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Leadership and management competencies required for Bhutanese primary health care managers in reforming the district health system

Authors Dorji K, Tejativaddhana P, Siripornpibul T, Cruickshank M, Briggs D

Received 24 November 2018

Accepted for publication 9 January 2019

Published 25 March 2019 Volume 2019:11 Pages 13—21

DOI https://doi.org/10.2147/JHL.S195751

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Professor Russell Taichman


Kinley Dorji,1,2 Phudit Tejativaddhana,1,3 Taweesak Siripornpibul,1,4 Mary Cruickshank,1,5 David Briggs1,6

1College of Health Systems Management, Naresuan University, Phitsanulok, Thailand; 2Ministry of Health, Royal Government of Bhutan, Thimphu, Bhutan; 3ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand; 4Faculty of Science, Department of Mathematics, Naresuan University, Phitsanulok, Thailand; 5School of Nursing and Healthcare Professions, Federation University, Mpunt Helen, VIC, Australia; 6University of New England, Armidale, NSW, Australia

Objective: This study aims to identify the required management competencies, current competency levels, and strategies for improving the management competencies of Bhutanese primary health care (PHC) managers.
Methods: A quantitative method with a cross-sectional survey using self-administered questionnaires. This study recruited 339 PHC managers across Bhutan. The data were analyzed using statistical software.
Results: This study identified three competency domains and seven key sub-domain competencies. People domain was perceived to be the highest required competency with a mean score of 4.2376, followed by execution (4.1851), and the transformation (4.0501) domains. For the seven key sub-domains, the communication sub-domain (4.3220) was perceived as the highest required competency, followed by professionalism (4.2967), managing change (4.1776), relationship building (4.1686), analytical thinking (4.1091), leadership (4.0980), and innovative thinking (3.9794). The current competency levels of PHC managers in domains and sub-domain competencies were the people domain (3.7322), execution (3.6471), and the transformation (3.5554). For the sub-domains, communication (3.8092), professionalism (3.7939), relationship building (3.6603), analytical thinking (3.6396), leadership (3.5805), managing change (3.5723), and innovative thinking (3.4543).
Conclusion: Findings of Bhutan health managers’ competencies are consistent with the findings of other international contexts. This study suggests that agencies responsible for health system need to focus more on the competencies defined by the study to positively influence health leadership and management development interventions.

Keywords: Bhutanese primary health care managers, district health system, health reform, leadership and management competency


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