Poor Leadership and Governance
Leadership and governance of health systems are one of the most complex yet crucial building blocks of any health system. The latter encompasses the government’s role in the health sector as well as other relevant stakeholders who impact highly on health through practices like overseeing and guiding the entire health care system to protect the interests. Leadership and governance, therefore, go beyond the Ministry of Health’s leadership role to the focus of responsibility and tasks for strategic management of the health system. It also includes the intersectoral and socio-political atmosphere through which health system functions (Lave & Wenger 1991, Brown & Duguid 1991). With regards to leadership and governance, a shortcoming carries negative implications, consequently causing challenges in the health sector as pertains translating knowledge to practice.
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Firstly, to overcome the problem of poor leadership and governance, there needs to be an update and review of national health policy and strategic plan; updating and enforcing public health laws; and strengthening mechanisms for transparency and accountability as well as intersectoral collaboration. This includes the addition and reinforcing of existing health policies to further the agenda of transparency, responsibility, and accountability in leadership. Another aspect that offers an opportunity to curb the challenge of poor leadership and governance is defining the roles and responsibilities of key actors in the health sector.
Secondly, the provision and enhancement of important enabling management, leadership and governance tools, such as pertinent policies and a workable health sector strategic development framework. These tools not only offer guidelines but also act as a means to measure competence and effectiveness of health managers. The organization of governance workshops is also an opportunity that enhances health managers’ leadership skills, responsibility to guide public interests as well as competence levels.
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Thirdly, good leadership and management are imperative within and across every level of the health system. Areas must be identified where strengthening would result in the highest returns in improving performance and health status. While the frontline health managers interface directly with the public and are often the target of attention, the national and the provincial levels need competent management to fulfil their role in enabling successful delivery of primary health care and hospital levels. Supervision and support, which are the key roles of health mangers are crucial.
Inadequate financing of knowledge generation
There is a rapid expansion of literature and knowledge generation in the health sector. Regardless, there are several knowledge ‘processes’ such as knowledge sharing, knowledge creation, knowledge exchange and knowledge transfer. Per say, one of the critical issues is ensuring innovation or competitive advantage, which is the need for knowledge embedded within one organizational group to become available or known to members of another group (Lave & Wenger 1991, Brown & Duguid 1991). All these processes require adequate funding and constant support from the government in ways that allow for research and knowledge generation. Inadequate funding is, therefore, a given shortcoming that negatively impacts on knowledge transfer experts as well as health managers.
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To overcome the challenge of inadequate financing for knowledge generation, health managers need to exploit funding opportunities available by ensuring that funders provide the financial support to individual researchers or teams of researchers (teams may include research users) to implement effective knowledge generation activities. These may include aspects like exploiting the opportunities that offer knowledge transfer supplement grants, prioritization on health factors by the government, embracing funding programs like research fundraisings, government intervention through effective cost sharing in all sectors of government based on estimated budgets and also embracing funding for knowledge synthesis projects.
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Health managers can also advocate for knowledge generation as a means to attract funders by addressing barriers to effective knowledge generation and transfer influences through publications, presentations as well as calls to actions on the inadequacy of the health system with regards to knowledge generation (Lave & Wenger 1991, Brown & Duguid 1991). They can also advocate by celebrating the work of researchers and others who are promoting a climate that fosters knowledge generation. This also involves mandating knowledge generation as part of funders’ programs and activities, as appropriate and also developing a culture of knowledge generation internally.
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Lack of political support
The government has a huge impact on the health sector hence political support by those in government is crucial in ensuring that health managers perform their responsibilities to the public. There are, however, concerns based on political inclinations where lack of political support poses a threat to the sustainability and effectiveness of the health sector as pertains to knowledge transfer. Aspects like corruption in the political arena and greed for power and money are key factors that derail political influence from offering adequate support and prioritize the health sector.
Given the broadness and complexities involved with political intricacies, health managers should embrace government laws and regulations to ensure that political influence does not steer health objectives from implementing the balance between the needs of each and those of all individuals—that is, the community. Protecting people’s right to equally receive essential health care services should be seized as an opportunity to offer a legitimate function of a civilized society (Baker 2001). Health managers should advocate for the health sector to be considered by all actors in government including politicians as a human necessity. This is a means to an end that provides the necessity to ensure that equal rights to proper health care, consequently health aspects like knowledge transfer are taken into consideration and backed by politicians.
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Poor Management Practices
The issue of poor management practice is a shortcoming that negatively affects the health sector as Pertains Translating Knowledge to Practice. Poor management practices lead to negative implications like low morale amongst staff and constant erosion in efficiency as a result of poor leadership skills. Consequently, health provision and knowledge transfer in the health sector is highly affected leading to poor health services and poor finance management issues. The development of excellent leadership skills amongst managers is a matter that needs to be adressed and embraced by health managers to curb the shortcomings tied to poor management practices. To deal with the challenge, there needs to be a decentarilzed system that breaks down the complexities of manaagement regarding budget size and large healthcare environments.
Health managers should also participate in management training programmes that create a wide cirriculum which not only covers effective management concepts but also outlines the relevant elements of hospital management at all levels which range from local to national health environments (Baker 2001). Also, stakeholders in the health sector, as well as health managers, should corelate and function as dependant entities within a bigger health system The corelation is significant in ensuring competence, coordination and also improve management skills. Management competence is also improved if helath managers are given the necessary authority and when decision-making is decentarlized within a structured system that ensures supervision and constant evaluation (Baker 2001).
Poor Sharing/ Exchange of Knowledge
Sharing and exchange of knowledge is a critical aspect in the health sector. As a result, any shortcoming in this area can have dier impacts that negatively affect the nature and effectiveness of health care as well as knowledge translation. Some of the causes of poor sharing of knowledge arise from an inadequate information sharing culture amongst staff, lack of adequate information sharing tools, poor health personel initiation and also poor peer eductaion. Poor knowledge sharing may lead to issues like severe injury, missing-diagnosis, wrong treatment, increased multi drug resistance and unexpected deaths.
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To curb the challenge of poor kbnowledge exchange, there needs to be an effective knowledge management tool that allows for the creation, sharing, translation, and application to increase effectiveness. Health managers have to update themselves through constant learning to deliver quality services and be in the best position to share their knowledge and experiences through lectures, questioning, conferences, demonstrations as well as training programs.
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Health mangers need to encourage knowledge sharing cultures to ensure that critical information and the exchange of ideas and information boosts health care systems as well as efficiate the translation of knowledge into practice. Health managers should, therefore, stay updated on matters of health management and also steer their staff to a knowledge sharing culture to improve the habit and practice of knowledge sharing. The acquisition of knowledge sharing equipment and technology should also be prioritized to further effect and better the practice of knowledge sharing in the health sector.
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