Health administration

What interviewers look for

• You keep services running: enough staff on every shift, medicines and supplies in stock, and equipment, power and water working.
• You manage with numbers: you read a budget, track spending against it, and use the facility's own data to make decisions.
• Records and confidentiality: patient files are complete, easy to find and protected, and information is shared only with the right people.
• Reporting on time: monthly HMIS reports are complete, accurate and sent by the deadline, and you understand how they reach DHIS2.
• Quality and people: you handle complaints fairly, lead small improvements, and work well with the Ministry of Health, partners and the community.

Questions they ask

1. 1“How would you prepare a monthly duty rota for nurses in a busy hospital?”

   Why they ask: The rota decides whether wards are safe at night and whether staff stay. The panel checks that you plan for safe staffing, skill mix and fairness, and that you have a plan for gaps.

   How to answer

   • Start from need: the minimum staff each ward needs on each shift, with at least one senior nurse on every shift.
   • Mix skills: pair new staff with experienced ones, and make sure a midwife covers maternity on every shift.
   • Be fair and open: share nights and weekends evenly, include approved leave, and publish the rota early.
   • Plan for gaps: a clear swap rule, an on-call list, and a record of overtime.

   I start from the minimum safe staffing for each ward and shift, agreed with the matron, and make sure every shift has a senior nurse and a midwife covering maternity. Then I enter approved leave and training days, and share nights and weekends evenly so the same people are not always on nights. I publish the rota two weeks before the month starts, with a simple swap rule: both staff agree and the ward in-charge approves. I keep an on-call list for sickness. When I did this at a regional hospital, complaints about unfair night shifts stopped within two months.

2. 2“The pharmacy has run out of an essential medicine twice this quarter. What do you do?”

   Why they ask: Stock-outs harm patients and damage trust in the facility. The panel checks that you look for the cause in the data and fix the system, not just place an emergency order.

   How to answer

   • Solve today's problem: an emergency order, borrowing from a nearby facility if allowed, and telling clinicians the alternative in the guidelines.
   • Find the cause: compare consumption with orders, check the stock cards, delivery times and whether the supplier delivered as agreed.
   • Fix the system: set minimum and maximum levels from real consumption, and review key medicines with the pharmacist every month.
   • If the cause is upstream, report it in writing to the ministry or partner that supplies the facility.

   First I would make sure patients are covered today: an emergency order, borrowing from a nearby facility if that is allowed, and telling the clinicians which alternative in the guidelines to use. Then I would sit with the pharmacist and look at the stock cards. Often consumption has grown but the order quantity has stayed the same, or deliveries take longer than we planned for. I would reset the minimum and maximum levels from recent consumption and build the delivery time into the reorder level. We would review key medicines every month, and if the problem was supply from the ministry or a partner, I would report it in writing.

3. 3“How do you keep patient records complete, easy to find and confidential?”

   Why they ask: Lost or incomplete files lead to repeated tests and unsafe care, and leaked information harms patients. The panel checks that you know a filing system, access rules and how records are released.

   How to answer

   • Use a unique patient number and one file per patient, with a clear filing system and an index to find the file.
   • Control access: locked storage, files signed out and back in, and passwords and user roles in any electronic system.
   • Share only on a need-to-know basis: release a file only with the patient's written consent or a legal requirement, and record every release.
   • Follow the rules for keeping and disposing of old records, and back up electronic data regularly.

4. 4“Our monthly HMIS reports are often late and incomplete. How would you fix that?”

   Why they ask: Late reports make the facility invisible in planning, and it can lose supplies or support. The panel checks that you find the real cause and build a routine that lasts.

   How to answer

   • Find out why: missing registers, unclear responsibility, untrained staff, or no internet for DHIS2 entry.
   • Set a routine: a named person for each register and an internal deadline a few days before the official one.
   • Check before sending: compare key numbers with the registers and with last month's report.
   • Use the data inside the facility so staff see why it matters, for example a one-page summary at the staff meeting.

   I would first find out why. In one facility I supported, the registers were complete but nobody was responsible for the monthly summary, and the only person trained in DHIS2 was often away. I named one staff member for each register, set an internal deadline a few days before the official one, and arranged for a second person to be trained in data entry. Before submitting, the in-charge and I checked five key numbers against the registers. We also started showing a one-page summary at the monthly staff meeting. After that, reports went in on time and staff understood why the numbers mattered.

5. 5“Funding for the year is lower than planned. How would you manage the facility budget?”

   Why they ask: Many facilities run on uncertain government and donor funds. The panel checks that you protect essential services, track spending against the budget and follow the rules on how money can be used.

   How to answer

   • Protect the essentials first: staff pay, essential medicines, infection prevention supplies, and power and water.
   • Track budget against actual spending every month, and explain any large difference in writing.
   • Look for savings that do not harm care, such as cutting waste and comparing supplier quotes.
   • Never move money between budget lines or donors without written approval; raise the gap early with the ministry or donor.

6. 6“A family complains that a nurse was rude and that they waited for hours. How do you handle it?”

   Why they ask: Complaints are useful information and a test of fairness. The panel checks that you listen, look at both sides, reply on time and fix the cause, without protecting or punishing anyone too fast.

   How to answer

   • Listen, thank them, and record the complaint: the date, what happened and what they want.
   • Look at both sides: speak with the nurse and the in-charge, and check the records and waiting times.
   • Reply to the family within the time your policy sets, saying what you found and what will change.
   • Fix the cause, such as staffing at peak hours, triage at the entrance or coaching for the staff member, and track complaints each month.

7. 7“Describe a quality improvement project you would start in your first months.”

   Why they ask: The panel checks that you can pick one measurable problem, test a change and measure the result, instead of promising to improve quality in general.

   How to answer

   • Choose one real problem, such as long outpatient waiting times or incomplete partographs.
   • Measure a baseline first, for example the time from arrival to seeing a clinician, for one week.
   • Test one change with the staff using PDSA: plan, do, study, act.
   • Measure again, keep what works, and share the result with the team.

   I would start with outpatient waiting times, because patients complain about them most. For one week, staff would note the arrival time and the time each patient sees a clinician, so we have a baseline. With the team I would test one change, such as triage at the gate, so very sick patients go straight in and simple follow-ups use a separate queue. After two weeks we measure again. If waiting times fall, we keep the change and share the results at the staff meeting; if not, we adjust and test again. That is the plan-do-study-act cycle.

8. 8“How do you work with the Ministry of Health and the partner NGOs that support the facility?”

   Why they ask: Most facilities depend on ministry guidance and partner support. The panel checks that you follow national policy, report on time, and coordinate so partners neither duplicate work nor leave gaps.

   How to answer

   • Follow national guidelines and reporting, and attend district or regional coordination meetings.
   • Keep one clear picture of who supports what: staff incentives, medicines, equipment and training.
   • Report problems and results honestly, in writing and on time.
   • Keep relations professional and transparent, and never accept gifts or favours that could influence decisions.

Example answers are in English, the language most panels use. Say it in your own words.

Topics to revise

• Duty rota and skill mixA duty rota shows who works which shift, in which ward, for the month. Skill mix means each shift has the right combination of senior and junior staff and the right professions, such as a midwife in maternity. Panels may ask how you cover a shift when two nurses call in sick.
• Essential medicines listThe national or WHO list of medicines a facility should always have. Stock-outs of these items are tracked closely, and when money is short the list tells you what to buy first. A panel may ask how you would decide which items to protect in a tight budget.
• Min–max stock and reorder levelThe reorder level is the stock at which you place an order; the maximum is the most you should hold. Both are set from average monthly consumption and the time a delivery takes. As a manager you review them with the pharmacist regularly, not only after something runs out.
• HMIS and DHIS2HMIS runs from registers and tally sheets at the facility, to a monthly summary form, to data entry into DHIS2 at district, regional or facility level. Know the monthly deadline, who signs the report, how you check it before sending, and what you have personally done in DHIS2.
• Reporting completeness and timelinessCompleteness is the share of expected reports received with every field filled; timeliness is the share received by the deadline. These are often the first numbers a ministry or partner looks at for a facility, and a common interview question is how you would raise them.
• Unique patient ID and filingOne number per patient, used on every file, register and form. Common filing systems are straight numeric and terminal-digit filing. A master index by name and number lets staff find the file when a patient forgets the number. Records posts may test you with a filing or retrieval exercise.
• ICD codingThe International Classification of Diseases gives each diagnosis a code, so causes of illness and death can be counted and compared. Many systems still use ICD-10, while ICD-11 is WHO's current version. Records and health information officers may be asked to code a few diagnoses from a short list.
• Confidentiality and release of informationPatient information goes only to people directly involved in care, or to others with the patient's written consent, or when the law requires it, and every release is recorded. Know what you would do when a relative, an employer or an official asks for a file: ask for the written request and follow the facility's policy.
• Budget vs actual (variance)Each month you compare what was planned with what was spent, line by line. The variance is the difference; large ones are explained in writing. Donor-funded budgets have their own rules on moving money between lines, usually with written approval. Expect an Excel or paper exercise on this.
• Quality improvement (PDSA)Plan-do-study-act: plan a small change, try it, study the measured result, then adopt, adapt or drop it. Common facility topics are waiting times, hand hygiene compliance and complete partographs. Panels prefer one small, measured example to a big promise.
• Complaints and feedback mechanismA clear way for patients to complain (a box, a phone number or a named person), a log, a fair investigation, a reply within a set time, and a monthly look for patterns. Anonymous complaints are also taken seriously. Panels often turn this into a role-play with an angry relative.
• Supportive supervisionRegular visits or checks where the manager observes work with a checklist, gives feedback in private and solves problems together with staff. It is different from an inspection that only looks for faults. Panels may ask how you would supervise a department head who is older or more senior than you.

Practical tasks you may get

1. 1Excel test, 45 to 60 minutes: build a simple duty rota, a budget-versus-actual table with variances, or a summary of monthly service data with a chart. Practise SUM, simple formulas, percentages, sorting and a basic chart before the day.
2. 2Case study: a facility with stock-outs, late reports and staff complaints. You write a short plan with priorities, who does what and by when. Put patient safety first and keep it realistic for the resources described.
3. 3Writing task: a one-page memo or email to the regional health office or a partner, reporting a problem such as a broken generator or an HMIS delay, and asking for specific support by a date.
4. 4Records task: file or retrieve records by patient number, spot errors in a register, or code a few diagnoses with ICD. Practise with a sample register and the ICD index if you are applying for a records post.

Mistakes to avoid

• Talking only about paperwork and forgetting that every management decision affects patient care.
• Promising to improve quality with no specific problem, no measure and no example.
• Suggesting you would move money between budget lines or donors without approval to close a gap.
• Treating confidentiality lightly, such as saying you would give a file to any relative who asks.
• Blaming staff for every problem instead of looking at the system: rotas, supplies, training and workload.
• Claiming DHIS2 or budget management experience you do not have; panels ask for the exact tasks you did.

Quick check

5 questions. Answer each one to see the explanation.