SUBGRANTING AND EFFECTIVENESS OF HEALTH P OJECTS;

A ASE OF AIDS RELIEF SERVICES-NSAMBYA IN

KAMPALA DISTRICT, UGANDA

A Thesis

Presented to the College of

Higher Degrees and Research of

Kampala International University

Kampala, Uganda

In Partial Fulfillment of the

Requirement for the Award of the Degree of

Master of Project Planning and Management

BY:

Kazadi Ntumba Bintu MPP/33723/111/DF

October, 2012 DECLARATION A

I, the undersigned declare that, this Thesis ~Sub-Granting and Effectiveness of Health Projects; A Case Study of Aids Relief Services in Kampala, Uganda”is my own original compilation and has never been presented to any organization or institution of higher learning either as a paper or for any academic awdrd.

I also hold full responsibilities for all the mistakes in this study.

Signature:

KAZADI NTUMBA BINTU MPP/33723/111/DF

Date: :~SL~J+tl ~ APPROVAL

This is to Approval that this Thesis entitled “Sub-Granting and Effectiveness of Health Projects; A case Study of Aids Rellef Services in Kampala, Uganda” Prepared and submitted by Ms. Kazadi Ntumba Bintu in partial fulfillment of the requirement for the award of the Degree of Master of Business Administration, Procurement and Supplies, has been examined and approved by the panel on oral examination with a grade of PASSED.

Name and Sig. of Chairman ~ZQ ~bd~1,t~ 4~~f~% Dr. Emuron Lydia Name and Sig. of Panelist

6 _ Name and Sig. of Panelist Name and Sig. of Panelist

Date of Comprehensive Examination:

Grade:

Name and Sig. of Director, CHDR

Name and Sig. of DVC, CHDR DEDICATION

I dedicate this piece of work to the Almighty God and to my family, most especially my husband Mr. Kazadi Mwayabo and children, Emmanuella Kazadi, Benitta Kazadi and Chris Kazadi, Colleagues; Niece as well as Nephews among others who played a very fundamental role in shaping and guiding me from and throughout my academic endeavors.

To my Parents; Mr & Mrs. Ntumba Kalombo Alphonse and Bintu Musenga Cecile; Munsense Christophe (RIP), Kayiba Generose, Lyly Nunsense whose support, encouragement, patience and most of all love, had given me strength to preserve through all those stressful moments during these two years.

iv ACKNOWLEDGEMENTS

I wish to thank the AlmIghty God for gMng me strength, grace, Opportunity and mercy In accomplishing this work. All that we know is a sum total of what we have learned from all who have taught us, either directly or indirectly.

I am forever gratified to the countless outstanding men and women who by their commth~ent and dedication to becoming the best they could be, have inspired me to do the same.

Dr. Novembrieta R. Sumll (DVC-CHDR) thank you very much for your outstanding contribution to our institution.

Dr. Mwanlki with your team member I thank you so much for the work welldone,maytheLordbewlthyou.

Managing Director Aihajjl Hassan Basajjabaiaba for being innovatIve and creative ideas in this great institution may you live to blow a thousand candles. I also wish to sincerely thank my Research Supervisor, Dr. Emuron Lydia who contiibuted a lot to the outcome of this research report

My sincere thanks to all the Health Projects of catholic Relief services, who took time to complete the questionnaires; all the staff and administrators, who were morally supportive and from whom most research assistants were selected.

I also thank the one anonymous reviewer for theIr comments on the final version of this ThesIs. I remain responsible for any errors In the paper.

Finally, I thank all those who contributed to the outcome of this pIece of work whose names would not appear here because of space and am appreciative to you all and Almighty God bless you.

V ABSTRACT

The study intended to establish the relationship between Sub-Granting and Effectiveness of Health Projects; the case of Aids Relief Services in Kampala, Uganda. The study was guided by the four objectives which included determining;- the demographic profile of the respondents ; level of successful Subgranting management; Level of effectiveness of health projects and significant relationship between level of successful subgranting and level of effectiveness of Health projects in Kampala. Researcher made questionnaire was used to collect data from 372 respondents selected purposively. A descriptive correlational, cross- sectional and expos-facto design were used. Data analysis was done using frequencies, percentages, means, and Pearson linear correlation coefficient (PLCC) were used to analyse data. More than half of the study participants were female (75.0%), Majority of the participants (33~O%) fall under the early adult stage of life (25-29 old), had Bachelor holder (37.4%),married (33.O%), clinical officers (37.4%), and had spend 3-4 years (30.9%). All aspects of subgranting were found to be positively and significantly correlated with effectiveness of Health projects. All aspects of subgranting were found to be High for example overall (mean=3.15). All aspects of Effectiveness of Health projects were found to be High for example overall (mean=3.24). The findings reveal that there is a significant correlation between subgranting and effectiveness of service delivery of health projects. The best way of subgranting is to have a manual for guiding and follow up of the process inflow and outflows. The researcher recommended that; government of Uganda to strengthen the training programmes in effectiveness of health institutions; Physical inspection; gathering physical evidence; providing written requests ,examining documents, obtaining management and employees’ responses, strengthen the participation at community level, evaluate a general contractor, compare the information contained in the document with other known information, improved feedback mechanisms among others. The staff must be skilled, transparent and be able to work as a team. In form of international system of contract management is required to ensure rights, obligations and expectations are monitored, feedback mechanization should be set and followed at all levels. Lack of expired drugs in the store, good financial management, high community participation and prompt responsiveness of subcontractors indicate effectiveness of health projects in Kampala Central Division. Once the above aspects are attended to, the subgranting will be a very useful vice in improving service delivery of health projects.

vi TABLE OF CONTENTS

PRELIMINARIES DECLARATION A I DECLARATION B II APPROVAL III DEDICATION IV ACKNOWLEDGEMENT V ABSTRACT VI TABLE OF CONTENT VII ACRONYMS X LIST OF TABLES XI LIST OF FIGURES XII

Chapter Page

One THE PROBLEM AND ITS SCOPE 1 Background of the Study 1 State ment of the Problem 3 Purpose of the Study 4 Research Objectives 4 Research Questions 4 Scope 5 Significance of the Study 6 Operational Definitions of Key Terms 7

Two REVIEW OF RELATED LITERATURE 9 Concepts, Ideas, Opinions from Authors/Experts 9 Theoretical Perspectives 15 Related Studies 15

vii Three METHODOLOGY 29 Research Design 29 Research Population 29 Sample Size 29 Sampling Procedure 30 Research Instrument 31 Reliability 31 Validity 32 Data Gathering Procedures 32 Data Analysis 33 Ethical Considerations 34 Limitations of the Study 34

Four DATA INTERPRETATION, PRESENTATION AND ANALYSIS 36 Demographic profile of the respondents 36 Level of successful Subgranting management 39 Levels of effectiveness of health projects 43 Relationship between subgranting and effectiveness of Health projects 55

Five FINDINGS AND RECOMMENDATIONS 57 Introduction 57 Summary findings 57 Conclusion 58 Recommendations 59 Area for further research 61

viii References 62 Appendices 67

Appendix I A - Transmittal Letter from CHDR 67

APPENDIX lB - Transmittal Letter for the Respondents 68

Appendix II - Clearance from Ethics Committee 69

Appendix III - Informed Consent 70

Appendix IVA - Demographic characteristics of the respondents 71 Appendix IVB-Questionnaires to determine the level of successful subgranting in health projects 72 Appendix IVC-Questionnaires to determine the effectiveness of Health projects 73

Appendix V - Sample size determination 76 APPENDIX IX: Sketch map showing the location of the study area 77 Researcher~s Curriculum Vitae 78

ix ACRONYMS

C~s : Consideration, Communication, Cooperation and Compensation CRS : Catholic Relief Services FGI Futures Group International IMA : Inter-Medical Association NHC : Nsambya Home Care OHS : Occupational Health and Safety PM : Project Planning PMP : Project Management Plan QC : Quality Control RFPs : Requests for information SOW : Scope of Work USG : United States Government WHO : World Health Organization

x LIST OF TABLES

TaWe Page Table 1: Population and Sample size distribution 30 Table 2: Cronbach’s Alpha for Subgranting and effectiveness of Health project 31 Table 3: Content validity index 32 Table 4: Number of respondents (372) 36 Table 5: Demographic Profile of Respondents in terms of gender, age, marital

status educational Level , Position in the organisation and Length of experience (n=372) 37 Table 6: Extent of subgranting Item Analysis (n=372) 39 Table 7: Levels of effectiveness of health projects (n=372) 44 Table 8: Relationship between the Relationship Level of subgranting and Extent of effecticeveness of Health projects in Aids Relief Centre-Nsambya-Kampala Uganda. 56

xi LIST OF FIGURES

Hgure Page

Hgure 1: Conceptual Framework 13

xii CHAPTER ONE THE PROBLEM AND ITS SCOPE

Background of the Study Subcontracting is a common practice in the commercial construction industry. On any particular project, general contractors may rely on 20 to 40 Subgrantings to perform the specific work items that are required. A typical group of contractors that work together on a project may include such diverse trades as electrical, drywall, roofing and steel erection to name a few. The characteristics of the project dictate the type, size and capabilities of each Subgranting that may be required (Knutson, Schexnayder, Fiori & Mayo, 2003). Each project has a unique combination of job-specific Subgrantings that are typically assembled under a general contractor acting as the head. The general contractor may also have his own labor force working alongside the various Subgrantings throughout the project. There is a team approach to completing the work on most projects with the general contractor taking the lead to manage the jobsite and direct the personnel. Subgrantings are a vital component of the success of every construction project. (Gliner, etaL,2000).

In many areas of projects practice, projects are utilizing project management (PM) concepts. PM concepts are increasing the quality and productivity level of services and products. Urban design it self is a project based profession. Therefore, urban designers may use the principles and concepts of PM for their projects. Urban designers are already adopting PM concepts to their projects around the world. especially, in the West, it is possible to see many examples concerning urban transformation, urban regeneration, conservation etc. The cases of London Dockland, Manchester Hulme City, Chicago are some of the examples in which the best practice of project management are exposed. On the other side, there are not many extensive studies which help us to grasp the condition of project management in Turkey’s urban design practice. Existing studies have dealt with the subject as big construction project (Loader et at, 1999) The Subgranting/subcontracting process; all sub grantees must comply with manual grant requirements as described for the specific grant year. The sections below briefly explain what the process entails and what information is mandatory to successfully administer a sub granted project from beginning to end. All projects are unique therefore we encourage sub grantees to use the information below as a quick reference guide and contact their program manager in advance to discuss each project individually (Loader etat, 1999)

Sub grantee must submit the following documents to Aids relief service: Scope of Work & Budget: Use exhibit A & B Form; special approvals: Some projects require special approvals which are outlined below; Equipment approval: Classify the equipment for your project; In rare occasions equipment needed for a project may not fit any of the classifications. Contact your program manager if this is the case with equipment for your project. Prepare the material for approval using Exhibit C Form Follow the example provided to fill out your equipment budget sheet correctly. If you have further questions, contact your program manager for guidance. Obtain approval from the Multi-disciplinary Equipment Planning Group (MEPG) and the State Equipment Subcommittee. Contact your program manager for monthly meeting schedules. Sole source vendor / Consulting Services approval

The Sub grantee must present a Narrative Progress Report and as indicated in the sub grant agreement. The sub grantee may choose to seek reimbursement for expenses incurred during the period reported or request a one time reimbursement after the project has reached its conclusion. For all requests for reimbursement of approved project expenses the sub grantee must submit: A. Narrative Progress Report with original authorized signature B. Invoice Summary and Detail Form with original authorized signature C. Complete, organL~ed and clearly identified supporting documents (copies are acceptable) cross referenced 2 to deliverables in sub grant agreement, which include but are not limited to: Purchase orders for equipment; Packing slips for equipment; Invoice from vendor.

Some of the studies that relate skills to health workers’ performance are Lule (2003) who examined continuing medical education and health worker performance; and Harrington (2003), who examined training as an incentive to improve the performance of employees. Some of the studies relating motivation to health workers’ Performance are those of: Hill eta! (1992) which probed the effects of delayed rewards and task interest on intrinsic motivation; Dolea (2005) which studied motivation of health care Workers’ emphasizing theories and evidences. All these studies looked at motivation and skills as isolated determinants of health workers’ performance.

Amount of the subgranting available to commit toward activities or available to sub fund or subgranting; All equipment purchased with Homeland Security grant funds is subject to inspection for the subsequent six years after the performance period has ended and sub grantee must make the equipment available for inspection when requested. Amount of the subgranting available to drawdown. This is the amount of the grant minus the amount drawn (Gliner, et a~ ,2000).

Statement of the Prob’em Many projects in the Health sector have several Health products to distribute. These products cannot be distributed solely by the project staff. Most project managers therefore opt to subcontract people or firms to deliver the products (Gliner, et aL, 2000). Despite this methods of easing service delivery in Uganda, most health products still expire before they can be used by the intended clients. Does subcontracting necessarily guarantee effectiveness of health projects? It upon this background that the research is keen to establish the where there is a relationship between subcontracting and the effectiveness of health projects using Kampala district in Uganda as the study.

3 Purpose of the study The following are the reasons why this study was conducted; (1)to test the hypothesis of no significant relationship between the level of Subgranting management and the extent of effectiveness of health projects. (2) to validate existing information related to the economic game theory model of fudenberg eta/.,1991 to which this study is based; (3) to generate new information based on the findings of the study; (4) to bridge the gaps identified in the previous studies.

Research Objectives Genera~ objective; This study investigated the relationship amid Sub-Granting and effectiveness of Health Projects to provide counter evidence and drawing on their contribution in Kampala Central Division-Uganda.

Specific: The study was to; (i) To determine the demographic profile of the respondents in terms of: gender, age, educational qualification post/position in the organization and length of experience (ii) To determine the level of Subgranting management in Kampala Central division. (iii) To determine the level of effectiveness of health projects in terms of delivery date, specification, support arrangement, dealing with disputes, negotiate changes and terms of reference in Kampala Central division. (iv) To establish whether there is a significant relationship between the level of subgranting management and level of effectiveness of Health projects in Kampala Central division Research Questions (i) What is the demographic profile of the respondents in terms of: gender, age, educational qualification post/position in the organization and length of experience? 4 (ii) What the level of subgranting management in Kampala Central division in Kampala Central division (iii) What is the level of effectiveness of health projects in terms of delivery date, specification, support arrangement, dealing with disputes, negotiate changes and terms of reference in Kampala Central division in Kampala Central division. (iv) Is there a significant relationship between the level of subgranting management and level of effectiveness of Health projects in Kampala Central division in Kampala Central division

Scope of the Study Geographkall Scope The study concentrated on Aids Relief service centre in Nsambya, along Ggaba Road in Makindye Division whose headquarter is in Uganda which carries out multiple health projects/services and holds a diversity of categories of health projects. The centre distributes its products to Health Projects. Each hospital is both a district hospital and a provider of regional services. The health projects bear responsibility for delivering effective services, within nationally-determined healthy policy and standards as stipulated by Ministry of Health and National Medical store, (1998).

Theoretical Scope The contentions, to which this study is based, are on economic game theory model of Fudenberg et al., 1991, where subgranting resource, allocation behavior. periodic review and adjustment of resource allocations to construction projects is critical for Subgrantings to maintain profitability under traditional unit price or lump sum contracts.

Content Scope This study mainly focused on subgranting management and effectiveness of Health Projects it included the internal departments that relate with tendering and 5 contracting as well as the external parties which include general clinics and Health projects. The study, further investigated the relationship amongst Subgranting and the effectiveness of health projects in Kampala Central division. The study particularly focused on skills, total quality management, timeliness, financial accessibility, motivation and effectiveness of health projects because, as stated by Dolea (2005), they are the key variables in hospital settings and their existence makes patients go to hospitals for services

Time Scope

The study was conducted within one year from January , 2011 to October, 2012. It started with a proposal development between January 2012 to July, 2012 the next activity was formulating the last few chapters of the study wherein the data gathered from the survey will be integrated and the analysis of the data included in the research. This took place with in May 2012 and March- April, was for writing a final report and in July the final report would be submitted, defended and final correction be handed over in October.

S~gnificance of the Study Government~ the Catholic Relief Centre System is declining in performance. Because of this, any study which was intended to identify the causes and solutions to the problem should be Significant for our government, hospital system, and the citizenry. The study may help government to understand the nature and level of skills required for effective and efficient performance Health sector. The government may be able to come up with proper subgranting/subcontracting recruitment and retention strategies for the National Health Referral System.

Researchers the findings from this study may also be important for researchers, lobby groups, government institutions, students and scholars in Project management. Although scholars and practicing managers have embraced behavioural management for about three decades (Pfeffer, 1995 Kopelman, 1986; Luthans & Kreitner, 1985); scant attention has been paid to the composite

6 effectiveness of health projects and Subgranting on project performance. The findings of this study therefore may form a basis of addressing important challenges, identifying new challenges as well as new areas of research which can be followed up fruitfully

Management it would also enhance management of Aids Relief Service in their bid to secure transparency, dependable, reliable service free from defects. This would enhance contractors” satisfaction and increased contract acceptance to gain sufficient workflow.

Operation& Definftions of Key Terms For the purpose of this study, the following terms are operationally defined as follows: Subgranting refers to an individual or in many cases a business that signs a contract to perform part or all of the obligations of another~s contract. A Subgranting is hired by a general contractor to perform a specific task as part of the overall project. While the most common concept of a Subgranting is in building works and civil engineering, the range of opportunities for Subgranting is much wider and it is possible that the greatest number now operate in the information technology and information sectors of business.

Effectiveness of Health Project refers to a state of complete physical, mental, and social well-being and the easy at which the service delivery are executed with less cost but with high quality output as well as covers some organizational resources enabling new creations

Competitor Ana/ysis refers to a companyTs marketing strategy which involves assessing the performance of competitors in order to determine their strengths and weaknesses and completion of the project in approved cost estimation.

7 Compilance Officer; refers to a corporate official whose job is to ensure that a company is complying with regulations, and that its employees are complying with internal policies and procedures.

Cost effective; refers to producing a product, offering a service, etc., in the most economical way to the benefit of the company and the customer.

EffectIveness refers to means the capability of producing an effect, and is most frequently used in connection with the degree to which something is capable of producing a specific, desired effect.

General Contractor refers to responsible for the day~to~day oversight of the construction site, and management of vendors and trades. In addition, keep communication between the general contractor and the involved parties open and clear through out the course of project. Before starting a job, the general contractor must first assess the project specific documents. In the case of renovations, sometimes a site visit is required to get a better understanding of the project. As a result of this, the contractor will generate a price, also called an “estimate”. The general contractor considers the cost of materials, equipment as well as the cost of labor to provide the owner with an approximate price for the project. In these contract documents, the contract agreement includes budget, the general and special conditions and the plans and specification of the project that are prepared by a design projects such as an architect. In many instances the general contractor is the project engineer or project manager for construction projects.

8 CHAPTER TWO REVIEW OF RELATED LITERATURE

Concepts, Ideas, Opinions from ExpertslAuthors Subgrantor Refers to a firm which is hired by a general contractor to perform a specific task as part & the overall project. While the most common concept & a Subgrantlng Is In building works and cMl engineering, the range of opportunitIes for Subgrantlng is much wider and It Is possible that the greatest number now operate In the information technology and information sectors of business (Aumann,et at,1987).

Subgrantlng Refers to an IndMdual or in many cases a business that signs a contract to perform part or all & the oblIgatIons of another’s contract. A Subgrantlng Is hired by a general contractor to perform a specific task as part of the overall project. While the most common concept & a Subgrantlng is In building works and cMl engineering, the range & opportunitIes for Subgrantlng Is much wider and it Is possible that the greatest number now operate In the Information technology and information sectors of business (Arditi et at, 2005). The sub grantee may choose to seek reimbursement for expenses incurred during the period reported or request a one time reimbursement after the project has reached Its conduslon (Arditi et at, 2005)

Many projects rely on the supply & hardware, software, facilities and services by various vendors or sub-contractors. The Project Manager may need to: select the best suppliers, conditions, agree, ensure the goods or services supplIed are acceptable, deal with disputes, negotIate changes where the dient requires new or changed deliverables from the vendor, ensure the vendor or sub contractor Is paid In accordance with the agreement, manage the relationship to maintaIn a good workIng relationship (Miller, etat, H2003). 9 General Contractor Refers to responsible for the day-to-day oversight of the construction site, and management of vendors and trades. In addition, keep communication between the general contractor and the involved parties open and clear through out the course of project. Before starting a job, the general contractor must first assess the project specific documents. In the case of renovations, sometimes a site visit is required to get a better understanding of the project. As a result of this, the contractor will generate a price, also called an “estimate”. The general contractor considers the cost of materials, equipment as well as the cost of labor to provide the owner with an approximate price for the project (Arditi et a!., 2005) • In these contract documents, the contract agreement includes budget, the general and special conditions and the plans and specification of the project that are prepared by a design projects such as an architect. In many instances the general contractor is the project engineer or project manager for construction projects.

Quallty checks and Performance Monitoring The main quality issue that the Quality Control (QC) division worries about is a part failing to meet measurement specifications (Chester, et a!., 2005). The incorrect measurements result either from vendor error or using equipments beyond their acceptable lifetime. To contain the former, detailed quality checks are carried out when a vendor first starts supplying a part and for the latter, routine quality checks are carried out at regular intervals to ensure that the vendor maintains quality. Additionally, at the end of the yearly contract, the QC division evaluates the past performance of vendors. This is used in future price negotiations, and in deciding the future level of orders (Chester, eta!., 2005)

General contractors utilize Subgrantings for various reasons such as: ifthey lack expertise in these types of work, it enables them to limit their risk exposure or it expands their available workforce so they have more opportunities to bid on

10 new projects (Gould & Joyce, 2009). Approximately 80% of the dollar value of construction is accomplished under subcontracts therefore the Subgranting”s perspective is important (Currie, Sweeney & l-Iafner, 1991).

Subgrantings rely on general contractors for virtually all of their work and the relationships they maintain with general contractors in their geographic area directly affect their long term success. Generally, a Subgranting evaluates the performance of the general contractor on a project-by-project basis (Arditi et at, 2005). A Subgranting can choose which general contractor to work with and this business decision can be affected by a number of factors. The perceived fairness and capability of the general contractor can be significant factors when considering futUre work with that general contractor (Knutson eta4 2003)

Although the practice of subcontracting is widespread and well established in the construction industry, there has been little research done on the topic. Subcontracting has only recently begun to be studied in peer-reviewed journals within the last 15 years. Prior to this, the topic was explored primarily in books and trade journals. Garrett (1979) published one of the first books about subcontracting. It was a broad presentation of the issues that are important to the subcontracting community including “principles of business management, accounting and other subjects that are particularly relevant to specialist subcontracting” (Garret, 1979, p. 2). The book was to be used as a training aid and a reference; it covered basic topics such as contracts, payment issues and estimating principles. Another major publication that has contributed to the current base of knowledge regarding subcontracting and Subgrantings is the book written by Currie, Sweeney and Hafer (1991), Construction Subcontracting: A legal Guide for Industry Projects.

A general contractor is responsible for the day-to-day oversight of the construction site, and management of vendors and trades. In addition, keep

~11 communication between the general contractor and the involved parties open and clear through out the course of project (Elton etaL, 1998)

Before starting a job, the general contractor must first assess the project specific documents. In the case of renovations, sometimes a site visit is required to get a better understanding of the project. As a result of this, the contractor will generate a price, also called an “estimate”. The general contractor considers the cost of materials, equipment as well as the cost of labor to provide the owner with an approximate price for the project. In these contract documents, the contract agreement includes budget, the general and special conditions and the plans and specification of the project that are prepared by a design projects such as an architect (Hendrickson, et a/.,2000)

Since Subgrantings secure virtually all their work through general contractors, the success of the typical Subgranting depends directly on the relationships they establish and maintain with those general contractors that need their expertise. Once the relationship is established, most Subgrantings work with the same general contractors on a regular basis and they tend to maintain the relationship over time (Shash 1998). stated that “general contractors and Subgrantings may not cooperate in a highly recurrent way; nevertheless they entertain long term business relations”. Statistics presented in the publication indicate that 76% of commercial Subgrantings have maintained their relationships with general contractors for an average of 21.1 years (Shash, 1988, p. 442).

In his paper, Golden Rule of Contractor-Subgranting Relations, Proctor (1996) emphasized the importance of developing a spirit of trust between general contractors and subcontractors which requires a long-standing practice of fair dealing between parties. He detailed the four Cus of the general contractor Subgranting relationship: consideration, communication, cooperation and compensation stating that “the ultimate responsibility for successful completion of a project lies with the general contractor” (Proctor, 1996, p.14). 12 Figure 1: Conceptual Framework Independent Variable (IV) Dependent rariable (DV) ~granting I

Productivity Effectiveness of ______r Health projects I~.______V Delivery date Transparency V Negotiate terms V Agree contracts

______V I— Negotiate changes Accountability V Select best supply I~’ V Deal with disputes ~imedeIive~~~ V r~a~ment V specification Efficiency

Source : Primary data

Figure 1. above illustrate the relationship between Subgranting management in terms of productivity, transparency, accountability, on time delivery as well as efficiency in relation to effectiveness of Health projects. In order to procure new work, Subgrantings typically submit bids to general contractors within their geographic area. Subgrantings are notified by general contractors about new bidding opportunities on upcoming projects that are in line with their expertise and experience (Huycke, etaL, 1998)

In addition to this, by referring to the knowledge areas of project management Gunaydin express that a project manager must be aware of the knowledge of technical fields used in the project and have the knowledge of general management and project management. Besides, he also informs about the requirements of international projects. According to this, project managers are

1—, I-, expected to have the certificate of “projects project manager” given by the Project Management Institute to work for an international project (Günaydin, 2001: 4)

Accountability Accountability is the obligation to render an account for the responsibility conferred. When systems for public transparency and accountability are being devised, four questions must be considered: (a) who is accountable? (b) for what is s/he accountable? (c) to whom is s/he accountable? and (d) how is that accountability discharged? As the discharge of accountability requires transparency, in this concept we will henceforth use the term ‘accountability’ as a shorthand for ‘accountability including transparency’ This concept examines financial aspects of accountability for the use of public funds, that is, fiscal accountability (Fernandez et aI.,1998 0. It explains the growing demand for fiscal accountability, answers the who, for what, to whom and how questions, describes the move toward performance accountability, details the benefits and costs, and concludes with general recommendations.

Effectiveness Refers to means the capability of producing an effect, and is most frequently used in connection with the degree to which something is capable of producing a specific, desired effect (Arditi etaL, 2005).

Effectiveness ofHealth Project it refers to a state of complete physical, mental, and social well~being and the easy at which the service delivery are executed with less cost but with high quality output as well as covers some organizational resources enabling new creations (Arditi eta!., 2005)

It has been the tradition in many firms to organize around marketing and production functions. Typically, marketing means selling something and production means making something. Although few business people would agree 14 that their organization is so simple, the fact remains that many businesses emphasize these functions while treating other activities, such as traffic, purchasing, accounting, and engineering, as support areas. Such an attitude is justified to a degree, because if a firm’s products cannot be produced and sold, little else matters. However, such a pattern is dangerously simple for many firms to follow in that it fails to recognize the importance of the activities that must take place between points and times of production or purchase and the points and times of demand. These are the logistics activities, and they affect the efficiency and effectiveness of both marketing and production (Fernandez etaL,1998)

Theoretical Perspective. This study based on the Economic Game Theory Model of Subgranting Resource Allocation Behavior of Fernandez et aL,1998, it states that, periodic review and adjustment of resource allocations to construction projects is critical for subcontracting/Subgranting to maintain profitability under traditional unit price or lump sum contracts. Project managers strive to control subcontracting/Subgrantings in an effort to meet budgets and schedules; Subgrantings/contracting often work on multiple projects simultaneously and strive independently to allocate resources to those projects where they perceive that they will bring maximum utility. An economic game theory model is proposed as a foundation for understanding the behaviour of Subgrantings in allocating resources to projects. The model describes the influence of the degree of reliability of the planned schedule on Subgrantings~ and project managers behaviours under traditional unit price contracting. Unreliable plans undermine efforts to promote cooperative behaviour.

Related studies

Tracey (1991) studied the Subgranting-general contractor relationship with the purpose “to better understand this relationship and possibly improve it” (p. 3). The thesis detailed the common experiences of Subgrantings and determined that, corporately, they have many common concerns: one-sidedness of subcontracts, 15 the bidding process favors the general contractor and the general contractors have the upper hand in the relationship. The most divisive areas in their relationships with general contractors were identified by the Subgrantings as bid shopping and onerous contractual clauses such as: pay-when-paid provisions, indemnification clauses and retainage practices (Schaufelberger eta!., 2009)

George Birrell (1986) summarized his 1978 dissertation about how Subgrantings evaluate the management capability and business practices of general contractors. Through interviewing Subgrantings and general contractors, the study identified the most significant criteria that affect the Subgranting efficiency in conducting their operations. The study identified a framework to evaluate a general contractor in order to provide Subgrantings with useful information to structure their future bidding practice toward general contractors. The better a general contractor was at management, the lower the Subgrantings pricing could be. Conversely, the poorly managed firms should receive higher pricing from Subgrantings when bidding new projects (Birrell, 1986)

Several studies link organizational commitment behaviour to performance while separating employees into best and worst performing groups. This research work attempts to understand which employee characteristics managers use to rate employees as best or worst performing. Organizational commitment behaviour has now been included in performance evaluations (Werner, 1994). Further, some employees may use “impression management” style in order to create a favorable impression of themselves (Bolino et a!., 2003). In order for organizational commitment behaviour to directly impact performance, these behaviors must be redirected towards promoting organizational effectiveness. Organ (1988) points out that in order for organizational commitment behaviour to affect performance, the individual contributions must be aggregated throughout the organization. Organ (1988) further argues that even though co-workers may benefit from employees who help others with heavy workloads or those who offer

16 advice to newer employees, individual acts of organizational commitment behaviour do not affect performance.

Work Authorization Before starting to bill time against a cost account, the Subgranting must first receive a work authorization form, duly signed by the Deputy Project Director. The Work Authorization Form will authorize the start of work, will identify the deliverable(s) of the cost account, will identify budget and schedule constraints, will identify the responsible manager, and will identify the reviewers and acceptors of the products or services. When the authorized work is complete, the Work Authorization Form will be closed, and the authorization withdrawn (Barrie et a!., 1992) Progress Reporting The prime contractor must be kept aware of the overall progress of the project. This includes the progress of each Subgranting. The Subgrantings will report progress at the cost account level on a weekly basis. Based on the information contained in the weekly Cost Account Level Progress Reports, the prime contractor will prepare a monthly progress report at the WBS level. Weekly cost account level progress reporting. Each week, the Subgranting organization will prepare and deliver to the system z Project Office a weekly progress report for each Cost Account for which an open work authorization form exists (Rahman eta!., 2005).

A single report may be produced provided the information for each cost account is clearly identified; the report is to be delivered by noon on Fridays. The report will identify: Authorized work that was scheduled to be performed during the week, Progress made against that authorized work presented as: a textual description of progress, a list of internal milestones attained, an accounting of the hours billed against that cost account by all Subgranting personnel, and an assessment of the time remaining to complete the activities in the cost account, A list of unplanned, but authorized work that was conducted, identifying the number of hours spent, Authorized work that is scheduled to be performed during the next 17 week, including any internal milestones expected to be reached, and A brief description of any problems encountered in performing the activities of the Cost Account or warnings of schedule slippage (Proctor eta!., 1996).

Subgrantings also learn of new bidding opportunities through local or online plan centers. These plan centers provide lists of the general contractors bidding on each project. Sometimes Subgrantings submit bids to general contractors without a formal bid request. General contractors may receive multiple bids from several different Subgrantings on the same area of work i.e. painting, flooring, steel erection, the general contractor must then decide which Subgranting is the best choice based on the Subgranting price, capabilities, experience and other factors and try to match them with the demands and requirements of each project (Garrett, 1979).

Management Practices Successful projects that involve Subgrantings all exhibit similar characteristics. They all have clear and unambiguous subcontracts established that include a Statement of Work. The efforts of all Subgranting/contracts are integrated into a cohesive project plan with all Subgrantings understanding where their efforts fit into the overall picture (Fowler, etaL, 1990)

The formal and informal interfaces between the prime contractor and the Subgrantings, as well as among the Subgrantings, are documented. Before starting specific work, the Subgrantings are granted authorization to proceed. This authorization is given, in writing, via a work authorization form. A formal team building process is established and implemented, these practices all contribute to reducing the risk of misunderstandings or isolationism (Fowler, etaL, 1990)

Retainage practices, withholding or “retaining” a portion of each progress payment owed to contractors and Subgrantings/subcontracting throughout the construction project is known as retainage. Owners provide partial payments to 18 the general contractor throughout the project duration as the work progresses (Gould & Joyce, 2009). Progress payments are typically made on a monthly basis to the general contractor and, subsequently, Subgrantings are paid from the proceeds. Extending payment for a project during production has inherent risks including overpayment for the work installed, payment for defective work and the continued solvency of the parties until the work is complete.

To counter these risks, retainage has evolved as a common practice in the construction industry whereby owners retain a percentage of each progress payment to their contractors (Sears et aI,~. 2008). Contractors in turn typically withhold a similar amount from their Subgrantings until satisfactory completion of the project. “Contractual arrangements vary, but retainage typically ranges from 5 to 10 percent of the value of the work installed” (Bausman, 2004, p. 2).

Tremendous differences exist among various contractors in experience, financial stability, technical ability and business acumen that will define whether a particular prime will be a good team member or not. These differences can and should be taken into account in fashioning a bid proposal to more than one prime contractor on a project. The price or other terms quoted need not be the same nor must a Subgranting bid to all primes. The bid to each prime must reflect a careful assessment of relative risks, benefits and burdens expected to arise out of a subcontract relationship (Hendrick & Schemm, 1991, p. 11)

Establishing Clear, Unambiguous Subcontracts Each Subgranting will have a legally binding, written contract that defines the following items The legal names of the parties involved in the contract will be specified. The scope of the contracted work, will be described in terms of: The responsibilities and authorities of each party to the contract, A clear definition of the deliverables and minimum content to be provided by the Subgranting, A clear definition of the services to be provided by the Subgranting, Any and all constraints imposed on the Subgranting by the prime contractor, such as schedule

19 constraints, budget constraints, specific tools to be used, and a clear statement of requirements for quality of deliverables and services including the requirement to allow independent quality inspections of materials and processes. Appropriate terms and conditions which will be imposed on both the prime contractor and the Subgranting will be identified. And the acceptance process will be clearly identified (Huycke, eta!., 1998).

The work of all Subgrantings will be coordinated by the prime contractor to assure that the efforts of all parties are integrated into a cohesive whole through the processes of concurrent engineering and top-down project control. A Project Master Schedule will be developed that establishes schedule constraints and identifies contractual and significant internal milestones. Intermediate schedules will be established that clearly show key project interfaces and the interdependencies of the work efforts. Concurrent engineering meetings will be conducted on a regular basis to provide visibility into work being performed and provide an opportunity for discussion among the project Partners. (Hollander, et a!., 2002)

Interfaces between Prime Contractor and Subgrantings; Each Subgranting organization will have a single point of contact with the prime contractor for contractual matters. The Subgrantings are expected to identify their own single point of contact for contractual matters, on a day-to-day basis, all Subgranting personnel will be free to interact with any prime contractor personnel as needed to fulfil the subcontract. Interfaces among the Subgrantings; Each Subgranting organization will identify the responsibilities and authorities of the system Z project staff. This information will be published in a project contact sheet. Informal, mutually beneficial contact is encouraged (Hinze, eta!., 1994)

Scholars and practitioners recognize that for today’s organizations to attain a competitive advantage, a skilled work force, cutting edge technological proficiency, exemplary customer service, and high quality products and services 20 are needed (0’ Reilly et a!., 2000). Most managers of today’s organizations would argue, and research has demonstrated that employees drive success, whether as productivity, customer satisfaction, or even profits (Hart eta!.1 2002). Further, it is also argued that commitment building organizations are those that consider skills development of individuals (Gallie, Felstead, Green 2000; Martin, 2006). A higher level of human capital that is to say collective skills and abilities can be attained by focusing on either the selection processes that determine the characteristics of the work force- “buy” orientation- or on developmental actions covering current employees-make” orientation. Martin (2006) argues that, organizations should target the improvement of the quality of employees.

Assessing the effectiveness ofhealth projects The following procedures must be followed when engaging a contractor or Subgranting. Contractor must provide details of their health project management structure, health project management record and their technical and commercial ability, for consideration when their suitability for the work is assessed (Dossick, et aL, 2007).

Documented project Requirements. The written contract, or in short term cases, in a letter of engagement to carry out the specific task, both must include commitment to meet contactor’s own OHS management standards and a reference to meeting Company’s OHS standards. In the case of a contractor not having their own OHS standards, a commitment to apply and meet Company’s OHS standards is satisfactory (Yates, etah, 2006).

Insurances, Licences, Registrations & Certificates. The Company manager or supervisor must ensure that contractor’s or Subgranting’s employees possess the insurances, licences, registrations and certificates required by Federal, State or local legislation. Pre-Work project Induction. Before work is commenced, the Company manager or supervisor will organise for the Company OHS induction training to be completed. Contractors and sub-contractors are not permitted to

21 start work until the Company OHS Induction is successfully completed (Birrell, et el. 1985).

Safe Work Procedures. Where applicable, copies of Company’s written safe work procedures must be given to the contractors. Particular attention must be paid to lockout or tag-out procedures. Copies of the contractor’s written safe work procedures must be provided prior to any work being undertaken. If contractors are undertaking Company’s standard work tasks, Company’s procedures can be utilised by the contractor (Wickwire, et aL, 1995).

Supervision. The Company manager must arrange for the work of the contractor or Subgranting to be monitored to ensure their compliance with contractors documentations, safe work procedures, Company standards and procedures, maintenance and correct use of tools or equipment and observance of good housekeeping, feedback. If the contractor or Subgranting is not working to expected OHS standards, the manager or supervisor must discuss the deficiencies with the persons concerned and work with the contractor to resolve the problems. At the completion of works or contract, where appropriate feedback is to be provided to the contractor on their OHS performance. (Hsieh, etaL, 1998).

Reporting Incidents, Injuries and Property Damage; Contractors, Subgrantings, or any other persons must be advised during Company’s OHS Induction that all incidents, injuries or damage to property must be reported to the relevant Company person on site, for example, manager or supervisor. Contractors who fail to meet the reporting standard will be subjected to Company’s disciplinary processes (Patrick 2001) Emergency Procedures. Emergency procedures must be explained to contractors and Subgrantings during Company’s OHS Induction. Contractors and Subgrantings will be required to take part in practice drills should they occur when the contractor or Subgranting is on site. If the contractor is undertaking any tasks, or brings onto site any tools/equipment or product that may affect the site’s emergency management, Company is to be notified prior to works to allow for a risk management strategy to be developed ( Shash, etaI~, 1998).

Environmental Protection. Company’s environmental standards must be clearly outlined prior to contractor engagement with the contractor or Subgranting having a understanding that strict adherence to these standards is required. This applies to, but not limited to: noise, dust, gas or fume emissions, water management, spillages and preservation of the local ecology (Patrick 2001)

Property Security, contractors, Subgranting or other persons must be made aware that they will be responsible for the security of their own property while on site. Drug and alcohol policy. Contractors and Subgrantings will be made aware of the details and the requirement to meet company’s drug and alcohol Standard during Company’s OHS Induction. Any person found to be not conforming with the Drug and Alcohol Standard will be immediately removed for the workplace and will be subjected to the Company disciplinary processes (Hsieh, eta4~, 1998).

Legal processes and sub-contractors activities During the project; during the project, the team needs to monitor the compliance of vendors and sub-contractors. They must ensure the goods or services supplied are acceptable. This needs to feed into the controls in the procurement process. Where sub-contracted project personnel are involved, conduct a regular review of performance and compliance. With supplied items, conduct the appropriate degree of testing and check that they meet the agreed specifications (Herroelen et aI~, 2000) Cities are the fields of conflicts among interest groups and rather complex relations. The major issue about plans and urban projects is about land ownership. Therefore, there are some laws to regulate the rights concerning it. A legal base provided for urban design projects in addition to existing laws is an indispensable need (Gibbons, etaI~, 1992)

23 In almost all relationships there will be disputes & wrangles. The Project Manager should have developed a good relationship with the management of major suppliers so that problems can be settled rapidly without becoming contractual disputes. There is a natural tension between you, the customer, wishing to get the most benefit from the deal and the supplier who will wish to maximise profits. Normally you can agree a reasonable compromise before calling the lawyers. If the dispute does need to be escalated, you would normally look to your senior management raising the issue with the senior management of the vendor. Most vendors will have an escalation process - try to accelerate your priority in it. Only as a last resort should you threaten a legal dispute. It usually costs far more than it is worth, can cause huge delays, may lead to the withdrawal of key elements of your solution, and may lead to sour relationships during subsequent operation and enhancements of the system (Herroelen et aL, 2000)

The project~s quality management processes should ensure that sub contracted work and deliverables meet the agreed standards. These controls should be tied into the contractual payment terms. The contract should have defined the procedures and terms for any remedial work that is required in the event of non-compliance. Provided the deliverables are accepted, ensure the vendor is paid promptly, and, where appropriate, thanked for their contribution. At the end of the project you need to finalise the relationship with your sub contractors: Inform the supplier about the people who will represent your organisation once the project team is demobilised for example the operational management, support and technical contacts (Tracey, et aL, 1991).

Make sure all final deliverables have been completed acceptably. Make sure any on-going support, maintenance and warranties are in place. Make any final payments. Communicate that the project has finished. In many cases you might have completed the project and started live operations but still have a list of minor problems or concerns that need to be addressed.(Davis, etaL, 2000).

24 Heafth projects and social development Selecting suppliers; the process of selecting suppliers is the subject of detailed methodologies. The style of selection will vary according to your needs and environment. We saw above that there is a large range of contractual situations to consider. The more significant the contract, the more attention you are likely to pay to the selection and procurement processes. (Simpson WP 2000)

In the private sector, the objective is usually to gain maximum benefit. That might be achievable by making a rapid choice from a small number of leading suppliers. It might also be possible to partner with a single reliable supplier. Selection exercises are used only where there is a genuine need to search the marketplace for the best supplier. Start by defining what you need. Try to limit this to the genuine business requirements. Do not make assumptions about the solution nor add in unnecessary detail. To do so would restrict the vendors~ ability to propose the best overall solution to meet your needs (Leishman KA, 2012)

External sub-contractors need to be mobilised in much the same way as the internal project staff: make sure they are lined up to arrive as required, provide appropriate briefings and induction, make sure they feel part of the team and share your enthusiasm for success. Where external components are being delivered, make sure your internal resources are prepared to receive them in a timely manner (Arditi, eta/,2005).

When submitting their bid to a general contractor, a Subgranting has a distinct disadvantage because, in many jurisdictions, the Subgranting is obligated to honor their bid but the general contractor is not legally required to award the work to them. This is called promissory estoppel and it literally means “stopped from withdrawing”. It is a term used to describe this situation where a prime contractor is entitled to expressly accept and bind the Subgranting to its bid subject to all accompanying terms and conditions (Sears, Sears & dough, 2008).

25 In many jurisdictions, if the general contractor relies on the bid, the Subgranting’s bid can be accepted without any communication to the Subgranting of formal acceptance by the prime contractor (Hendrick etaI~, 1991).

There are many reasons why a general contractor may decide not to enter into contract with a Subgranting that is to say, inexperience, lack of manpower to meet the schedule requirements of the project, financial instability, etc. Although the general contractor has the right to make this decision unilaterally, many Subgrantings believe that they have a right to be granted the work if the general contractor utilized their bid to win the project. Over time, if a Subgranting is not awarded enough work from a particular general contractor, they may decide not to bid to them in the future (Constantino, eta~, 2001).

Subgranting Work performance Individual performance is a core concept within work settings. In the past, researchers have made progress in clarifying and extending performance concept (Campbell, 1990). Moreover, advances have been made in specifying major predictors and processes associated with individual performance. With the ongoing changes that we are witnessing within organizations today, the performance concepts and performance requirements are under going changes as well (Iligen & pulakos, 1999). With this overview this study should be able to contribute to an integration of the scattered field of performance-related research (Roe, 1999). Despite the great relevance of individual performance and the widespread use of job performance as an outcome measure in empirical research, relatively little effort has been spent on clarifying the performance concept.

Some authors, agree that when conceptualizing performance one has to differentiate between an action aspect and an outcome aspect of performance (Campbell et.a4 1993; Campbell, 1990; Kanfer, 1990).The behavioral aspect refers to what an individual does in the work situation. It encompasses behaviors such as teaching basic reading skills to patients, attendants, or performing heart 26 surgery for the case of this study. Not every behavior is subsumed under the performance concept, but only behavior which is relevant to the organizational goals. Performance is what the organization hires one to do, and do well (Campbell etaL, 1993).

Subgranting Performance is not defined by the action itself but by judgmental and evaluative processes (Ilgen & Schneider, 1991; Motowidlo eLat, 1997). Moreover, only actions which can be scaled, i.e., measured, are considered to constitute performance (Campbell et aL, 1993). While Campbell’s argument is agreed, there is need to note that there are certain actions or behaviors that may not be quantified as for the case of healthcare or any other service sector. Failure to recognize such actions and/or behaviors will make employees lose morale, hence poor performance. This is a gap that this study intends to bridge. The outcome aspect refers to the consequence or result of the individual’s behavior. The above described behaviors may result in outcomes such as numbers of health workers, patients, attendants reading proficiency, or number of successful heart operations. In many situations, the behavioral and outcome aspects are related empirically, but they do not overlap completely. Outcome aspects of performance depend also on factors other than the individual’s behavior.

It is difficult to imagine how to conceptualize such criteria without simultaneously considering the outcome aspect of performance at the same time. Thus, the emphasis on performance being an action does not really solve all the problems. This is a gap that the study should address. Moreover, despite the general agreement that the behavioral and the outcome aspect of performance have to be differentiated, authors do not completely agree about which of these two aspects should be labeled “performance’. This study adopts the suggestion of (Brumbrach 1998), that performance should be measured by behavior and action

Organizations need highly performing individuals in order to meet their goals, to deliver the products and services they specialized in. Performance is also

27 important for the individual in that, accomplishing tasks and performing at high level can be a source of satisfaction, with feelings of mastery and pride. Lower performance and not achieving the goals might be experienced as dissatisfying or even a personal failure. Moreover, performance if recognized by others within the organization is often rewarded by financial and other benefits. Performance is a major although not the only prerequisite for future career development and success in the labor market (Vanscotter et.a~. 2000). The widespread use of individual performance measures in several studies shows that individual performance is a key variable in work and organizations. Interestingly, individual performance is mainly treated as a dependent variable-which makes perfect sense from a practical point of view that individual performance is something organizations want to enhance and optimize.

From the amount of literature available on subgranting, it is clearly evident that a lot of surveys regarding Health projects and effectiveness of them have been undertaking. These employee motivation surveys have been conducted in many different job situations, among different categories of employees using different research methods and applications. One of the very first survey to be conducted was on industrial workers by (Hershey and Blanchard, 1969) over the years, similar or different survey of employees have been carried out see (Lindner et al., 1999).

28 CHAPTER THREE METHODOLOGY Research design The study employed a non-experimental survey, quantitative correlational research design. It was quantitative because the variables are measured in numerical form. Statistical applications involved computation of frequencies, percentage and mean levels of Subgranting, and effectiveness of health projects. It also put into consideration a correlational dimension because the levels of Subgranting and motivation were correlated with employees’ performance.

Thus the level to which Subgranting is related to effectiveness of Health projects. (Amin 2005:218). The researcher employed; qualitative, correlation, cross sectional survey, as well as quantitative. The quantitative pattern was used in that it utilized techniques and measurement that generate numerical or quantifiable data and statistical tools like excel was utilized for analysis on the qualitative part the study employed in order to obtain in-depth point of view of the respondents (Amin, 2005) According to Saunders, Lewis (2003), the design enables the researcher to carryout in-depth investigation into the subject matter

Research Pop Wation The target population under the study comprises of 900 with a 372 sample in sections of; distribution, transportation, Human resources, finance, counseling, it involved workers on probation, permanent, and contract employment terms. Both consultants and other staff participated in the study. The target population was selected on the basis of convenience sampling and due to large population.

Samp’e Size While there are several ways of determining sample size, the researcher used, The Slovene’s formula is used to determine the minimum sample size of 372 respondents, as indicated below: n = N / 1+N (e2~.

29 Where n=the required sample size; N= known population size and e2 =margin of error at 0.05 level of significance n=N/1+N (e2) n=900/1+900 (0.052) n=900/2.4193548 n=372 so a total of 372 respondents were used for the research

Table 1 Population and Sample size distribution Distributions Population Sample size

Communication Information Technology — 130 — 53 Transportation 129 54 Finance section 130 50 General Services Budget 128 55

Contracts Management and Procurement 130 — 54

Medical Quality Assurance Section 128 - — 53 Purchases and logistics 125 53

Total 900 — 372 — Source: Primary Data 2011/2012

Sampling Procedure Choice of respondents was based on two techniques: stratified sampling and simple random sampling. Stratified sampling ensured that all categories of health workers were represented; while simple random sampling gave each health worker a chance of representation. Care was taken to ensure that all work shifts; the day, evening and night were represented in the study. Centre was chosen using the simple random sampling technique to ensure objectivity in the study. 30 Research Instruments Three measuring tools used in this study were 1. face sheet, questionnaire to determine demographic characteristics of the respondents; 2. Researcher made questionnaire to determine the level of subgranting is a non standardized tool with response modes and scoring system as follows: Very High (4); High (3); Moderate (2); Low (1). 3. The questionnaire for the extent of effectiveness of Health project is non standardized items and these scoring systems: Very High (4); High (3); Moderate (2); Low (1). Rehabihty Here pre-tested questionnaires and individual consultation was used to establish the perspectives of the respondents about the subgranting. The qualitative and quantitative data collected during the interviews were coded, categorized, assembled, conceptually organized, interpreted and presented thematically in accordance with the research questions in order to make descriptive and qualitative conclusions. Tab~e 2 Cronbach’s Mpha for Subgranting and effectiveness of Heallth project

Tp~o~con~iruct f~bveraii Aiphas Subgranting 0.811

De~ve~y date______— Negotiate terms 0.797 0.950 Agree contracts 0.790 Negotiate changes 0.883 Select best supply 0.870 Deal with disputes 0.804 0.809 Support arrangement specification 0.727 Effectiveness of Health Project Task and conceptual performance 0.614 0.641 organizational commitment Behavior 0.585 Source: Field Data, 2012 Table 2 showed that, the overall alpha for subgranting was (0.950), for health effectiveness was (0.809) and for performance was (0.641). Suggesting that skills had the highest overall alpha (0.950), followed by motivation (overall alpha =

0.809), and trailed by performance (overall alpha = 0.641): (Skills > Motivation > Performance). Nunnally (1978) states that permissible alpha values can be slightly lower (>0.60). Therefore, an alpha value 0.60 was considered as the cut off value. This indicates that the measure for performance was also reliable.

VaNdity To establish content validity of the questionnaires, the researcher specified the indicators which were relevant to the concept being measured The researcher relied on the supervisor to measure content validity. The supervisor assessed what concept the instrument was trying to measure and ascertained that the instruments adequately measured subgranting, and effectiveness of Health projects. A representative sample of indicators from the domain of indicators of the concepts of: subgranting and effectiveness of Health projects were selected referred to as sampling validity. The researcher relied on the supervisor to measure content validity. The supervisor assessed what concept the instrument was trying to measure and ascertained its validity. Tab~e 3: Content vaNdity ~ndex Items Va~id Items Tot& Items VaNdity [~ocurement_procedures 30 30 j 100% The results in table 2 indicated that 21 items were used and valid based on the contents of the instrument. Thus CVI= the number of relevant questions The total number of questions

Data Gathering Procedures Before data gathering 1. An introduction letter was secured from the College of Higher Degrees and Research to conduct the study after which permission from Aids Relief services (Appendix IB) be sought to distribute questionnaires to their staffs and beneficiaries at Aids Relief Services In Nsambya 2. The researcher oriented and brief her research assistants on the sampling and data gathering procedures. 3. The questionnaires for actual distribution were prepared and coded accordingly. 4. The non standardized Instruments were tested for validity and relIability. 5. The questionnaires were written In English representing the language spoken by the health workers In these sections.

During data gathering The respondents were requested to answer the questionnaires as objectively as possible and not to leave any option unanswered.

After data gathering The data collected were collated, organized and entered into the Statistical Package for Social Sdences (SPSS) for data processing and analysis. Data Analysis Data analysis Involved editing, categorizing, and tabulating the collected data sets. Frequencies and percentage distribution were used to determine the profile & respondents. Means scores were used to determIne the level & subgrantlng and Effectiveness & Health projects. These numerical values were utilized for the Interpretations of means: Mean Range Response Mode Interpretation 3.26-4.00 Strongly agree Very high 2.51-3.25 Agree HIgh 1.76-2.50 DIsagree Moderate 1.00-1.75 Strongly Disagree Low A multiple correlation coefficient to test the hypothesIs on correlation (Ho #1) at 0.05 level of significance was employed using a t-test. The regressIon analysis R2

33 (coefficient of determination) were computed to determine the influence & the dependent variable on the Independent variable.

Ethical Consideration To ensure that ethics Is practiced In this study as well as utmost confidentiality for the correspondents and the data provided by them, the following were done: (1) CodIng & all questionnaires; (2) The respondents were requested to sign the Informed consent form; (3) The authors mentioned In this study acknowiedged within the text; and (4) FindIngs were presented In a generalized manner (5) Respondents were not subjected to research before they agreed to it Throughout the process of data collection, participants were asked to cooperate with the researcher. The relevant respondents were assured that the research data shall be used solely for the purpose & the study.

Umitations of the Study The research environments are dassified as unconfrolled settings where extraneous variables influenced on the data gathered such as comments from other respondents, anxiety, stress, motivation on the part of the respondents. Testing: The use of research assistants rendered inconsistencies such as differences in conditions and time when the data was obtained from respondents although they were brief. Instn,mentation: coding of the questionnaires took a lot of time due to interruption of the power. Incomplete questionnaires; some questionnaires were not fully completed, although the research had distributed more than the required number which helped much to bridge the gap.

Intervening or confounding vanlabies: These are factors that were beyond the researcher’s control such as honesty of the respondents and personal 34 biases. To minimize such conditions, the researcher requested the respondents to be as honest as possible and to be impartial/unbiased when answering the questionnaires

Testing a statistically sound analysis requires a lot of data, in this case, it required a lot of volunteers, and a lot of time to analyse the data. The use of research assistants may render inconsistencies such as differences in conditions and time when the data shall be obtained from respondents. This will be minimized by orienting and briefing the research assistants on the data gathering procedures

The researcher was not exposed to a wide range of information sources to generate recent and update literature on the subject under investigation. Hence it may be difficult to enrich the literature to depict the current state of affairs in the quality environment

The study used the sample population, which was a collection of some elements of the target population. Although findings of the sample can be generalized to the target population, the similarity of the findings to the two populations is a matter of the degree.

9 -3 CHAPTER FOUR

DATA INTERPRETATION, PRESENTATION AND ANALYSIS

This chapter presents analyses and interprets findings on demographic characteristics of respondents, level of subgranting, extent of Effectiveness of Health projects and significant relationship in subgranting and extent of Effectiveness of Health in Aids Relief Service-Nsambya, Kampala, Uganda.

Demographk ProfHe of Respondents Respondents were asked to provide information regarding their gender, age, marital status, educational levels, and experience Tab~e 4 Number of respondents Response Mode Number of respondents

-~ Percentages(°!o)

_c______~_~ _~I~___ -_ - 37~4 Sjy~g~~__ 115 30~9

93 — 25~0 Strongly Disag~e 25 670

Tota’ _____ 372 100~0 Source; Primary Data, 2012

Table 4J. Indicated that most of the respondents (139 or 37.4%) agreed that, Subgranting influences effectiveness of Health projects followed by 115 (30~9%) who strongly agreed with Subgranting influences, 93 (25.0%) disagreed, while 25 (6~70%) strongly disagreed. This indicates that the institution does not always operate without Subgranting~

The above data is in agreement with Porter (2001), who say that, success requires both the right strategy and “operational effectiveness”. “Managers must clearly distinguish operational effectiveness from strategy. Both are essential, but the two agendas are different.

-3 Tab’e 5 Demographic ProfHe of Respondents in terms of gender, age, marita~ status educationa~ Levee, Position in the organisation and Length of experience (n=372)~ Category Frequency Percentage% Gender: Male 93 25.0 Female 279 75.0 Total 372 100 Age: 20-24 years 103 28.0 25-29 years 124 33.0 30-34 year 113 30.0 35-39 year 32 9.00 Total 372 100 Marital status Married 139 37.4 Single 115 30.9 Divorced 25 6.70 Widowed 93 25.0 Total 372 100 Educational Levels 25 6.70 Diploma Bachelors Degree 139 37.4 Masters 115 30.9 PhD 93 25.0 Total 372 100 Position in the organization Doctor 93 25.0 Nurse 115 30.9 clinical Officer 139 37.4 Therapist 25 6.70 Total 372 100.0 Length of experience 1-2 years 25 6.70 3-4 years 115 30.9 5-6 years 93 25.0 Above 7 years 139 37.4 Total 372 100.0 Source: Primary Data 2012

2 The findings indicated in Table 5 shows that, most respondents were female 279(75%), followed by male who composed of 93 (25%). This implies that female participants / respondents dominated the study. There in need to encourages more males in participating in such studies as well as the number employed in working sections of the centre under study.

Regarding the age, half of the respondents were between 25-29 years 124(33.0%), followed by 30-34 years 113(30.0%), then 20-24 years 103(28.0%) and lowest being between 35-39 and above who were 32(9.00%). This implies that, middle age respondents dominated the study an indicated in Table 5

On the Marital status, Table 5 shows that (139 or 37.4%) of the respondents were married, followed by (115 or 30.9%) single, (93 or 25.0%) widowed, while 25 (6.7O%) were divorced or separated. This implies that the institution makes use of more married employees compared to other counter parts as seen from above.

Table 5 the findings shows that (139 or 37.4%) of the respondents were Bachelors” holder, followed by (115 or 30.9%) Masters holder, (93 or 25.0%) PhD, while 25 (6.70%) Diploma holder. This implies that the institution employees more bachelors and Master employees compared to other educational levels as seen from above. Table 5 The findings shows that (139 or 37.4%) of the respondents were Clinical Officer, followed by (115 or 30.9%) Nurse, (93 or 25.0%) Doctor, while 25 (6.70%) Therapist. This implies that the institution makes use of more Clinical Officer compared to other educational levels as seen from the table above.

Table 5 The findings show that at least (139 or 37.4%) of the respondents had spent more than seven years (experience, followed by (115 or 3O.9%) between 3-4 years, (93 or 25.0%) 5-6years, while 25 (6.70%) had spend 1-2 years at the organization. This implies that the majority of the respondents had working experience in the institution. 38 Lev& of Successftd Subgranting management ~n Heafth Projects The independent variable in this study was subgranting for which the researcher wanted to determine its level in which respondents were required to indicate the level to which they rate(high or low) with each of the items by indicating the number that suits their perceptions. Each of these questions was measured on a 4-point Likert scale. Their responses were analyzed using SPSS and summarized using means as indicated in table 6 below; Tab~e 6 Extent of subgrant~ng management item Analysis (n=372) Item Mean ~p~~pretation Rank You prepare the procurement package, evaluating 1 proposals, and managing all activities of the 3.64 Very High ~ You always collaborate with subgranting and prime 3 48 Very High 2 contractors. You have clear procedure for measurement of ~ High 3

------—~----_— You delegated budget responsibility to individual 3 36 Ve Hi h dep~ents/stakeho~er ryg You have representatives of Product Assurance as High 5 the quality requirements and evaluation 3.24

—-—— ---————---—--—- You have clear commitments to excellence in High 6 performance, internal Enterprise “ownership’ and 3.25 jjrideinthesubcontr~ç~ç~product. Your documents are signed and reviewed by both 3 15 High 7 j~r~±~____ Your integrity on the part of all individuals and 8 groups, both company and Subgranting, who are 3.14 High

~LkLe_~ -*___ ~ You have a clear program requirements, integration High 9 representative; and Program Controls where 3.01 warranted. You delegate responsibility to enterprise individual for 2 94 High 10 the performance of aW effort for b~g~p~ibili. You emphasize clear commitments to excellence in 11 performance and internal Enterprise “ownership” and 2.88 High dehesubconr~pfoduct. What is being procured is an off the shelf or catalog High 12 item, some development will be required by the 2.80 ~Lc_~___ ~g~f~ti~9 firms are committed to their work 2.79 ~ 13 Average mean 3.15 H~gj~ Overall 3.15 Source: Primary Data 2012

3 Gu~de to interpretation of means Mean range Response mode Interpretation 3.26-4.00 strongly agree Very High 2.51-3.25 Agree High 1.76-2.50 Disagree Moderate 1.00-1.75 Strongly disagree low

About subgranting, they were thirteen items were ranked very High with a average mean of 3.15, on you prepare the procurement package, evaluating proposals, and managing all activities of the procurement was ranked highest with a mean of 3.64 and low on Subgranting firms are committed to their work with a mean of 2.79. This indicates that the level of successful subcontracting of health projects with the two facets of effectiveness is agree on a four point scale. With regard to accuracy transparency, the highest item by rankings was, work that provides sub grantor/subcontractor with opportunities for increasing their knowledge and skills, with a mean value of 3.64 on a four point scale. This was closely followed by finding out how good one can be at work; mean value 3.48; then enjoying the work one does, with a mean score of 3.41. Results further indicate that health projects have higher levels of intrinsic motivation than extrinsic motivation. The results suggest that health projects level of effectiveness is influenced by factors such as subctractors’ ability if improving, the inherent characteristics of nursing, and the nursing team, all of which are intrinsic factors.

According to Tom , 2009, he argued that, given the high rate of project failures, you might think that companies would be happy to just have their project finish with some degree of success. That’s not the case. Despite the odds, organizations expect projects to be completed faster, cheaper, and better. The only way that these objectives can be met is through the use of effective project management processes and techniques.

After the project definition has been prepared, the work plan can be created. The work plan provides the step-by-step instructions for constructing project

40 deliverables and managing the project. You should use a prior work plan from a similar project as a model, if one exists. If not, build one the old-fashioned way by utilizing a work-breakdown structure and network diagram.

Create a detailed work plan, including assigning resources and estimating the work as far out as you feel comfortable. This is your planning horizon. Past the planning horizon, lay out the project at a higher level, reflecting the increased level of uncertainty. The planning horizon will move forward as the project progresses. High-level activities that were initially vague need to be defined in more detail as their timeframe gets closer. In theory, since you already have agreement on your project definition and since your work plan and project management procedures are in place, the only challenge is to execute your plans and processes correctly. Of course, no project ever proceeds entirely as it was estimated and planned. The challenge is having the rigor and discipline needed to apply your project management skills correctly and proactively.

Review the workplan on a regular basis to determine how you are progressing in terms of schedule and budget. If your project is small, this may need to be weekly. For larger projects, the frequency might be every two weeks. Identify activities that have been completed during the previous time period and update the workplan to show they are finished. Determine whether there are any other activities that should be completed but have not been. After the workplan has been updated, determine whether the project will be completed within the original effort, cost, and duration. If not, determine the critical path and look for ways to accelerate these activities to get you back on track.

Monitor the budget. Look at the amount of money your project has actually consumed and determine whether your actual spending is more than originally estimated based on the work that has been completed. If so, be proactive. Either work with the team to determine how the remaining work will be completed to hit 41 your original budget or else raise a risk that you may exceed your allocated budget. Thus, Managers are hired after projects are designed, budgets are approved, partnerships are formed and contracts are negotiated. One of your first tasks as a newly-hired Project Manager should be to locate all key documents that define the project and its commitments. You’ll refer to these documents often: they should serve as the foundation of project planning, compliance and monitoring of project activities.

The project management procedures outline the resources that will be used to manage the project. This will include sections on how the team will manage issues, scope change, risk, quality, communication, and so on. It is important to be able to manage the project rigorously and proactively and to ensure that the project team and all stakeholders have a common understanding of how the project will be managed. If common procedures have already been established for your organization, utilize them on your project.

A small variance in schedule or budget starts to get bigger, especially early in the project. There is a tendency to think you can make it up, but this is a warning. If the tendencies are not corrected quickly, the impact will be unrecoverable. You discover that activities you think have already been completed are still being worked on. For example, users whom you think have been migrated to a new platform are still not. You need to rely on unscheduled overtime to hit the deadlines, especially early in the project.

Team morale starts to decline. Deliverable quality or service quality starts to deteriorate. The basics of managing the schedule, managing scope is the most important activity required to control a project. Many project failures are not caused by problems with estimating or team skill sets but by the project team working on major and minor deliverables that were not part of the original project definition or business requirements. Even if you have good scope-management procedures in place, there are still two major areas of scope-change management 42 that must be understood to be successful: understanding who the customer is and scope creep

According to Arditi eta~, 2005 that, scope-change management procedures if they are asked to add a major new function or a major new deliverable to their project. However, sometimes the project manager doesn’t recognize the small scope changes that get added over time. Scope creep is a term used to define a series of small scope changes that are made to the project without scope-change management procedures being used. With scope creep, a series of small changes none of which appear to affect the project individually can accumulate and have a significant overall impact on the project. Many projects fail because of scope creep, and the project manager needs to be diligent in guarding against it.

On the overall, it is deduced that subgranting in organizations are generally High with a mean of 3.15 as the overall mean index (Grand average mean) for the thirteen aspects, which confirmed that the level of subgranting is High where respondents agreed with it.

Lev& of Effectiveness of heallth projects The dependent variable in this study was Effectiveness of Health Projects, for which the researcher intended to determine its effectiveness. Respondents were asked to rate the level of Health projects in the organisation by indicating the extent to which they rate (very high or low) with each question. Their responses were analyzed using SPSS and summarized using means and indicated in table 7

A-, Tab’e 7 Lev&s of effect~veness of heafth projects (n=372)~ Interpretation Rank Item _____ Mean 1 You acquisition for commodities, is usually eviated by 3.97 competition High You accurately are reflecting all of the applicable Very High 2 prime contract requirements. ______3.95 You expect services of higher performance Very High 3 requirements, faster product development, higher 3.92 technology, materials. ______You maintain maximum project_control. 3.80 Very High 4 You have evaluation policy. 3.76 Very High 5 Your Program cost is minimized 3.67 Very High 6 You have a strong technical base 3.65 Very High 7 Your firm minimize the resulting efficiency losses 3.60 Very High 8 High 9 You maintain maximum project control over all 3.54 resources and disputes. You pay little attention on how relationship-specific High 10 investments affect contracts. 3.40 You have policies and procedures set up 11 independently for each project. 3.33 High You have product assurance representative and 12 subcontract quality requirements. 3.30 High You get in touch with people working for the project High 13 You_always screen out unqualified bidders 3.29 High 14 You open issues diligently to ensure that they select High 15 best supply. 3.28 Knowledge is available for all projects 3.25 High 16 You behave opportunistically 3~3 High 17 Your subgranting base ona face-to-face discussion. 3.10 High 18 You seek a competent, reliable supplier with a good 3.09 High 19 competitively priced product solution. High 20 You conducts the source selection process ______3.10 You have legal officers responsible for legal matters 2.96 Moderate 21 You plan with the participation of supporting Moderate 22 organizations ______2.20 Your contract is signed between the company and its Moderate 23 employee. ______2.18 You prepare results for review and approval 2.14 Low 24 You negotiate terms with representative on the 25 subcontract management team. 2.13 Low Average mean 3.24 High Overafl 3.24

44 Guide to interpretation of means Mean range Response mode Interpretation 3.26-4.00 strongly agree Very High 2.51-3.25 Agree High 1.76-2.50 Disagree Moderate 1.00-1.75 Strongly disagree low

The findings in Table 7 Show that, on aspect of Effectiveness of the Health Projects, twenty five items were measured and showed on average High with a mean of 3.24. Also the means ranged from (3.97-2.13), this means that effectiveness of Health projects is considered vital in the organization in order to increase on the protection from loss and storage.

The project manager should manage open issues diligently to ensure that they are being resolved. If there is no urgency to resolve the issue or if the issue has been active for some time, it may not really be an issue. It may be a potential problem (risk), or it may be an action item that needs to be resolved at some later point. Real issues, by their nature, must be resolved with a sense of urgency.

The findings are in agreement of Constantino eta!., 2001. Who say that when the planning work is occurring, the project team should identify all known risks. For each risk, they should also determine the probability that the risk event will occur and the potential impact on the project. Those events identified as high-risk should have specific plans put into place to mitigate them so they do not, in fact, occur. Medium risks should be evaluated to see whether they need to be proactively managed. (Low-level risks may be identified as assumptions. That is, there is potential risk involved, but you are “assuming” that the positive outcome is much more probable.) Some risks are inherent in a complex project that affects every person in the company. Other risks may include not having the right level of expertise, unfamiliarity with the technology, and problems integrating smoothly with existing products or equipment.

45 The monitoring, or evaluation, step in both project management and the nursing process is dynamic. The best results are produced when theres constant evaluation and feedback. Whereas the manager in this project reports progress to administration monthly, results on the progress and why errors occurred should be given even more frequently to the unit team in order to allow for new information to be assimilated and the plan to be modified as needed. New information should be strategically added to the plan and then revaluated.

Project effectiveness requires that every member of the unit staff understands the goal, expectations, and timeline. A well-run project allows all participants to be able to instantly access the data. Success depends on every team member being a part of the implementation process in ways that are vital and change oriented. In our project, involvement of the whole team also allows every mislabeled specimen to be an opportunity to evaluate where the process broke down and what was missing to allow for success. No one person is responsible for making a mistake, but every team member is responsible for investigating why the mistake was made and contributing to the process change.

Management activities are an essential part of implementation, especially in the first and last years of the project life. While it might be difficult to link some activities to specific project outcomes, outcomes are considered to be a foundation for executing many of the project’s conventional activities. Due to this level of importance, along with some of the activities’ substantial cost and time implications, the planning team has to make critical decisions linked to the project’s implementation stage.

The Subgrantees may also gain valuable insights by consulting other members of their community. You may find that your project is having unintended side effects, positive or negative, on other agencies, and can then work with those personnel to identify appropriate responses to spillover effects. You may also find that other agencies could contribute to or benefit from expansion of your project 46 to include them; either way your project accomplishes more. And donTt overlook the people who participate in your project you can gain many valuable insights that would otherwise have never occurred to you by directly asking prosecutors how the special unit is coming along, asking court personnel what makes your database easy or difficult to use, asking law enforcement officers what they thought of the training you provided, or asking victims whether the projectTs services were helpful and what else they needed.

Thus, Sub grantee must present a Narrative Progress Report and as indicated in the sub grant agreement (not more frequent than monthly and no longer than quarterly)~ The sub grantee may choose to seek reimbursement for expenses incurred during the period reported (monthly, bi-monthly or quarterly) or request a one time reimbursement after the project has reached its conclusionS For all requests for reimbursement of approved project expenses the sub grantee must submit: A. Narrative Progress Report with original authorized signatureS

Subgrantings rely on general contractors for virtually all of their work and the relationships they maintain with general contractors in their geographic area directly affect their long term success. Generally, a Subgranting evaluates the performance of the general contractor on a project-by-project basis. A Subgranting can choose which general contractor to work with and this business decision can be affected by a number of factors. The perceived fairness and capability of the general contractor can be significant factors when considering future work with that general contractor (Knutson eta!, 2003)

Hendrickson, et a/.12000 argued that, before starting a job, the general contractor must first assess the project specific documents~ In the case of renovations, sometimes a site visit is required to get a better understanding of the project. As a result of this, the contractor will generate a price, also called an “estimate”. The general contractor considers the cost of materials, equipment as well as the cost of labor to provide the owner with an approximate price for the 47 project. In these contract documents, the contract agreement includes budget, the general and special conditions and the plans and specification of the project that are prepared by a design projects such as an architect.

Since Subgrantings secure virtually all their work through general contractors, the success of the typical Subgranting depends directly on the relationships they establish and maintain with those general contractors that need their expertise. Once the relationship is established, most Subgrantings work with the same general contractors on a regular basis and they tend to maintain the relationship over time Shash (1998) stated that “general contractors and Subgrantings may not cooperate in a highly recurrent way; nevertheless they entertain long term business relations”. Statistics presented in the publication indicate that 76% of commercial Subgrantings have maintained their relationships with general contractors for an average of 21.1. years (Shash, 1988, p. 442).

In his paper, Golden Rule of Contractor-Subgranting Relations, Proctor (1996) emphasized the importance of developing a spirit of trust between general contractors and subcontractors which requires a long-standing practice of fair dealing between parties. He detailed the four C”s of the general contractor Subgranting relationship: consideration, communication, cooperation and compensation stating that “the ultimate responsibility for successful completion of a project lies with the general contractor

Gunaydin, 2001: argued that, a project manager must be aware of the knowledge of technical fields used in the project and have the knowledge of general management and project management. Besides, he also informs about the requirements of international projects. According to this, project managers are expected to have the certificate of “projects project manager” given by the Project Management Institute to work for an international project.

48 The formal and informal interfaces between the prime contractor and the Subgrantings, as well as among the Subgrantings, are documented. Before starting specific work, the Subgrantings are granted authorization to proceed. This authorization is given, in writing, via a Work Authorization form. A formal team building process is established and implemented. These practices all contribute to reducing the risk of misunderstandings or isolationism.

Thus, the general contractor considers the cost of materials, equipment as well as the cost of labor to provide the owner with an approximate price for the project. In these contract documents, the contract agreement includes budget, the general and special conditions and the plans and specification of the project that are prepared by a design projects such as an architect, In many instances the general contractor is the project engineer or project manager for construction projects.

Overall, results in table 7 indicate that health projects in Kampala in Uganda have high levels of task and conceptual performance. This is substantiated by the fact that the roles of health projects are clearly defined, and thus one’s level of performance is rated according to the job description. This is clearly specified in the Human resource manual of Ministry of Ministry of health, 2010.

Thus, Scholars and practitioners recognize that for today’s organizations to attain a competitive advantage, a skilled work force, cutting edge technological proficiency, exemplary customer service, and high quality products and services are needed (Pfeffer et a/U, 2000).Most managers of today’s organizations would argue, and research has demonstrated that employees drive success, whether as productivity, customer satisfaction, or even profits (Hart et.aI., 2002). Further, it is also argued that commitment building organizations are those that consider skills development of individuals (Gallie, et a/, 2006). A higher level of human capital can be attained by focusing on either the selection processes that determine the characteristics of the work force- “buy” orientation- or on developmental actions 49 covering current employees-make” orientation. Martin (2006) argues that, organizations should target the improvement of the quality of employees.

According Barrie etaL, 1992 with reference to this study, before starting to bill time against a Cost Account, the Subgranting must first receive a Work Authorization Form, duly signed by the Deputy Project Director. The Work Authorization Form will authorize the start of work, will identify the deliverable(s) of the Cost Account, will identify budget and schedule constraints, will identify the responsible manager, and will identify the reviewers and acceptors of the products or services. When the authorized work is complete, the Work Authorization Form will be closed, and the authorization withdrawn.

However, before starting a job, the general contractor must first assess the project specific documents. In the case of renovations, sometimes a site visit is required to get a better understanding of the project. As a result of this, the contractor will generate a price, also called an “estimate”. The general contractor considers the cost of materials, equipment as well as the cost of labor to provide the owner with an approximate price for the project.

Thus, to contain the former, detailed quality checks are carried out when a vendor first starts supplying a part and for the latter, routine quality checks are carried out at regular intervals to ensure that the vendor maintains quality. Additionally, at the end of the yearly contract, the QC division evaluates the past performance of vendors. This is used in future price negotiations, and in deciding the future level of orders. (Chester, eta!., 2005)

General contractors utilize Subgrantings for various reasons such as: they lack expertise in these types of work, it enables them to limit their risk exposure or it expands their available workforce so they have more opportunities to bid on new projects (Gould & Joyce, 2009). Approximately 80% of the dollar value of construction is accomplished under subcontracts therefore the Subgranting perspective is important 50 In the private sector, the objective is usually to gain maximum benefit. That might be achievable by making a rapid choice from a small number of leading suppliers. It might also be possible to partner with a single reliable supplier. Selection exercises are used only where there is a genuine need to search the marketplace for the best supplier. Start by defining what you need. Try to limit this to the genuine business requirements. Do not make assumptions about the solution nor add in unnecessary detail.

When submitting their bid to a general contractor, a Subgranting has a distinct disadvantage because, in many jurisdictions, the Subgranting is obligated to honor their bid but the general contractor is not legally required to award the work to them. This is called promissory estoppel and it literally means “stopped from withdrawing”. It is a term used to describe this situation where a prime contractor is entitled to expressly accept and bind the Subgranting to its bid subject to all accompanying terms and conditions (Sears, Sears & dough, 2008). In many jurisdictions, if the general contractor relies on the bid, the Subgranting’s bid can be accepted without any communication to the Subgranting of formal acceptance by the prime contractor (Hendrick & Schemm, 1991)

According to Constantino, et a/, 2001, there are many reasons why a general contractor may decide not to enter into contract with a Subgranting that is to say, inexperience, lack of manpower to meet the schedule requirements of the project, financial instability, etc. Although the general contractor has the right to make this decision unilaterally, many Subgrantings believe that they have a right to be granted the work if the general contractor utilized their bid to win the project. Over time, if a Subgranting is not awarded enough work from a particular general contractor, they may decide not to bid to them in the future

In the past, researchers have made progress in clarifying and extending performance concept (Campbell, 1990). Moreover, advances have been made in specifying major predictors and processes associated with individual performance. 51 With the ongoing changes that we are witnessing within organizations today, the performance concepts and performance requirements are under going changes as well (Iligen et a!., 1999). With this overview this study should be able to contribute to an integration of the scattered field of performance-related research. Despite the great relevance of individual performance and the widespread use of job performance as an outcome measure in empirical research, relatively little effort has been spent on clarifying the performance concept.

Some authors, agree that when conceptualizing performance one has to differentiate between an action aspect and an outcome aspect of performance. The behavioral aspect refers to what an individual does in the work situation. It encompasses behaviors such as teaching basic reading skills to patients, attendants, or performing heart surgery for the case of this study. Not every behavior is subsumed under the performance concept, but only behavior which is relevant to the organizational goals. Performance is what the organization hires one to do, and do well (Campbell eta!., 1993).

Subgranting Performance is not defined by the action itself but by judgmental and evaluative processes (Ilgen & Schneider, 1991; Motowidlo et.aL, 1997). Moreover, only actions which can be scaled, i.e., measured, are considered to constitute performance (Campbell et aL, 1993). While Campbell’s argument is agreed, there is need to note that there are certain actions or behaviors that may not be quantified as for the case of healthcare or any other service sector. Failure to recognize such actions and/or behaviors will make employees lose morale, hence poor performance. This is a gap that this study intends to bridge. The outcome aspect refers to the consequence or result of the individual’s behavior. The above described behaviors may result in outcomes such as numbers of health workers, patients, attendants reading proficiency, or number of successful heart operations. In many situations, the behavioral and outcome aspects are related empirically, but they do not overlap completely. Outcome aspects of performance depend also on factors other than the individual’s behavior. 52 In practice, it might be difficult to describe the action aspect of performance without any reference to the outcome aspect, because not only actions relevant for organizational goals constitute performance, one needs criteria for evaluating the degree to which an individual’s performance meets the organizational goals. It is difficult to imagine how to conceptualize such criteria without simultaneously considering the outcome aspect of performance at the same time. Thus, the emphasis on performance being an action does not really solve all the problems. This is a gap that the study should address. Moreover, despite the general agreement that the behavioral and the outcome aspect of performance have to be differentiated, authors do not completely agree about which of these two aspects should be labeled “performance’. This study adopts the suggestion of Brumbrach. (1998), that performance should be measured by behavior and action.

Organizations need highly performing individuals in order to meet their goals, to deliver the products and services they specialized in. Performance is also important for the individual in that, accomplishing tasks and performing at high level can be a source of satisfaction, with feelings of mastery and pride. Lower performance and not achieving the goals might be experienced as dissatisfying or even a personal failure. Moreover, performance if recognized by others within the organization is often rewarded by financial and other benefits. Performance is a major although not the only prerequisite for future career development and success in the labor market. Although there might be exceptions, high performers get promoted more easily within an organization and generally have better career opportunities than low performers (Vanscotter eta/ 2000). The widespread use of individual performance measures in several studies shows that individual performance is a key variable in work and organizations.

Several studies link organizational commitment behaviour to performance while separating employees into best and worst performing groups. This research 53 work attempts to understand which employee characteristics managers use to rate employees as best or worst performing. Organizational commitment behaviour has now been included in performance evaluations (Werner, 1994). Further, some employees may use “impression management” style in order to create a favorable impression of themselves (Bolino et aL, 2003). In order for organizational commitment behaviour to directly impact performance, these behaviors must be redirected towards promoting organizational effectiveness. Organ (1988) points out that in order for organizational commitment behaviour to affect performance, the individual contributions must be aggregated throughout the organization.

In the private sector, the objective is usually to gain maximum benefit. That might be achievable by making a rapid choice from a small number of leading suppliers. It might also be possible to partner with a single reliable supplier. Selection exercises are used only where there is a genuine need to search the marketplace for the best supplier. Start by defining what you need. Try to limit this to the genuine business requirements. Do not make assumptions about the solution nor add in unnecessary detail. To do so would restrict the vendors’ ability to propose the best overall solution to meet your needs (Knutson et al, 2003).

External sub-contractors need to be mobilised in much the same way as the internal project staff: make sure they are lined up to arrive as required, provide appropriate briefings and induction, make sure they feel part of the team and share your enthusiasm for success. Where external components are being delivered, make sure your internal resources are prepared to receive them in a timely manner (Arditi, et a!. ,2005).

During the project, the team needs to monitor the compliance of vendors and sub-contractors. They must ensure the goods or services supplied are acceptable. This needs to feed into the controls in the procurement process. 54 Where sub-contracted project personnel are involved, conduct a regular review of performance and compliance. With supplied items, conduct the appropriate degree of testing and check that they meet the agreed specifications (Herroelen et a/, 2000)

Tracey (1991) studied the Subgranting-general contractor relationship with the purpose “to better understand this relationship and possibly improve it” . The thesis detailed the common experiences of Subgrantings and determined that, corporately, they have many common concerns: one-sidedness of subcontracts, the bidding process favors the general contractor and the general contractors have the upper hand in the relationship. The most divisive areas in their relationships with general contractors were identified by the Subgrantings as bid shopping and onerous contractual clauses such as: pay-when-paid provisions, indemnification clauses and retainage practices (Schaufelberger eta!., 2009)

It usually costs far more than it is worth, can cause huge delays, may lead to the withdrawal of key elements of your solution, and may lead to sour relationships during subsequent operation and enhancements of the system (Herroelen eta!., 2000) On aspect of Effectiveness of the Health Projects, twenty five items were measured and showed on average High with a mean of 3.24. Also the means ranged from (3.97-2.13), this means that effectiveness of Health projects is considered vital in the organization in order to increase on the protection from loss and storage.

Significance R&ationship between the Lev& of subgranting and Extent of effecticevefless of Heafth projects in Aids ReNef centre Nsambya-Kampa~a-Ugaflda. The forth objective of sought to determine relationship between the level of Level of subgranting and Extent of effecticeveness of Health projects in Aids Relief centre-Nsambya-Kampala-Ugaflda. On this, the researcher stated a null hypothesis that there is no significant relationship between subgranting and Extent of 55 effecticeveness of Health projects. To achieve this last objective and to test the null hypothesis, the researcher correlated the means of all aspects of subgranting and Extent of effecticeveness of Health projects in Aids Relief Centre using Pearson linear correlation coefficient, as indicated in table 8 below:

Tab~e 8

Rdationship between the Relationship LeveH of subgranting and Extent of effecticeveness of Heafth projects in Aids Relief centre-Nsambya-KampaDa Uganda.

(Level of Significance = 0.05) VariaWes Correlated r-vaftie Sig. Interpretation JDecision on Ho Subgranting .383 .000 Significant Rejected Vs correlation Effectiveness of Health projects

Source: primary Data 2012

The results in table 8 indicate that the relationship that exist between subgranting and Extent of effecticeveness of Health projects in Aids Relief centre-Nsambya Kampala-Uganda is significantly correlated, (all sig.<0.05). This means that the more subgranting is given attention and available in the firm, the more the effecticeveness of Health projects in Aids Relief centre-Nsambya-Kampala-Uganda and the lower the subgranting contribution, the less the effecticeveness of Health projects.

56 CHAPTER FIVE

SUMMARY OF FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS

Introduction This final chapter presents and summarizes the findings, conclusions and recommendations of study. The study aimed to determine the relationship between the extent of subgranting and the level of effectiveness of health projects in Aids Relief centre-Nsambya-Kampala-Uganda SUMMARY OF FINDINGS The following were the findings of the study. 1. Respondents’ demographic characteristics in terms of gender, age, marital status, education level, position in the organisation, and length of experience. 1.1 More than half of the study participants were fem&e (75.0%) 1.2 Majority of the participants (33.0%) fall under the ear~y aduft stage of Dife (25-29 old). 1.3 On educational level, Bachdor hoilder dominated among others (37 .4%). 1.4 Regarding marital status, most of the respondents were married (33.0%) 1.5 Majority of the respondents were cUnica~ officers (37.4%) 1.6 With regards to length of experience, most respondents had spend 3- 4 years in the orgnisation(30.9%)

2. The extent of subgranting as practiced in the mission ranged from very high, Moderate to low~ Evidently there were some areas of subgranting in which the respondents were fully satisfied such as; 2.1 Subgranting firms are committed to their work. 2.2 What is being procured is an off the shelf or catalog item, some development will be required by the supplier selected.

57 2.3 You negotiate terms with representative on the subcontract management team. 2.4 You prepare results for review and approval.

3. Majority of the respondents response on the level of effectiveness of Health projects were good with these options most frequently rated high: 3.1 You acquisition for commodities, is usually eviated by competition 3.2 You accurately are reflecting all of the applicable prime contract requirements. 3.3 You expect services of higher performance requirements, faster product development, higher technology, materials. 3.4 You maintain maximum project control 3.5 You prepare the procurement package, evaluating proposals, and managing all activities of the procurement 3.6 You always collaborate with subgranting and prime contractors 3.7 You have clear procedure for measurement of performance

4~ There was a significant relationship between the extent of subgranting and the level of effectiveness of Health projects in Aids Relief centre-Nsambya Kampala-Uganda

Conclusions Based on the findings of this study, the following conclusions were drawn: 1. Participants of the study were satisfied with the extent of of subgranting and the level of effectiveness of Health projects in Aids Relief centre Nsambya-Kampala-Uganda. As indicated by the high only both in independent and dependent variable. Since the ratings were confined only from very high to low level, the participants in the of subgranting and the level of effectiveness of Health projects in Aids Relief centre-Nsambya Kampala-Uganda under study .As for the null hypothesis, results indicated a 58 positive significant relationship between extent of subgranting and the level of effectiveness of Health projects leading to a conclusion that the more attention subgranting is given in the firm, the more effectiveness of Health projects. 2. The Theory of Economic Game Theory Model of subgranting Resource Allocation of Fernandez eta,,1998, were this study was based was proven to be correct as revealed in the findings, it states that, periodic review and adjustment of resource allocations to construction projects is critical for subcontracting/Subgranting to maintain profitability under traditional unit price or lump sum contracts. Project managers strive to control subcontracting/Subgrantings in an effort to meet budgets and schedules; Suhgrantings/contracting often work on multiple projects simultaneously and strive independently to allocate resources to those projects where they perceive that they will bring maximum utility. An economic game theory model is proposed as a foundation for understanding the behaviour of Subgrantings in allocating resources to projects. The model describes the influence of the degree of reliability of the planned schedule on SubgrantingsT and project managers~ behaviours under traditional unit price contracting~ Unreliable plans undermine efforts to promote cooperative behaviourS

Recommendations In light with the findings of the study, the following pointers were suggested: The Aids Relief centre-Nsambya under study should thoroughly look into the weak points both in the practice of procurement procedures and supply delivery and identify ways on how to enhance and rectify further on these areas such as: a~ Subgranting a~1 Need for the government of Uganda to strengthen the training programmes in effectiveness of health institutions, including regular

59 continuing medical training education programmes, as well on subgranting trainings. a.2 Physical inspection; Gathering physical evidence (if required) when testing high-risk sub recipients. a.3 providing written requests to a third party to confirm assertions made by the sub recipient. a.4 examining documents that support a recorded transaction and a verification of the recording of a document in the accounting records. a.5 Obtaining management and employees’ responses to questions about the operations of the sub recipient. a.6 Re-performance, performing computations to independently verify the integrity of transactions or balances that is to say, determining eligibility and benefits for a program. a.7 Need to strengthen the participation at community level, especially guardians in operating health project as a means of skills transfer and empowerment Need for improved documentation of project management processes, including appraisal documents, activity reports, close out reports and other documents for reference. a.8 evaluate a general contractor in order to provide Subgrantings with useful information to structure their future bidding practice toward general contractors b~ Effect~veness of heafth projects b.1 witnessing physical activities such as taking physical inventory, touring facilities, and attending client staffing meetings b.2 Reconciliation; matching two independent sets of records to provide assurance of completeness and existence b.3 critically reading a document to compare the information contained in the document with other known information bA Need for improved feedback mechanisms at all levels of project

60 implementation b~5 Need for coordination of support by various originations at school level to maximize support utilization and help promote comprehensive support for as well as reduce on possible duplication of efforts and promote continuation of support. b~6 Need to consider giving Relief centre support that is holistic, including meeting children’s emotional needs through psycho- social support b.7 Projects needed to focus on sustaining Health intervention which were being implemented~ b~8 Need to consider giving subgranting firms support that is holistic, including meeting children’s emotional needs through psycho-social support. There needs more support beyond material and school requisites which include emotional support and socializationS

2. To reinforce the recommendations mentioned above, Aids Relief centre Nsambya-Kampala-Uganda under study should present the findings of the research and proposed strategies encounter them.

Areas for further research The researcher proposes that further research could be done along the following areas. (1) A similar study in other the same area be conducted in several organisation to enrich the findings of this study. And (2) the issues of employee training , awarding tenders and qualification of the tenders should be given a thorough research

61 REFERENCES Adrian, J. 3. (1987). ConstructIon Productivity Improvement New York: Elsevier Science. Arditi, D., Chotibhongs, R. (2005). Issues in Subcontracting Practice. Journal of Construction Engineering and Management, 131(8), 866-875. Aumann, Robert 3., and Sergiu Hart, ed. (1992, 1994, 2002). Handbook of Game Theory with Economic Applications, 3 v., Elsevier. Table of Contents and “Review Article” (Abstract) links Barrie, D. S., Paulson Jr., B. C. (1992). Projects Construction Management Induding CM,Design-Construct and General Contracting. New York: McGraw-Hill, Inc. Bausman, D.C., (2004). Retainage Practice in the Construction Industry. Alexandria, VA. Birrell, G. S. (1985). General Contractors” Management: How Subs Evaluate It. Journal of Construction Engineering & Management, .3~ 3), 244-259. Callahan D. “The WHO definition of !healthl.H The Hastings Center Studies, 1(3),

1973 - http://www.jstor.org/pss/3527467 Chester, M., Hendrickson, C. (2005). Cost Impacts, Scheduling Impacts and the Claims Process Constantino, N., Pietroforte, R., Hamill, P., (2001). Subcontracting in Commercial & Residential Construction: An Empirical Investigation. Construction Management and Economics. 19, 439- Cooper, Robert G.; Scott 3. Edgett, and Elko 3. Kleinschmidt (1998). Portfolio Management for New Products. Reading, Mass.: Addison-Wesley. Critical Chain Project Management. Tides of Change ‘98 PML Proceedings of the 29th Annual Project Management Institute 1998 Seminars and Symposiums; AIPM. Pennsylvania, USA: PMI; 1998. Davis, S., Prichard, R., (2000). Risk management & Insurance Bonding for the Construction Industry. Alexandria VA: Associated General Contractors of America. 62 Denney, Richard (2005). Succeeding with Use Cases: Working Smart to Deliver Quality Boston, Mass.: Addison-Wesley. ISBN 0-321-31643-6. Dossick, C.S., Schunk, T.K., (2007). Subgranting Schedule Control Method. Journal of Construction Engineering and Managemen4 262-265. Douglas Hubbard (2007).TTHow to Measure Anything: Finding the Value of Intangibles in BusinessTT John Wiley & Sons, During Construction. Journal of Construction Engineering and Management. Egan, Eileen. For Whom There L9 No Room: Scenes from the Refugee World NY: Paulist Press, 1995. ISBN 0-8091-0473-3 Elton J, Roe J. Bringing disci7iline to project management Harvard Business Review 1998(March-April): 153-9. Fernandez, L F.; Bierman, H S. (1998), Game theory with economic applications, Addison-Wesley, ISBN 978-0-201-84758-1. Suitable for upper-level undergraduates. Foundation of the American Subgrantings Association, Inc. Fowler, F., (1990). Standardi~ed Survey Interviewing—Minimi~ing Interviewer Error. Thousand Oaks, CA: Sage Publications, Inc. Fudenberg, Drew; Tirole, Jean (1991), Game theory, MIT Press, ISBN 978-0-262- 06141-4. Acclaimed reference text. Description. Garrett, M. D., (1979). Complete Handbook of Successful Subcontracting. Englewood Cliffs, N.J.: Prentice-Hall. Gibbons, Robert D. (1992), Game theory for applied economists, Princeton University Press, ISBN 978-0-691-00395-5. Suitable for advanced undergraduates Gliner, J. A., Morgan, G. A., (2000). Research Methods in Applied Settings: An Integrated Approach to Desi~in and Analysis. Mahwah, NJ: Lawrence Erlbaum Associates, Inc. Gould, F. E., Joyce, N. E., (2009). Construction Project Management 3 Rd ed. Upper Seattle River, NJ: Pearson Education, Inc.

U ~) Gray V, Fela n J, Urn ble E, Urn ble M. A comparison of drum-buffer-rope (DBR) and critical chain (CC) buffering techniques. Project Managernent Research at the Turn of the Millenium. Proceedings of PMI Research Conference 2000. Harneri A-P, Heikkila J. Improving efficiency: tirne critical interfacing of Project tasks. International Journal of Project Managernent 2002;20(2):143-53. Hendrick, D., Schernrn N., (1991). Safeguarding Your Subcontract Rights. Alexandria, VA: Foundation of the Arnerican Subgrantings Association. Hendrickson, Chris. & Au, Tung. (2000) the Design and Construction Process. Project Managernent for Construction: Fundamental Concepts for Owners, Engineers, Architects and Builders. Herroelen W, Leus R. On the merits and pitfalls of critical chain scheduling. Project Management Research at the Turn of the Milleniurn. Proceedings of PMI Research Conference 2000. 21-24 June 2000; (21-24 June 2000); AIPM. Hinze, J., Tracey, A., (1994). The Contractor-Subgranting Relationship: The Subgranting’~s View. Journal of Construction Engineering and Management. Hollander, H. J., (2002). “Pay When Paid” Construction Contract Requirement: Bane of the Subgrantings Existence. Florida Bar Journai~. June, 101-103. Howard, Nigel (1971), Paradoxes of Rationality: Games, Metagames, and Political Behavior, Cambridge, Massachusetts. Hsieh, T., (1998). Impact of Subcontracting on site Productivity: Lessons Learned in Taiwan. Journal of Management Engineering, 124(2), 91-100. Hunt, G. (2006) ‘The Principle of Complementarily: Freedom of Information, Public Accountability & Whistle blowing’, chap 5 in R A Chapman & M Hunt (eds)

Open . Ashgate, Aldershot, Government in a Theoretical and Practical Context Huycke, A. E., (1998). Primary Causes of Subcontract Failure and Recommended Strategies to Prevent Failure. Unpublished master’s thesis, University of Washington, Seattle.

64 Leyton-Brown, Kevin; Shoham, Yoav (2008), Essentials of Game Theory: A Concise, Multidisciolinary Introduction, San Rafael, CA: Morgan & Claypool Publishers. Loader R. Creating an organisation-wide Project management culture. The Art of

Strategy. Project Management - Creating Solution. AIPM 1999; AIPM. Sydney: Australian Institute of Project Management (AIPM); 1999. Miller, James H. (2003), Game theory at work: how to use game theory to outthink and outmaneuver your competition~ New York: McGraw-Hill, ISBN 978-0-07-140020-6. Suitable for a general audience. Moylan WA.(2001) Managing manufacturing by Project. PMI Seminars and Symposium Proceedings; 2001 Nov. 1-2001 Occupational Health and Safety (OHS) Act 2004 (Vic)

Patrick ES. Buffering against risk - critical chain and risk management. PMI Seminars and Symposium Proceedings 2001; 2001 Nov. 1-2001 Nov. 10; AIPM (CDR0m). USA: PMI; 2001. Proctor Jr., J.R., (1996). Golden rule of Contractor-Subgranting Relations. Practice Periodical on Structural Desiqn and Construction, 1(1), 12-14. Rahman,.M.M., Kumaraswamy, M. (2005). Relational Selection for Collaborative Working Arrangements. Journal of Construction Engineering Management~. 131(10), 1087-1098. Rufus Isaacs, (1999), Differential Games: A Mathematical Theory With Applications to Warfare and Pursuit~ Control and Optimization, New York: Dover Publications. Sanwal, Anand (2007). Optimizing Corporate Portfolio Management: Aligning Investment Proposals with Organizational Strategy. WIley. Schaufelberger, 1, (2009). Construction Business Management Upper Seattle River, NJ: Pearson Education, Inc. Seminars and Symposium. Proceedings 99; 1999 Oct. 10-1999 Oct. 12; AIPM (CD Rom). USA: PMI; 1999.

65 Shash, A.A., (1998). Subgrantings~ Bidding Decisions. Journal of Construction Engineering & Management, 124~3), 219-225. Simpson WP. Critical success factors. Discussion in Project management circles is centred on determining what is new about critical chain Project management and what isn’t. Australian Project Manager 2000;20(2):34-5. Wickwire, 1 M., Fisher, W. B~, Kelley, M. P., Bertke, F. H., (1995). The Construction Subcontracting Manual Practice Guide with Forms. Hoboken, NJ: John Wiley & Sons, Inc. Workplace Health and Safety Act 1995 (QId) World Health Organization. 2006. Constitution of the World Health Organi~ation Basic Documents, Forty-fifth edition, Supplement, October 2006. Yates, 1K., Duran, 1, (2006). Utilizing Dispute Review Boards. Journal of Projects Issues in Engineering Education and Practice, 132(4), 334-341.

66 APPENDICES

APPENDIX 1k TRANSMITTAL LETTER FROM CHDR

- ‘ a1 \i”HR$’ 17

OF~BCE OF THE HEAD OF DEPARTMENT~ ECO” ) “ICE 7’ 7 MANAGE’IENT CCI I ‘I dES

Hi’,: ZIQC’SI’KaJ/i)i ~UMfIk f’UC &7’I)l C”’ R’,VAR,iI C,’ I IC ,~ \~ ‘ 7)’

T”9a )QQVC rite tEa ird a a flanaiftif’ stad,”tt ti ‘amp-ta ft a’ ‘a’ ,3U~1,IiiflC, [“last-a’s itt Project iCaarmmmmp.

‘-ti “a [p -,:m7’’citaa ,‘ a am C a -i--I El c.ctl’ enecs C I’ “~oeite Fi-oject’ ‘t C. :7, a. ‘C 5’”’ ‘in-- Relief Services in Nsariaya, ‘sakindvn C v’s a ~,a ‘raii; Vgsroa

Yr)mjm Cr’ mi~rIi C,ilOml ma’; Dr’C’ti mdermtmlmcc ~is ‘ ,am a’:” ,‘er,-mmmmae [a, ha’ a’s-a a V OjCc’a [[IC’ ~t11tM)~C. -a’ [a mvai[ rat “ritE mIle [0 m’l’r’l(’mlt mn(crmatmom simm- reai a’’

a ~ a’a’ -~m ‘Q~ ‘>0, p -a,- 1’’ ft a ‘ m a, a ‘ a lIt”

[a’s a’>smat -mar r trio’, I’ Cc tIe ;vml’ P - i’mc,j’C. ate ,‘-‘ t- a

“ r.” tat’ a,,

“1.’:” ,‘ttt,1c,’ ar’ mm 5’t,~, ‘-~ sea’ ‘Y “aria--ar- etH a-acm’: tea’s an C >J’anageament Sciences, ~,C a

m’i7’m’E S / -~ Spurt a,> ~t i’~ ,CI’t~ ‘rmaCirsti -17177

67 APPENDIX 1B: TRANSMITTAL LETTER FOR THE RESPONDENTS

Dear Sir/Madam,

Greetings!

I am a postgraduate student of Kampala International University. Part of the requirements for the award is a dissertation. My study is entitles, “Sub granting and effectiveness of Health Projects; A case ofAIds Relief Services in Kampala, Uganda” Within this context, may I request you to participate in this study answering the questionnaires? Kindly do not leave any option unanswered~ Any data you will provide shall be for academic purposes only and no information of such kind shall be disclosed to others

May I retrieve the questionnaire within five days (5)?

Thank you very much in advance.

Yours faithfully,

Kazadi Ntumba Bintu 0757 933 338

68 APPENDIX II: CLEARANCE FROM ETHICS COMMITTEE

Date______Candidate’s Data Name______Reg.# Course ______

Title of Study —

Ethica~ Review CheckHst The study reviewed considered the foHowing: Physical Safety of Human Subjects Psychological Safety Emotional Security Privacy Written Request for Author of Standardized Instrument Coding of Questionnaires/Anonymity/Confidentiality

— Permission to Conduct the Study

— Informed Consent Citations/Authors Recognized

Resufts of Ethica~ Review Approved Conditional (to provide the Ethics Committee with corrections) Disapproved/ Resubmit Proposal

Ethics Committee (Name and Signature) Chairperson

Members ______

69 APPENDIX III: INFORMED CONSENT

Gas ___ CATHOUC RH iFF SEIMCES p~517,mxk~Nsmt~aRd P Ob3OO~.krosia

TO WHOM IT MAY CONCERI% March 28~ 2012

Dear SiPNadani,

Re: KAZADI NTUMBA BJtslU’a study.

~ on, “Sub-granling and Effectiveness of Heahh Project in Uganda”. We assisted her in sharing bet queslionnaires ~ ~

K. Mwayabo. MD. MPH. Chief of Party-AlDSReliefProgrfl Catholic Relief Services-Uganda Program. Tel: ÷2563~2266422 E-mail: ~pJ%~1fl4CtLOtIOtiCffiflnb4Pt1~c0m

70 Appendix IV A: FACE SHEET: DEMOGRAPHIC CHARACTERISTICS OF THE RESPONDENTS Direction: Please provide information about yourself. Kindly tick or fill out in the blank spaces of each option:

A~ Organization (Company) Staff

Gender: Male ______Female

Age: 20-39 years

40-59 years

60 years and above

Marital status: Married ______Single

Divorced Widowed

Educational level:

Certificate _____ Masters ______

Diploma Ph.D.

Bachelors ______Others (please specify)

Your position/post in the bank: ______

Number of years service as company staff: ______

71 Appendix IV B : QUESTIONNAIRE TO DETERMINE THE METHODS USED FOR SUCCESSFUL SUBGRANTING IN HEALTH PROJECTS Direction: Please write your preferred option on the space provided before each item, Kindly use the rating guide below: Response Mode Rating Description Strongly Agree (4) You agree with no doubt at all. Agree (3) You agree with some doubt Disagree (2) You disagree with some doubt Strongly Disagree (1) You disagree with no doubt at all 1. The employee performance evaluation is one of the key activities in a performance management process?. 2. Your subcontract management approach is intended to emphasize; clear commitments to excellence in performance; measurement of performance; internal Enterprise ‘~ownership11 and pride in the subcontracted product; and integrity for both company and Subgranting, who are working on the product. 3. The acceptance of responsibility by an Enterprise individual for the performance of all effort for which budget responsibility has been delegated. 4. Unless what is being procured is an off the shelf or catalog item, some development will be required by the supplier selected. 5. Each team is responsible for preparing the procurement package, evaluating proposals, and managing all activities of the procurement ~ Each team should include representatives of (1) Engineering as the subsystem manager1s delegate; (2) Materiel as the subcontract representative and team business manager; (3) Product Assurance as the quality requirements and evaluation representative; (4) Program Office as the program requirements and integration representative; and (5) Program Controls where warranted. ~7. One of the initial functions of the subcontract management team is the development of a subcontract procurement package

72 Appendix IV C: QUESTIONNAIRE TO DETERMINE THE EXTENT OF EFFECTIVENESS OF HEALTH PROJECTS Direction: Please write your preferred option on the space provided before each item. Kindly use the rating guide below: Response Mode Rating Description Strongly Agree (4) You agree with no doubt at all. Agree (3) You agree with some doubt Disagree (2) You disagree with some doubt Strongly Disagree (1) You disagree with no doubt at all

8~ Subcontract definition based on and accurately reflecting all of the applicable prime contract requirements~ 9. Customers expect that products or services must be supplied in a way responding; higher performance requirements, faster product development, higher technology, materials and processes pushed to the limit, lower contractor margins and fewer defects 1O. Project managers get in touch with people working for the project to announce the decisions and the works what to be done. 11. The team conducts the source selection process following applicable policies and procedures, and prepares the results for review and approval by the designated source selection authority within the Enterprise. _12. Company—wide, the organizational structure is not cost-effective because more people than necessary are required, primarily administrative~ 3. Each functional representative on the subcontract management team is his or her organization’s spokesperson for that subcontract, including that organization’s “ownership” responsibilities during all phases of the procurement. _14. The Materiel subcontract representative is the team’s contracting officer and as such is the expert on the “rules of the road” for procurement 15. The project manager maintains maximum project control (through the line managers) over all resources, including cost and personnel.

I-) ~16. Policies and procedures can be set up independently for each project, provided that they do not contradict company policies and procedures

17. The project manager has the authority to commit company resources, provided that scheduling does not cause conflicts with other projects. 18. The Product Assurance representative is the team quality manager and as such is responsible for developing the subcontract quality requirements and assuring that they are consistent with the prime contract quality requirements 19. A strong technical base can be developed, and much more time can be devoted to complex problem- solving. Knowledge is available for all projects on an equal basis 20. There is Presence of written and operational promotion policy. 21. Some excellent and lasting supplier selections have been made outright on the basis of a face-to-face discussion. 22. Screening out unqualified bidders can be accomplished by sending out requests for information (RET’s) to any interested parties with the objectives of the procurement and necessary qualifications ~ Because key people can be shared, the program cost is minimized. People can work on a variety of problems; that is, better people control is possible. 24. A strong technical base can be developed, and much more time can be devoted to complex problem- solving. Knowledge is available for all projects on an equal basis ~25. The acquisition of commodities, products, or services, presents four common types of problem that can be alleviated by competition. 26.In selecting sources of supply for any commodity or service we seek a competent, reliable supplier with a good competitively priced product solution, who is interested in being a valued member of the project team, and who shares the buyer’s values.

74 27. In the formulation of a program strategy, the program or project manager should prepare the proposed make or buy plan with the participation of supporting organizations 28. Contract management is the management of the contract which is signed between the company and its employee 29. if contracting is costly, the possibility that the parties might behave opportunistically after the investments are sunk to try to get a larger share of these rents. The boundaries of the project are chosen optimally the minimize the resulting efficiency losses. 30. A question that has received little attention is how relationship-specific investments affect contracts when the boundaries of the firm are given

Thank you very much for your cooperation

75 APPENDIX V: SAMPLE SIZE DETERMINATION

S = 1+P (O~O5)2

Where: P = Population = 900

S = Sample size

0.05 = Level of Significance

= 900 I 2.4193548 =372

76 APPENDIX VI: Sketch map showing the location of the study area ( Nsambya)

9~

0 0

I (

I ~i 0

~~flifW~ - 0

ci :i~~ i~ ~t :~ ~:l :

:J ~: i I Gt~bgI~~ t$ ~2D~ Gooq~ Tr ~c t~s 4Mr

Source: secondary data 2011 Key; Aids Relief Service Centre (Study area) The study will be carried at Aids Relief service Nsambya Makindye division.

77 RE5~ARCHER’S CIJRRICLLLVM VITEAIOI1 PERSONAL PROFILE: NAME : KAZADI NTUMBA BINTU GENDER FEMALE MARITAL STATUS : MARRIED NATIONALITY : CONGELESE RELIGION : CATHOLIC DATE OF BIRTH : 09/AUGUST/1979 PLACE OF BIRTH : KOLWEZI /LUMUMBASHI CONTACT ADDRESS : P. 0. Box, 20000, Kampala International Universit:y TELEPHONE NO : +256 757933338 E-mail : myliantumba@yahoo~com

EDUCATION BACKGROUND: Year Hea[th /Institution Award Obtained 2010/2012 Kampala International University Masters of Project P.O Box 20000,Kansanga Ggaba Planning and Management Road Kampia-LJanda (Candidate)

2005 - 2000 Democratic Republic of Congo Bachelors of Law Lubumbashi February 1999 Loycee Twendelee Secondary Uganda Advanced to November Health Certificate Education 1994 P.O Box Democratic Republic of (U.A.C.E). Lc~n~cJKi nshasha

WORKING EXPERIENCE; LYear Organisation/Institution ~Designation/position Paluis De Justice 26th July De Lubumbashi Assistant Barrister ~ SUMMARY OF DUTIES /RESPONSIBILITIES

o Receiving both inland and international calls, attending to clients with information concerning the University, in charge of University mails. o Registering clients, preparing meetings, typing minutes, attending to clients’ complaints 78 • Typing minutes, attending to clients’ complaints concerning missing results, harmonizing time tables of all faculties.

Projects Skills Computer Skills:Training in MS office, internet access, dream weaver, photo shop Interests: Charity work, community work, computer work, trading, accountancy, traveling and reading Language proficiency Other Languages a) English, b) French c) Ki nya rwa nda, d) Lingara e) and little Swahili

REFERENCES; 1. Dr. Kazadi Mwayabo Chief of Party Aids Relief-Nsambya Kampala -Uganda

2. Miss. Asiimwe Fridah Administrative Assistant - p4LPI Deputy Director Academic Affairs Kampala International University P. 0. Box, 20000 Kampala-Uganda Mobile: +256 782619303 ~o ~2-~ 3. Mr. Musoke Matthew Head of Administrative Assistants (CEODL) College of Education, Open, & Distance Learning Kampala International University P. 0. Box, 20000, Kampala, Uganda. Mobile: +256 752 400 274 Declaration; I, Kazadi Ntumba Bintu, declare that the information given in this resume is correct and to the best of my knowledge as per 2012.