Management competence is the essential precondition for program success. Stories of mismanagement and under-management and observations such as those of Dr Garnier will undermine the will of our supporters. It is the responsibility of human resource development leaders to address the managerial competence gap head-on and do so soon, if the health sector is to avoid a collapse of the hope that the new resources will reach the people.
HR is the advocate for making the investment in managerial competence. To successfully compete for the resources that HR must have to develop managerial competence, HR must start with a solid assessment of the need. Each position, at every level (Ministry of Health, hospitals, health centers, programs, etc.), must be analyzed to identify the specific management competencies required to meet the objectives of the position. The analysis will produce up-to-date position descriptions and identify the skills that need improvement.
HR's advocacy has several targets. Management training is an essential expense of successful enterprises of all kinds. Every application to every donor should include a request for support for management development as a component of every program. Donors will respect and respond to objective assessments of management skill needs that are directly related to achieving the results of the investment. Finance ministries and some donors make a serious mistake when they argue that the country should not borrow for management training. They are setting projects up for failure. Ministries of Health and Finance have to be convinced to include the money in loan and project requests. HR is in the best position to make the case. You will not get what you do not ask for.
Another advocacy target is the regular budget process. HR people know that training, especially for management, is often left out of operating budgets or that it is the first thing to be cut when money gets tight. The needs assessment, tied directly to results, is essential to make the case for support.
Build internal advocacy for management competence development. The experience of several countries demonstrates that health care managers who are well organized are effective advocates for training resources and for improving managerial practice. HR leads by organizing national and regional associations of health care executives and administrators. These professional associations encourage individuals with management responsibilities to take pride in their roles. They can develop credentials and recognitions for outstanding performance, organize courses, create publications that promote self-improvement and share "best practices". Most importantly, professional associations of health care executives are valuable partners of HR in advocating for management training resources.