How does capacity-building of health managers through training interventions work?

Health workforce performance is an important determinant of health service delivery and hence good health outcomes. Yet, there are few studies from India and globally on whether and how improved health management at the district level may lead to better outcomes. We propose a mixed methods study of a capacity-building intervention in Tumkur district of Karnataka state, South India to understand the mechanisms through which a mix of contact classes and problem-solving field mentoring of health managers at district and sub-district levels impacts management practices and health outcomes, specifically their planning and supervision practices.

A mixed methods study will be conducted to understand the determinants of planning and supervision in the intervention and a control district. A triangulation design consisting of a sequential exploratory qual->QUANT study and a qualitative study will be used to analyse findings and explain the mechanisms through which health managers apply what they learn in a training programme. The mechanisms through which change might have occurred will be investigated in the various talukas (sub-districts) and the reasons for possibly varied responses of the talukas to the intervention will be studied.

The study will evaluate the district-level capacity-building intervention and improve our understanding of the mechanisms through which capacity-building interventions change (or not) management at the district level. The study will also improve our methodological understanding on how to evaluate complex human resource management (HRM) interventions.