Effective primary health care requires strong management structures behind frontline service delivery. Health systems must be able to coordinate people, resources, processes and institutional responsibilities effectively if services are to function consistently.

Understanding where management systems are performing well and where capacity gaps exist is therefore an important step in designing meaningful health system improvements.

A structured management capacity diagnostic provides a way to examine these issues before interventions are designed, helping ensure that subsequent strengthening efforts respond to the realities of the health system rather than assumptions about its needs.