Table . Unified methodology for assessing decision space, capacities and accountability Function / Level of decision space (DS), capacity (CAP) or accountability (ACC) Dimension Illustrative Indicator Narrow/Low Moderate Wide/High Planning Local involvement in DS Local health administrator mainly defer Local health administrators make some Local health administrator mainly planning to central planning norms/targets local-level adaptations to central include locally defined strategies and planning norms/targets targets CAP No training in planning for health Some health administrators trained in All health administrators trained in administrators; no involvement of other planning; some involvement of other planning; other sectors routinely sectors sectors involved ACC Locally elected officials play no or Locally elected officials play some Locally elected officials exercise active minimal oversight role (e.g., via oversight role but also defer to civil oversight role alongside civil service service administrators administrators Samitis) Budgeting Preparation of DS Budget line items conform mainly to Local revisions made to budget line Local revisions made to budget line regular budget central norms items but most allocative decisions items with minimal revisions made by made by higher authorities higher authorities CAP Previous achievements not Previous achievements reviewed year’s year’s reviewed to inform budgeting process to inform budgeting process ACC Locally elected officials not involved Locally elected officials involved but Locally elected officials provide input restricted by other local significant inputs to and final administrators authorization of budget HR Management of DS All HRM functions handled centrally Some HRM functions handled locally Most/all functions handled locally human resources for permanent staff; no ability to for permanent staff (e.g., posting, (including salary levels); ability to contract non-permanent staff promotion, incentive payment); ability contract most/all cadres of to contract some cadres of staff staff (e.g., ancillary staff) CAP No/few managerial staff trained in Some managerial staff trained in HRM; Most/all managerial staff trained in HRM; no performance evaluation performance evaluation mechanisms HRM; performance evaluation mechanisms used used variably mechanisms used regularly ACC Locally elected officials not actively Locally elected officials actively Locally elected officials actively involved in vested HRM powers (e.g., involved in some of their vested HRM involved in most of their vested HRM monitoring and certifying doctor powers powers
Table . Unified methodology for assessing decision space, capacities and accountability Function / Illustrative Indicator Dimension Level of decision space (DS), capacity (CAP) or accountability (ACC) Narrow/Low Moderate Wide/High Planning Local involvement in planning DS Local health administrator mainly defer to central planning norms/targets Local health administrators make some local-level adaptations to central planning norms/targets Local health administrator mainly include locally defined strategies and targets CAP No training in planning for health administrators; no involvement of other sectors Some health administrators trained in planning; some involvement of other sectors All health administrators trained in planning; other sectors routinely involved ACC Locally elected officials play no or minimal oversight role (e.g., via Samitis) Locally elected officials play some oversight role but also defer to civil service administrators Locally elected officials exercise active oversight role alongside civil service administrators Budgeting Preparation of regular budget DS Budget line items conform mainly to central norms Local revisions made to budget line items but most allocative decisions made by higher authorities Local revisions made to budget line items with minimal revisions made by higher authorities CAP Previous year’s achievements not reviewed to inform budgeting process Previous year’s achievements reviewed to inform budgeting process ACC Locally elected officials not involved Locally elected officials involved but input restricted by other local administrators Locally elected officials provide significant inputs to and final authorization of budget HR Management of human resources DS All HRM functions handled centrally for permanent staff; no ability to contract non-permanent staff Some HRM functions handled locally for permanent staff (e.g., posting, promotion, incentive payment); ability to contract some cadres of staff (e.g., ancillary staff) Most/all functions handled locally (including salary levels); ability to contract most/all cadres of staff CAP No/few managerial staff trained in HRM; no performance evaluation mechanisms used Some managerial staff trained in HRM; performance evaluation mechanisms used variably Most/all managerial staff trained in HRM; performance evaluation mechanisms used regularly ACC Locally elected officials not actively involved in vested HRM powers (e.g., monitoring and certifying doctor Locally elected officials actively involved in some of their vested HRM powers Locally elected officials actively involved in most of their vested HRM powers
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