Patterns of Strategic Change in Health Care: District Health Authorities Respond to AIDS (original) (raw)
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Since the detection of the HIV/AIDS virus in Ghana in 1986, it has had a devastating consequence on all components of our society and has become the most deadly infectious scourge. The syndrome is seen as a threat to the stability of entire nations and regions, affecting the most productive members of the society. HIV/AIDS has become a global phenomenon, however the disease is most pronounced in developing countries particularly Sub-Saharan Africa. Several programmes have been implemented by various institutions and organizations to reduce the prevalence, yet the fight has not been won. The study sought to identify the existing strategic management practices of managing and controlling HIV/AIDS in Ghana as well as determine the efficacy of the existing strategic management practices and its associated challenges. Data for the study was collected using questionnaires and interviews. In all 155 participants took part in the study. The study revealed that strategies of the organizations were to some extent effective in managing and controlling the HIV/AIDS epidemic in Ghana. The study also identified quite a number of strategic management challenges NGOs faced in the management and control of the HIV/AIDS menace. The most significant ones included: non involvement of PLWHA, wide gap between policies and laws and their enforcement.
How eff ective was organizational reform implemented inside one critical New York City health agency? Specifi cally, we examine the extent to which the reorganization of the HIV/AIDS Services Administration (HASA) into the Medical Insurance Services Administration (MICSA) achieved three goals: (1) realizing synergies among the component MICSA programs; (2) cross-fertilizing ideas among MICSA agencies; and (3) facilitating HASA operations through the lens of organization change theory. Qualitative methods including interviews, site visits, and document analysis triangulate the eff ects of the reorganization. Implications for organization change literature are explored, especially highlighting where more theoretical and empirical studies are needed.
Management Successes and Struggles for AIDS Service Organizations
Administration in Social Work, 2007
AIDS Service Organizations (ASOs) began 25 years ago as alternative, community-based advocacy entities designed to address institutional neglect. They evolved into hybrid agencies, both activist and service-providing. As ASOs have changed, they now face management challenges common in all alternative agencies in later stages and challenges unique to the HIV field. Stigma, changing practice contexts, volunteerism, partnership, cultural competence, financial health, professionalism, service integration, job stress, and organizational cohesion are presented as typical challenges and contexts, paired with strategies to address them. Managers in the HIV field must balance many competing forces as the pandemic increases while funding and attention decrease. However, shifting contexts can create successes and struggles. ASOs remain viable and necessary as part of the tapestry of human services provision.
Leadership in Crisis: Managing HIV Vulnerability Through Strategic Interventions
Elite Journal of Medical Sciences, 2024
This review explores the management of HIV vulnerability through strategic leadership interventions, highlighting the effectiveness of various leadership approaches in enhancing HIV care and prevention. The review examines the application of transformational theory to address the multifaceted challenges associated with HIV vulnerability. It emphasizes the role of strategic communication, data-driven decision-making, and innovation in optimizing HIV management. Key findings indicate that leadership strategies that integrate technology, support research and development, and engage stakeholders are crucial for improving HIV outcomes. Effective crisis management and communication are essential for maintaining public trust and managing misinformation during emergencies. The review also underscores the importance of resilience building through healthcare infrastructure development, workforce capacity enhancement, and community engagement to sustain and expand HIV programs. Recommendations include strengthening data-driven approaches, fostering innovation, and implementing comprehensive crisis management strategies to effectively manage HIV vulnerability. These insights provide a framework for leveraging strategic leadership to enhance HIV care and work towards the global goal of reducing HIV prevalence and improving patient outcomes.
Sociology of Health and Illness, 1996
Ahstract Using the implementation of the Griffiths Report as an example, this paper examines the way in which sociologists and others have examined the process of managing change within the NHS. Several studies of Griffiths have documented a number of unintended consequences of its implementation but it is argued that none of these have adequately theorised these unintended outcomes of the policy implementation process. It is suggested that the process-sociological approach of Norbert Elias, and in particular his game models, enable us better to understand the complex interweaving of planned and unplanned processes which is involved in all processes of managed change.
THE MANAGEMENT OF STRATEGIC CHANGE IN PUBLIC ORGANISATIONS
The literature on strategic change management in organizations generally pays relatively little attention to their legal status. The problem of change most often focuses on psychological, psycho-sociological or sociological characteristics of human behaviour that are assumed to be similar regardless of the nature of the organization (private enterprise or public administration). As a result, the issue of change in public management has not been the subject of research that highlights the particular complexity of public organizations and the greater difficulty for senior managers to implement strategic change policies. (Ban, 1995). While in private enterprise, strategic change is often one-dimensional, referring to value creation and profit maximization as the most decisive constraint, in public administrations, change is always protean in nature, largely determined by the socio-political context, the weight of history and the institutional and cultural constraints of a nation. 1
A note on co‐ordinating the AIDS crisis: issues for policy management and research
The International Journal of Health Planning and Management, 1997
THE NEED FOR MANAGEMENT RESEARCH Though not always popular in health circles, good management can be as crucial to eective health care as getting the basic science or medicine right. In many areas, healthcare systems excel at the latter but do not necessarily regard healthcare management itself as a proper topic for scienti®c research. Where the methods of policy implementation are routine, well understood, not organizationally complex, and relatively unpoliticized (some child-immunization programmes perhaps), the omission may be benign; and, for other conditions, the diverse nature of aected groups, the international dierences in epidemiology, and the variations in economic and social institutions involved in responding to the issues, an understanding of the managerial issues is critical (Moodie and Kwarteng, 1993). In a sense, the establishment of the UN's multiagency Global Programme for AIDS (GPA) in 1996 illustrates the international recognition of this point at a structural level. Whether healthcare management will be accorded the importance given to ®elds like public health, social psychology or even health economics within GPA's research portfolio is another matter. An issue that has emerged, however, in the management of an organizational response to HIV at all levels (from grass root organizations to international organizations) arises from the need to coordinate between a wide variety of organizational types, and within a mix of professional and lifestyle cultures. Some work has already been done in this area, though much of it is critically descriptive; for instance, Shilts (1988), Panem (1988), Perrow and Guillen (1990), Foreman (1993). Useful as this kind of research is, the emphasis tends to be on highlighting problems and, without some appropriate conceptual (managerial) framework, prescriptions for remedial action are dicult to generate (sometimes) and/or evaluate (frequently). This note seeks to sharpen our understanding of coordination and its signi®cance in healthcare management by oering a picture of an activity where information, incentives and the mixing of various (professional and other) cultures are key. The research design was policy driven (Hakim, 1988), and concentrated on incentives, decision-making and information gathering/
Managerial Challenges in Addressing HIV/AIDS: Gujarat State AIDS Control Society (GSACS)
IIMA Working …, 2008
The spread of HIV/AIDS is not merely a problem of public health; it is also an economic, political, and social challenge that threatens to hinder decades of progress in different parts of Gujarat. There is an urgent need to significantly scale-up public health interventions that work to make a meaningful impact. While NGOs and community based organizations have a critical role to play in implementing these interventions amongst the various population groups, the government must shoulder the overall responsibility for planning, coordinating, mobilizing, and facilitating the various HIV/AIDS prevention, care and treatment services in the state. Generally, the departments of HIV/AIDS are dominated by doctor-managers who lack training in management. This working paper was developed with objective of enhancing the skills of the program implementers. In this paper, in first three chapters we describe the overall situation of HIV/AIDS globally and nationally. Major challenges in managing sentinel surveillance, behavior surveillance, targeted interventions and its subcomponents have been described in chapter four. Issues related to integration of HIV/AIDS activities with reproductive health has also been discussed in the chapter. In chapter five, we present a few case studies from Gujarat State AIDS Control Society. These cases focus on the managerial issues in the following areas: Project Management, Blood Bank Management, VCTC/ICTC Management, Behavioral Surveillance and MIS for Targeted Interventions. These case studies bring out the ground level realities and can help participants develop insights for better management of the HIV/AIDS programme.