Rationale and Approach

The approach to District Health Management presented in this manual is based on the concept and principles of Primary Health Care. Since the mid 1980s, the health district as an operational unit has become the essential element of health policy concepts in low income countries (Harare conference in 1987). Structural adjustment and health sector reform promote the decentralisation of decision making power and financial responsibility to the district level. The complex task of building up and managing a modern health system requires professional training that goes beyond the classical transfer of knowledge. Besides sound technical knowledge, District Health Managers need qualifications like good leadership ability, communications skills, process-oriented thinking and the capacity to co-operate in local and regional networks. The experiential, participatory, problem-oriented training approach outlined in this manual, promotes practical knowledge and skills, gender/diversity-sensitivity, and the exchange of ideas, personal experiences and perspectives.