Situation analysis tools

The first step is to agree and collect a minimum data set between all participating research sites. Depending on the focus of the project, this could include basic information on the health workforce, the composition of a District Health Management Team (DHMT), the local health system and local and national influences on DHMT performance. It is faster to collect, and more sustainable to use, existing (or secondary) data. Such sources include data routinely collected such as:

  • Health Management Information System; reports; plans; budgets; minutes of meetings etc.
  • Data collected by institutions such as the Ministry of Health, Ministry of Finance, Non-Governmental Organisations, development donors etc.

Where there are information gaps, it may be necessary to undertake primary data collection through key informant interviews or focus group discussions with DHMT members. Key informant interviews are used when it is important to gain insight into experiences, behaviours, attitudes, values of individuals. They vary in formality and structure. A focus group discussion is a moderated discussion that is used to explore the extent of shared beliefs, values and behaviours.

Data should be analysed within the action research team. The different roles and responsibilities in analysis should have been discussed at the beginning of the project, with flexibility allowed for these responsibilities to evolve over the course of a project. The whole team should then reflect on the issues emerging from these analyses. Some of these issues, for example, could include staff absenteeism rates and how decisions are made within the DHMT.

Once this analysis is conducted it is time to ask, “But why?” A list of follow-on questions should be compiled. As a result problematic areas of workforce performance can be identified and human resource/health system strategies selected to address them.  

Tips on how to facilitate an introductory meeting with District Health Management TeamsIf you are thinking of beginning an action research project with your District Health Management Team (DHMT) making a good impression at your first meeting and communicating clearly are crucial. Based on our experience here are some hints and tips which will ensure that your meeting goes as smoothly as possible.

Problem tree analysis. Problem tree analysis helps to find solutions by mapping out, in a structured way, the anatomy of cause and effect around an issue. Problem tree analysis should be used with the District Health Management team in advance of the first stakeholder meeting in order to get a clearer view of the human resources/health systems problems that are being faced.

Strengths, weaknesses, opportunities and threats exercise. The process of identifying strengths, weaknesses, opportunities and threats will allow the District Health Management Teams develop the team in a way that builds on their strengths and opportunities while managing and eliminating their weaknesses and threats.