Behavior Profile: District Health Management Teams program yearly budgets
Health Goal: Catalyze transformation of a holistic health system to sustain equitable improvements in health for all
District Health Management Teams program yearly budgets that meet identified community needs
Percentage of the District Health Management Teams’ budgets programmed in accordance with community needs

Behavior Analysis

Strategy

BEHAVIOR AND STEPS

What steps are needed to practice this behavior?

District Health Management Teams (DHMTs) program yearly budgets that meet identified community needs

  1. Gather information from the communities in health zones to understand their needs
  2. Develop a budget based on this understanding and information.
  3. Share this information with RHMTs for their inputs and alignment with Government priorities
  4. Share reviewed budget with communities and get their feedback on needed changes
  5. Finalize budget based on feedback from communities
  6. Share budget with RHMT
  7. Share budget with communities

FACTORS

What factors may prevent or support practice of this behavior?
Structural
Accessibility: DHMTs do not program yearly budgets because they does not have administrative capacity at the national level to overcome regularly delayed approvals of district funds.
Accessibility: DHMTs do not program yearly budgets because they do not have funds to plan for the budgeting process.
Service Experience: DHMTs do not program yearly budgets because they do not sufficiently involve District Assemblies in decision making.
Service Experience: DHMTs do not program yearly budgets because they do not have incentive to budget due to delays in reimbursement from health insurance.
Social
Norms: DHMTs do not program yearly budgets because they do not have decision-making authority and are not involved in the planning and implementation of health services.
Internal
Self-Efficacy: DHMTs do not program yearly budgets because they do not feel empowered to explore their decisions to respond to and address local challenges.
Skills: DHMTs do not program yearly budgets because they do not have the requisite competency for effective budget process.

SUPPORTING ACTORS AND ACTIONS

Who must support the practice of this behavior, and what actions must they take?
Institutional
Policymakers: Set up a comprehensive and simplified budget planning template for District Health Management Teams to enable them capture all the relevant information to the budget planning process.
Policymakers: Ensure sufficient funding is allocated for health so that activities can be carried out in a timely manner.
Managers: Ensure District Health Management Teams receive sufficient training in comprehensive budget planning using clinic compounds as the unit.
Managers: Ensure District Health Management Teams receive requisite training in effective budgeting.
Managers: Empower district directors of health service in the planning and implementation of health services.
Regional and Districts Officers: Actively engage the various district assemblies in their budgeting process to ensure buy-in for support.

POSSIBLE PROGRAM STRATEGIES

What strategies will best focus our efforts based on this analysis?

Strategy requires Communication Support

Enabling Environment
Financing: Prioritize and the release of budget guidance should be accompanied with funding for the budget process.
Institutional Capacity Building: Strengthen the policy planning monitoring and evaluation division to ensure that District Health Management Teams receive effective hands on training in budgeting.
Policies and Governance: Develop concise protocols and guidelines that make it a requirement for all District Health Management Teams to undertake competency based training on this protocol.
Policies and Governance: Develop policy directive for all District Health Management Teams to fully participate in District Budget Planning and make presentations to the district assemblies on proposed budgets.
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