Introducing Performance Management in National Health Systems: Issues on Policy and Implementation

Using preliminary research results from 15 case studies conducted the world over we examine the prerequisites for successful introduction of performance management systems which are appropriate for developing country situations. The key message and conclusion is that it is important to measure and value staff performance, but that this requires levels of organisational management and an external policy environment that are seldom in place in a developing context. Amongst the internal factors to consider are the sufficiency of the wage level to attract staff to work the hours in their contracts, the tools and supplies with which to carry out their work, the existence of a culture of local planning, and the ability of managers to manage. External factors are also important, particularly the extent of external pressure for the organisation to meet even basic levels of performance. [abstract]