Organisational capacities | Kilifi experiences | Mitchell’s Plain experiences |
Cognitive capacities, for example,
| SCHMT members demonstrate concern for and commitment to staff and community Medical superintendent in hospital demonstrates openness in engagement with staff and supportiveness (box 1) | Mid-level managers demonstrate sense of purpose in trying out new processes and practices, role-model new approaches to staff HAST managers demonstrate sense of purpose and decisiveness in their approach to their challenge; by role-modelling and language they signal respect for others and importance of communication and relationships (box 2) |
Behavioural capacities, for example,
| SCHMT adapts supervision practices in order to maintain support to PHC facility managers New routines of inclusive decision-making in one hospital strengthen collective sense of duty and encourage innovative practice (and may enable response to future threats) | Mid-level managers introduce new practices in, for example, way meetings are run, that provide spaces for learning and developing shared values —and support future action HAST managers adopt participatory approach, in working with staff to develop develop new principles of communication and engagement, that recognise importance of relationship-building to their work—and support future action |
Contextual capacities, for example,
| Individual managers demonstrate willingness to take risks and respect for others SCHMT drew on resource networks to access funding for supervision and address cholera outbreak Hospital superintendent engages people respectfully, spreads responsibility for decision-making and generates strengthened sense of collective duty | Individual managers demonstrate willingness to take risks by trying out new approaches Mid-level and HAST interventions founded on respectful interactions and recognise diffused power and responsibility Mid-level and HAST managers draw on research team in developing new approaches |
HAST, HIV/AIDS/sexually transmitted infections/tuberculosis; SCHMT, Sub-County Health Management Team.