Management capacity in the Afghan Ministry of Public Health pre-Taliban: A mixed-methods study of political and socio-cultural issues.

Abstract

Introduction: This paper identifies how political and socio-cultural issues affect management capacity and leadership. Methods: A mixed-methods case-study was conducted amongst staff at the Afghan Ministry of Public Health exploring its management capacity. Interviews were conducted with 12 senior staff and qualitative data were analysed thematically. A quantitative survey, covering directors of 30 departments, was analysed using descriptive statistics. Result: Overall, management capacity was weak. Key appointments including directors were subject to political interference and many directors appointed by politicians lacked the skills to manage well. Consequently, those directors were not able to support employees appropriately or to create a healthy work environment. The respondents reported that there were strong socio-cultural influences such as nepotism and favouritism. Due to these problems employees believed they were not treated consistently or fairly. This was compounded by overly complex administrative systems. Conclusions: The government needs to appoint competent and committed staff who can recognize/address the gaps in the functioning of the Ministry, especially the negative political and socio-cultural practices that undermine effectiveness.