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From the brink of bankruptcy to a model for performance-based management: The story of one Yaoundé hospital

We took over the management of the obstetrics, gynecology, and pediatric hospital in Yaoundé (HGOPY) in 2014, inheriting an institution that faced chronic structural debt, obsolete equipment, and dilapidated buildings. No debt repayment plan was in place and fixed expenses such as staff salaries and benefits were extremely high.

This situation was regrettably common in many institutions across Africa which were hit hard by the economic and social crisis that resulted from structural adjustment policies implemented in by several countries, including Cameroon. Furthermore, the decision to increase health care charges adversely affected the poorest, limiting their access to health care and leading to a rise in maternal and infant mortality rates.

In response, African countries signed the Abuja Declaration in 2000, committing to earmark at least 15% of their national budget to the health sector. In addition to the goal of providing universal health care, the sector was expected to enhance the performance, effectiveness, and efficiency of its services.

Assessments: The Art of Measurement of Performance: Lessons from the Medical Profession

Tanya Gupta's picture
In our last blog we talked about why measuring competency and performance is vital for development professionals.  In this blog, we talk about some take-aways from the medical profession on the measurement of competencies and performance.
 

The medical profession, by necessity, has hard requirements  (inflexible and critical requirements) for measuring competencies and performance. In fact, such measurement is mission critical. While the development profession does not have “hard” requirements, we can learn from their rigorous approach. Here are a few principles and rules that we could borrow:

Why Performance Measurement for Development Professionals is Critical: Learning from Miller’s Pyramid

Tanya Gupta's picture

According to a training report  no less than $55.4 billion in 2013 was spent on training, including payroll and external products and services, in the US alone. The US and other countries spend a significant amount of money on employee development with the implicit assumption that training is correlated to improved on- the- job performance.   However, what exactly should we measure to ensure that this money is well spent? What is it that we need to measure to determine that employees are performing as expected and thus benefitting from these training expenditures?

Two responses that we often get to this “what should be measured” question are “performance” and “competencies”. The Government Accountability Office (GAO) of the United States defines  performance measurement as the “ongoing monitoring and reporting of program accomplishments, particularly progress toward pre-established goals.”  Performance measures, therefore, help define what success at the workplace means (“accomplishments”), and attempt to quantify performance by tracking the achievement of goals. Competencies are generally viewed as “a cluster of related knowledge, skills, and attitudes” (Parry 1996), and are thought to be measurable, correlated to performance, and can be improved through training.  While closely connected, they are not the same thing. Competencies are acquired skills, while performance is use of those competencies at work. Measurement of both is critical.

Quote of the Week: Malcolm Gladwell

Sina Odugbemi's picture

“Social and economic mobility, in any system, is essentially slack arbitrage: hard work is a successful strategy for those at the bottom because those at the top no longer work so hard. By custom, we disparage the idleness of the idle rich. We should encourage it. It is our best chance of taking their place. “

 

-Malcolm Gladwell, Staff Writer, The New Yorker

-As quoted in The New Yorker article, Slackers, July 30, 2012.

Help Us Assess Our Work

Anne-Katrin Arnold's picture

As many of you know by now, CommGAP is closing its doors this fall. We believe we have achieved a lot in the past five years, but we want to know what you think about our work - and about the role of communication for governance reform in general. Please help us assessing our performance and get a sense of your perception of the link between communication and governance by participating in our survey! It only takes about ten minutes. Deadline for participating is July 15.

Bangladesh Local Governance at Work: Learning from the Field

Nilufar Ahmad's picture

This week, we recap the World Bank’s Spring Meetings event, “Toward Universal Health Coverage by 2030.” Each Friday, we share a selection of global health Tweets, infographics, blog posts, videos and other content of note. For more, follow us @worldbankhealth.

China's Accountability and India's Voice

Yongmei Zhou's picture

International migration is the most effective action that people in developing countries can take to increase their incomes and well-being. Yet our ability to learn about the policies that enhance or inhibit the gains to migration is severely restricted due to the poor state of migration data. One element of this is the lack of representative surveys of immigrants.

Call for a green China: permanent improvement, with room for more

David Dollar's picture

Children perform during "Call for Green China" – a unique cultural tour to raise awareness about pressing environmental issues in China and possible solutions.
The old people in the park are saying that this was the best April in 20-plus years in terms of air quality here in Beijing. There has been permanent improvement based on some of the changes made for the Olympics: some factories relocated to less populous areas, restrictions on private car use, improved public transportation as an alternative.

Other factors are more long term – the sandstorms common when I lived here in 1986 are largely gone, owing to successful re-greening efforts west of here. There was a frenzied pace of construction as modern Beijing was being built, which has naturally slowed down – construction dust was a key part of air pollution here.

There is more room for improvement, but the progress was notable during a lovely April. One key issue going forward will be to continue to control private vehicle use.

Good indicators for good governance?

Naazneen Barma's picture

The Bank’s increased attention to governance since the early 1990s has naturally brought with it calls for robust measures that enable us to specify what exactly we are trying to improve in this area and how well we seem to be doing it.  Overall, however, the consensus on the centrality of good governance to development is yet to be matched by agreement on good indicators for it.