Thank you to everyone who joined the webinar today on Reframing Decision Making. The slides that were presented can be found here. Also, any feedback or additional comments are always very welcome.

We appreciate the questions that you all posed. We didn't have time to answer all of them, so the discussion continues here with the remaining questions. 

1. Were there insights from managers on how they thought meetings could be made more effective, e.g. to have data review and discussion in those meetings?

Data review meetings were universally appreciated by all levels but there often was often not enough budget to actually conduct them regularly. If meetings did have data review, we found that the data was usually compiled, analyzed and visualised by either the Sub County or County HRIO, which also supported our insights into the concentration of data capability in those kinds of positions.

2. Did you find that HWs were empowered to make certain decisions vs. others? For example, willing to make decisions on a daily basis (microadaptations to protocols) but were hesitant to make larger decisions where they would be seen as responsible for that decision?

It seems that HWs at the facility level are very clear and feel that they have control about making the daily operational decisions at the facility such as how to organize an immunization session. However, while we saw some micro-adaptations to protocols, such as creating a separate tracking book for BCG for the maternity ward, it sought to facilitate the HW's daily operations at the facility. We tended to not see in contrast, the behaviour of or the appetite for making larger decisions that would affect broader actions. In our next webinar, we talk about the various actors in the system & the decisions they make on their own, with others, and decisions others make that impact their work. This information and further insights can also be found in our Kenya Insights report.

3. I think you said that people preferred to access data through meetings, not systems. Any thoughts about systems that can better address that point?

We found that people seemed to prefer receiving information from other actors within the system. As doctors and nurses are used to interacting with people on a daily basis, they seem to carry this preference over to higher-level positions. With many competing priorities, managers tend to have lots of trust in the people working under them to provide them with the data they need. A system is unlikely to replace this. We should look at instead, at ways that we could empower and support those that hold the data and are trusted sources of information as this human-centred layer will always be there.  

You can now watch the webinar "Re-framing how we think about decision-making: 3 lessons from healthcare workers and managers in Kenya" video and download the related presentation.