New Series: Leadership, Management, and Governance for Stronger Health Systems

New Series: Leadership, Management, and Governance for Stronger Health Systems

{Photo Credit: Carmen Urdaneta/MSH}Photo Credit: Carmen Urdaneta/MSH

Strong, well-functioning health systems need strong leadership, management, and governance. Over the next couple of weeks, leading up to conversations that MSH is hosting at the Global Symposium on Health Systems Research next month in Vancouver, we will be sharing stories and insights about the role of leadership, management and governance in health systems strengthening.

Over the last five years at the MSH-led, USAID-funded Leadership Management and Governance Project, our experience has underscored the importance of good governance, management and leadership to achieve service delivery outcomes in all health areas — from family planning to maternal, newborn and child health to HIV and AIDS.

The Leadership, Management and Governance Project's activities range from strengthening leadership and management skills of staff at the centralized level of Haiti's Ministry of Public Health and Population to supporting midwife managers to deliver high-quality family planning and reproductive health services in their communities at the decentralized level in Malawi.

Participants in our Leadership, Management, and Governance for Midwifery Managers certificate course — developed with our partner Amref Health Africa and rolled out in ten countries in sub-Saharan Africa — were able to use the skills they learned to increase prenatal visits, hospital deliveries, and male involvement in partners' pregnancies.

Our recent prospective research study in Cameroon demonstrated that when service providers received skills building in leadership development along with clinical training, there was a significant increase in women receiving antenatal and postpartum family planning services at those health facilities, compared to health facilities where staff received clinical training alone. On average, training through MSH's enhanced Leadership Development Program Plus (LDP+) training combined with clinical training increased the hospital's antenatal counseling rate by 54 percent and postnatal counseling rate by 69 percent. The LDP+ is also proving to be valuable in bringing together actors from different sectors to work on health issues, like epidemic preparedness in Côte d'Ivoire. This work was recently highlighted by the Global Health Security Agenda.

Working with partners, the Leadership, Management and Governance Project has been able to include leadership, management, and governance competencies into national curricula for health workers in Ethiopia, Rwanda and Zambia—giving students key planning, critical thinking, teamwork, and problem solving skills before they graduate.

We've also seen results embedding long-term advisors in National Malaria Control Programs in six countries to strengthen their organizational capacity and, ultimately their ability to effectively implement their national malaria strategies. In Guinea, for example, central level malaria control program staff worked with private facilities to increase submission of monthly malaria data by 83 percent — from 17 percent to 100 percent over four months.

Indeed, leadership, management, and governance can be improved at all levels of a health system. By building the capacity of individuals, organizations, and governments, we can improve health service delivery and ultimately improve health outcomes.

Stay tuned for our next message which tells the story of Linvell Nkhoma—a midwife manager at Mitundu Community Hospital in northern Lilongwe, Malawi. Six months after starting our midwifery managers certificate course, Linvell was able to decrease premature neonatal mortality at her hospital by 25 percent.

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