Improved Management through Participatory Appraisal and Continuous Transformation (IMPACT)

Improved Management through Participatory Appraisal and Continuous Transformation (IMPACT) is an integrated approach to strengthening vital elements of health service management. It was developed collaboratively by health managers from across Africa, through Health Partners International and Health Partners Ghana. Together, we adapted several tools to address the specific needs of areas with poor resources.

The approach: IMPACT uses a systems approach, acknowledging that health services are complex organisations and that tinkering with only a few small parts will not induce or sustain the required systemic transformation. IMPACT helps introduce management reforms while building the skills of different level managers, helping them to understand and strengthen management systems.

Tools and techniques:
IMPACT integrates a variety of tools, including Participatory Rapid Appraisal, systems analysis, change management techniques and methodologies for assessment and accreditation. It consists of four components:

  • Peer appraisal and planning
  • Building management systems and capacity
  • Integrated support and supervision
  • Quality assessment and recognition.

Key features that make IMPACT successful:

  • Simplicity - enabling all health staff to participate, despite limited experience in appraisal, planning or management
  • Strong peer participation - promoting sharing and objective appraisal
  • A constructive and non-threatening approach - creating an emphasis on moving forward
  • Comprehensiveness - ensuring all health system issues are addressed
  • Support - allowing the development of achievable plans and identification of practical solutions
  • Sustainable approaches - institutionalising better management practices and systems
  • Engagement of clients and communities with increased communication - spreading best practice within and across health services.

We use IMPACT with local health managers who adapt and integrate it into their own organisations, with a focus on improving health care delivery. IMPACT is constantly being developed and improved by those who use it. Its components are immensely popular at all levels and have helped managers implement major improvements in health services.