governance

Dr. Jonathan Quick, President and CEO of MSH, tours with Dr. Christian Nzitimira, director of Kibagabaga Hospital in Rwanda. {Photo credit: Jon Jay/MSH.}Photo credit: Jon Jay/MSH.

In a postoperative ward of Kibagabaga Hospital, the district hospital serving Rwanda’s capital city of Kigali, Eric Bizimana sits up in bed. Bizimana, 25, had sought care after severe pain in his right leg forced him to stop work as a barber. He was diagnosed with a bone infection called osteomyelitis. Antibiotics alone couldn’t clear the infection. Without an operation to remove the diseased bone, Eric faced the possibility of losing his leg.

Eric was one of the 40 patients who enter Kibagabaga for surgery every day. In Rwanda’s tiered healthcare delivery system, patients are referred from local health centers up to the district hospital when their conditions require more complex care. Most babies are delivered at health centers, for example, but a woman suffering complications or who was expected to need a C-section would be referred to the district level.

Integrating the Leadership Development Program into Guyana's national nursing school training (watch video): Guyana HIV/AIDS Reduction and Prevention, phase two (GHARP II), a PEPFAR-funded and USAID-supported project.

Developing Strong Health Leaders Saves Lives, the newest edition of MSH's Global Health Impact e-newsletter (subscribe), features:

Conference attendees were still full of energy on the final day of Kenya’s First National Conference on Health Leadership, Management and Governance. {Photo credit: MSH.}Photo credit: MSH.

After a very busy week scurrying around behind the scenes at Kenya’s First National Conference on Health Leadership, Management and Governance, the staff of the USAID-funded Leadership, Management and Sustainability project in Kenya (LMS/Kenya) gathered on Friday morning before the start of the fourth and final day. Generally, the last day of a conference is filled with summaries and closing-day formalities. But this time, Project Director Karen Caldwell informed us that we still had one essential task ahead. Our challenge was to assist the more than 250 participants to articulate, with a common voice, a clear and actionable “Way Forward” based on all of the rich and complex discussions of the many sessions, skills-building workshops, and networking meetings that had occurred during the past week. This is critical as Kenya is transitioning to a new health sector governance structure that will give responsibility for service delivery to the county-level authorities; for many conference attendees it was their first opportunity to discuss how they can shape and support this process.

Maria Francisco, USAID, with guest speakers from Ethiopia, Dr. N. Kedir Bilal, and Ghana, Dr. Elias Sory. {Photo credit: MSH.}Photo credit: MSH.

Today, in Nairobi, Kenya, we’re celebrating the opening of the First National Conference on Health Leadership, Management and Governance, a joint undertaking of the Ministry of Medical Services and the Ministry of Public Health and Sanitation with support from Management Sciences for Health through the USAID-funded Leadership, Management and Sustainability Project in Kenya (LMS/Kenya).

By coincidence, it also marks the second anniversary of my own arrival in Kenya to assume responsibilities as the communications specialist on the LMS/Kenya project. In these past two years, I've seen the “buzz” about leadership and management in the health sector grow into a virtual shout. This conference is the culmination of a steady and persistent push to strengthen health leadership and management capacity in Kenya which started long before I came here.

MSH: Saving lives and improving health in 2013.{Image credit: MSH.}Image credit: MSH.

We have seen some remarkable gains in global health in 2012. Yet millions of women, children, and men still die from preventable causes. As we pause and reflect on 2012 and look ahead to the new year, I invite you to read and share some of our favorite blog posts from the year.

Richard Horton moderates a panel on post-2015 development goals. {Photo credit: HSR-Symposium.org}Photo credit: HSR-Symposium.org

Last month, I joined over 1,800 participants from more than 100 countries in Beijing at the Second Global Symposium on Health Systems Research. We've made some concrete steps forward since we last met in Montreux, Switzerland, two years ago, among them the launch of a new research society Health Systems Global. Central topics of this year's discussions included: “Inclusion and Innovation towards Universal Health Coverage” (UHC), the symposium theme, and monitoring and evaluation.

K4Health Knowledge Management/Health Systems Strengthening Conceptual Framework. {Image credit: MSH.}Image credit: MSH.

Cross-posted from the K4Health blog

No matter which health system building block you are trying to improve, you need specific data, information, and knowledge to inform your decision-making process—this is where good knowledge management comes in handy.

The Intersection of Knowledge Management and Health Systems Strengthening: Implications from the Malawi Knowledge for Health Demonstration Project” provides an interesting case study of the connection between improved knowledge management and health systems strengthening.

Senegal {Photo credit: Galdos/MSH.}Photo credit: Galdos/MSH.

Crossposted on Maternal Health Taskforce's mhtfblog as part of the Maternal Health Commodities Blog Series.

Despite a decade of significant progress reducing maternal mortality rates, very few countries are on target to meet Millennium Development Goal of reducing the maternal mortality ratio by three-quarters by 2015.

Women meeting in Senegal. {Photo credit: Galdos/MSH.}Photo credit: Galdos/MSH.

Good governance in health care matters at all levels of the health system—from communities to health facilities to governments. When a community HIV & AIDS association in Zanzibar grew from 40 members to more than 1,000, it needed better governance. When women in Senegal raised concerns about lack of privacy and poor security at a district hospital, it needed better governance. And when the national health insurance program in Kenya was underperforming even after efforts to address its management and leadership, it too needed better governance.

Until recently, governance was arguably the most tenacious but unspoken barrier to achieving widespread, large-scale, sustainable health impact. In the 1990s, global health programs focused on training health managers. In the 2000s, as management improved and the need for stronger leaders became evident, the focus expanded to leadership development. By now, we’ve developed robust practices for building the capacity of health managers and leaders at all levels of country health systems.

{Photo credit: MSH.}Photo credit: MSH.

Policy makers and health sector leaders in low- and middle-income countries are recognizing the value of smart governance for significant and sustained gains in health status outcomes. The new USAID Leadership, Management and Governance (LMG) project, led by MSH with a consortium of partners, is actively engaged in building the capacity and competencies of those expected to accomplish smart governance.

To explore smart governance, LMG convened a Roundtable on Governance for Health in low- and middle-income countries May 18, 2012, at The Brookings Institution in Washington DC.

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