Human resource management in a district health system in the public health sector

Orientation: There is a misalignment between the strategic goals of the public health sector, which include strengthening health systems to produce desired health outcomes, and the human resource management of the human resources for health. Research purpose: This study aimed to describe the extent and identify the factors influencing the human resource management in achieving the strategic objectives of the public health sector. Motivation for the study: Managers in the public health sector can develop interventions and effective procedures to improve alignment in the human resource management of the human resources for health to improve health outcomes. Research approach/design and method: A qualitative descriptive study design with an interpretivist approach was utlised to conduct the study. A document review and sixteen face-to-face interviews were conducted, eight human resource (HR) practitioners and eight line managers purposively selected from an urban and rural district. Main findings: The public health sector provides a unique context that requires different considerations for human resource management. Human resource managers and line managers do not only have different backgrounds and orientations but they also function in different contexts (administrative vs. clinical) in the public health sector. The factors influencing effective human resource management are as follows: the lack of capacity to implement key HR strategies in the public health sector, competing priorities and the absence of clear roles in performing human resource practices. Practical/managerial implications: There is a need to foster a partnership approach between the HR manager and line manager to provide effective human resources management as it is complex and fractured, particularly during change and decentralisation. Contribution/value-add: This article addresses the research gap on human resource management in the public health sector shifting focus from individual practices to a systems thinking approach in strengthening human resource management. It also makes a theoretical contribution by adding context to human resource management as a key requirement for implementation decision making.