-project viability is unclear. Management improvements are being tested in 5 functional areas, and 1 mini- and 13 microcomputers have been provided to serve related data processing needs. Training has been remarkably strong, given project difficulties: 2 Moroccans are receiving long-term U.S. public administration training; some 30 other MOH employees have received short-term U.S., third-country, or in-country training; and on-the-job training in computer and management skills is being provided. Still, institutionalization of an ongoing MOH ability to identify and implement administrative improvements will require some intraministry reorganization and the MOH will have to assume greater responsibility for following up systems already introduced. Lessons learned are: (1) project expectations should reflect a realistic assessment of host country capabilities and potential; (2) computerized management information systems should stress the applications of data to management improvement needs; (3) considerable time should be allowed for the discussion and negotiation needed to unify multiple viewpoints within the MOH; (4) in order that implementation be a joint contractor-MOH effort, contractor responsibility for transferring activities and the capability to implement them to the MOH should be clearly defined; (5) management improvement projects should thoroughly assess the availability of qualified administrators and (6) with regard to training: the MOH must be aware at the outset of all budgetary implications; consideration should be given to making a contractor responsible for selecting a language training program; and a 6-month (rather than 90-day) period should be allotted for developing a training plan. Key action decisions are to extend the PACD two years and the TA contract one.