Mrs. Makinda, director of the family planning clinic, heard a car pull up next to the clinic building and knew that Mrs. Ndenda, the Family Planning Services Coordinator from the Central Office, had arrived for the clinic's scheduled supervisory visit. She went to the door to greet Mrs. Ndenda, and after they had exchanged greetings and Mrs. Ndenda had greeted the rest of the staff, the Coordinator began to go through the items that she had selected to supervise on this visit. After she had listened to a clinic nurse explain family planning methods to a new acceptor, examined the clinic rooms and the contraceptive supplies, and observed another nurse conducting a physical exam, Mrs. Ndenda proceeded to Mrs. Makinda's office. They discussed the progress the clinic staff were making toward their targets and whether the staff were meeting their performance objectives. Then Mrs. Ndenda asked Mrs. Makinda for the program information that she had requested three months earlier, on how many of the program's current family planning acceptors had been with the program for two or more years.
Mrs. Makinda looked startled and a little embarrassed, "Oh, I asked Nurse Veronica Afoto to gather those figures for me. Let me go ask her for the results. Please excuse me."
Several minutes later, Mrs. Ndenda heard angry voices in the hall, and Mrs. Makinda stalked in, frowning. "I must apologize," she said, "the information is not ready. I gave Nurse Afoto the assignment three months ago, when you told me you needed this information, and she has not completed the project. In fact, she has hardly begun it. I am very sorry, because I know you need this information now to pass on to your superior. We will compile it as soon as we can." She frowned again. "I am really very annoyed with Nurse Afoto. I told her to do this assignment. She is really causing problems these days."
"What kinds of problems?" asked Mrs. Ndenda. "I haven't noticed anything wrong in her performance reviews. She seems to work very hard."
"Well, her temper is very short these days. She makes it very clear that she is unwilling to take on any additional projects. And, as we see here, she doesn't always get her work done."
"Perhaps she has too much to do."
"Oh, I don't know. Everyone here works hard."
"Why don't you let me talk with her," said Mrs. Ndenda, and Mrs. Makinda left the room to find her.
A few minutes later, Nurse Afoto entered the room, looking a little harried. "I'm sorry," she said, "I don't have very much time. I have several family planning patients waiting for me, and I have a lot of paperwork to catch up on, and Mrs. Makinda tells me I must get the information on the women who have been family planning acceptors here for more than two years to you right away. It will take me a while to compile it."
"Did you know that the information was supposed to be ready by today?" asked Mrs. Ndenda.
"Not exactly," said Nurse Afoto. "Mrs. Makinda told me several months ago that you needed this information, but she didn't give me the exact date when it was needed."
"Did she tell you how to collect the information?"
"No, but the only way I can see to do the job is to go through all the files of the women who came in for family planning this year, and look up the date when they first came to the clinic for family planning. It is very time-consuming work. I did begin it, but I am so busy with my regular work that I have no time to spare for these sorts of projects, and I can't work late these days. My mother takes care of my children during the day, but she has been sick lately and gets very tired by the end of the day, so I have to leave as early as I can. I have told Mrs. Makinda that I don't have time to do these projects in addition to my regular work, that maybe one the others could do it, but she always gives them to me anyway."
"Did she remind you that the due date was coming close?" asked Mrs. Ndenda.
"Oh, no. She tells you and that is that, you are supposed to get it done," said Nurse Afoto.
"I see," said Mrs. Ndenda. "I won't keep you much longer because I know you have to get back to work, but I want to have Mrs. Makinda join us so we can settle this now." She left the room an returned a minute later with Mrs. Makinda.
"I believe we have communication problem here," said Mrs. Ndenda, " And we need to resolve it before it gets worse. When I asked that this information be collected, you, Mrs. Makinda, correctly delegated it to one of your staff to carry out. Nurse Afoto tells me that when you asked her to do this task, she informed you that she didn't have time to carry out this assignment in addition to all her other duties. However, it seems that you thought Nurse Afoto was the most qualified. Let's discuss what happened. Did you tell Nurse Afoto how to go about collecting the information?"
Mrs. Makinda looked annoyed. "She knows perfectly well how to collect the information; you have to go through the files and record the information.
Mrs. Ndenda then asked, "Did you discuss when Nurse Afoto would be able to work on this task and whether she would need any help?"
"I told her that the information was needed in three months, and she knew she would just have to find the time. I didn't think she would need any help. We all have too much to do here, and when we are given extra work we just have to shift things around and stay late if we need to."
"But Mrs. Makinda, I told you that I can't work late these days," objected Nurse Afoto. "I really didn't know exactly when it was supposed to be done. I was hoping there would be a lull in the work and that I'd be able to get one of the other nurses to help me."
Addressing both Mrs. Makinda and Nurse Afoto, Mrs. Ndenda said, "I need to have this information in two weeks, so we can begin a study on whether family planning acceptors are content with our services. How can you manage this so that I can have it by then?"
"Well," said Mrs. Makinda, "Obviously it is too much for you to do alone, Nurse Afoto. Since this needs to be done quickly, I'll ask Nurse Esther Leribe to help you with this. I would like to meet with both of you later this afternoon to make adjustments to your workload so you can get this done in time. Would you be so kind as to tell Nurse Leribe about this meeting?"
"Yes, what time would you like to meet?" asked Nurse Afoto. They arranged to meet at four o'clock, and Nurse Afoto left the room to return to her patients.
"Mrs. Makinda, I think I'd like that cup of tea you offered me earlier," said, "It is always a good idea to check up on projects like these to make sure things are going according to schedule, that the people who have been assigned the projects know what to do and aren't running into any problems. Often when they are having problems, they don't want to come and ask for help."
"It is also a good idea," she continued, "to make sure they know when the project is due. When people have to carry out a number of different tasks, they may forget the deadline of one of them because they're working on the others. I'm glad that you are going to have Nurse Leribe help Nurse Afoto. Learning from this experience, can you think what you might do to prevent something similar from happening in the future?"
"Well," said Mrs. Makinda, "I suppose I need to discuss what I expect when I give out an assignment and see whether the person doing the assignment has any questions about it."
"Yes, that's good," responded Mrs. Ndenda. "You should also ask what you can do to make it possible for the person to carry out the assignment. You know, the staff in the clinic in the next district were able to collect this information within two weeks. Why don't you call Mrs. Otoo, the supervisor there, and ask her how they approached the task. When you meet with Nurse Afoto and Nurse Leribe this afternoon, you might discuss these ideas with them."