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Being a vertical manager (OR 0.19; CI: 0.05, 0.84) and having a higher HIV M&E knowledge score (OR 1.22; CI: 0.99, 1.49) were predictive of higher degrees of authority over HIV data use (Table 3).
As Table 3 shows, horizontal managers, facility managers, and managers in Site A exercised higher degrees of authority over HIV data collation, while being a vertical manager, working at provincial level, having a postgraduate qualification or a higher M&E knowledge score were associated with exercising a higher degree of authority over HIV data use.
Our inclusion criteria were: i) manager works at any level from facility to provincial; ii) manager is primarily responsible for general health services or information (horizontal manager) or for vertical services or information (vertical manager); iii) manager coordinates the production of HIV information (data collection, collation, analysis) and/or uses HIV information.
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We hypothesise that vertical managers and those with higher management capacity and HIV M&E knowledge exercise more authority.
Linked to this should be clarity in allocation and application of their respective roles, as ignoring this can exacerbate confusion about how vertical managers should engage with horizontal management structures (18).
For example, for the health system M&E function (which entails data collection, collation, analysis, and use (17)), administrative integration might mean that horizontal managers exercise authority in coordinating collection and collation of disease-specific data and refer to vertical managers for technical advice on how to use these data for management.
In this way, vertical managers are forced to monitor nationally defined HIV programme indicators.
We compared the distribution of dependent variables between horizontal and vertical managers (Chi-square test).
Such attitudes may perpetuate vertical managers' dominance in using HIV data rather than improving the capacity of horizontal managers.
The HIV M&E is characterised by horizontal managers producing HIV information while vertical managers use it.
Finally, vertical managers possess higher HIV M&E knowledge scores (70% vs. 51%) and HIV data use scores (70% vs. 48%) than horizontal managers.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com