Improvement of the managerial functions of the directors of polyclinics in Cuba: an urgent necessity

Abstract

The results of a research aimed at improving the managerial functions of Cuban polyclinic directors in the current context of primary care are presented. The study addressed how these functions should be updated to meet the demands of efficiency, sustainability, and quality imposed by recent transformations of the National Health System. A cross-sectional descriptive design with a qualitative approach was applied, which included group interviews with 218 polyclinic directors and 127 municipal general health directors, as well as document review and source triangulation. The main findings revealed an insufficient normative definition of managerial functions, a predominance of clinical management over strategic management, high turnover in the position (39% with 1-3 years), a low level of teaching category (51.8% without category), and limited professional development in managerial topics. Consultation with 31 experts validated the proposed improvements with a consensus of 80.65%. It is concluded that updating the functional framework of polyclinic directors is urgent, integrating strategic, operational, performance, and transversal dimensions, as well as strengthening managerial training programs and the human resources policy in primary care.