Clear proceedings as workplace health promotion. Supervision and management tools in rural Uganda

Abstract Health centres and supervision teams in rural/poor settings in developing countries are affected by limited resources, uneasy reporting to higher level of power and unclear proceedings to filling the gaps. Inconsistency in supervising visits lead to mistrust. Supervisees react with resistance or indifference. Supervisors react behaving as policemen. In Uganda, Oyam Health District, february-august 2018, actions were taken in order to solve conflicts, sustain quality, improve interactions. Sharing the concept and the implementing process could inspire colleagues engaged in workplace health promotion. Key points were informed by direct observations, talks with staffs, literature review, ugandan Ministry of Health official directives and tools, NGO’s adaptations. Selected issues were discussed during two workshops held in april ’18 involving all the concerned staff: 100 people. Agreement reached, based on a 3 (gap-act-resp) 5 (0-4 grading) algorithm, re-designed tools were able to reduce aléa during inspections, grade the gaps, guide actions and to address the appropriate level of responsability. User friendly reporting formats, database and unicode for linkage were designed ex novo. Information flow was agreed with the Health District Authorities. After the learning period, staffs felt empowered about resolving gaps and less stressed advocating higher authorities. Conflicts lost harshness. Satisfaction was captured by a self-filled anonymous questionnaire in june 2018 (n = 80, 12 core questions, 0-4 likert scale, mean >3, SD < 1, median= 4, open sentences positives). Quality improvements of health care services were measured by the Ugandan Ministry of Health independently. Unclear targets, shortage of means, ineffective communication flows reduce quality and trigger frustration. Sustaining transparency, organizing communication flows and proceedings, sourcing staff’s experience could enhance success both in reaching targets and promoting relational health at workplace. Key messages Transparency, shared decisions, clear communication, awareness of the aims and mastership are able to reduce conflicts and misunderstandings, sustaining a healthier workplace relational environment. People spend 60 to 80% of their active time at workplace. Well designed tools, policies and information flows, could be effective health enhancer as well. Work style is a lifestyle.