Core competencies for primary health care management

Introduction: To enable more effective leadership in health care institutions in a changing business environment, as a first step the performance gap between their own professional needs and the relevance of certain tasks and functions critical for their job positions has been assessed in order to allow the development and implementation of tailored training programmes.
Methods: The cross-sectional study was conducted in 2007 and included 99 managers (directors, heads of departments and chief nurses) from 17 Belgrade health institutions. The performance gap was assessed building upon the management competency framework “Core Management Competencies Model for Public Health Managers” developed by CDC/ SMDP (USA). Participants’ general data and six competencies (leadership, communication, team building, planning and priority setting, performance assessment, and problem solving) were self-assessed by questionnaire and prior to intensive trainings. Each of the competencies consists of three to six tasks. The response rate reached 97%.

Results: At their current management position females (n=72) found several tasks significantly more relevant than males (n=24) in relation to following competencies: communication (p_II=0.033; p_III=0.001; and, p_IV=0.005), planning and priority setting (p_III=0.002; p_V=0.036; and p_VI=0.035) and performance assessment (p_II=0.001; and p_III=0.035). Those participants who were longer than one year in a managerial position (n=67) felt a greater need to improve planning and priority setting skills (p_V=0.047). However, they did not esteem public relations i.e. media as important as those who were in their position less than a year (p=0.020). The higher performance gaps are seen regarding performance assessment (Perf.gap_III= 7.05), than in communication (Perf.gap_II=6.81 and Perf.gap_III=6.59).

Conclusion: The greatest gap between current levels and perceived needs of professional management skills can be determined for particular competences: planning and priority setting, communication and problem solving. They constituted the baseline for the set up of the training programme, its evaluation and for the follow–up of management improvements.