Program Management

In the context of the global health arena, project or program management is likely to be more challenging on several levels (e.g., logistics, politics, socio-economic factors) in developing versus more industrialized countries. Reasons for these challenges are complex, including extreme poverty, political instability or civil war, an ineffectual or corrupt government, lack of infrastructure, and a high burden of disease coupled with an overwhelmed and inadequate health system. Project viability and success in such settings center on several critical, interrelated components. Perhaps most important, the project must aim to address local needs that are recognized—by the local population—as important (serious, worth addressing) and in some sense solvable. Other factors involved in successful project management include the following:

  • Clear objectives – What exactly is the project trying to accomplish?
  • Realistic goals – Are the desired outcomes realistic in relation to resources available (funding, time, capacity)?
  • Clear lines of responsibility, accountability and authority – Is everyone involved aware of who is doing? Are there mechanisms in place to ensure that different parties fulfill these responsibilities? Does everyone understand the “chain of command”?
  • Effective and efficient decision-making and communication – Are there mechanisms in place to facilitate and support the decision-making process and ongoing communication?
  • End-user buy-in and participation – Are local individuals and organizations at all levels of the health system “on board” with and involved in the project? Does the project have local champions, who are respected by the community and publicly demonstrate support for the project or its aims?
  • Local capacity – Do the local organizations and individuals who will sustain improvements realized by the project after it ends have the capacity (guidelines, skills, supplies, etc.) required to do so?  
  • Sponsorship – Does the project have the funding it needs to achieve its goals?

After project objectives are clearly identified, the project management path usually proceeds with an assessment of the current situation to fully characterize the problem, followed by a dialogue among key stakeholders on exactly how the problem will be addressed (project planning).  Project management continues with close tracking or monitoring of progress, problem-solving as needed and, finally, evaluation of results.