Creating a Common Vision for Saving Children’s Lives in Côte d’Ivoire

{Photo Credit: Julienne Ahua/MSH}Dr Kouadio (with the stethoscope) and her pediatric team at Yamoussoukro Regional Hospital Center.Photo Credit: Julienne Ahua/MSH

"My passion for babies was born from personal experience. I lost my parents at a very early age,” recalled Dr. Kouamé Kouadio, Head of the Pediatric Department at the Regional Hospital Center of Yamoussoukro, the administrative and political capital of Côte d'Ivoire.

As an orphan, she could not pay for medical care, and she had no one to care for her when she was sick. When she was in the first grade, she often had seizures and was sent to the hospital. But when she arrived, the health workers would become  frustrated with her and often failed to provide appropriate care.

“Every time I went through this,” said Dr. Kouadio, “I promised myself I would become a doctor one day to transform the image of this hospital.”

The Yamoussoukro Regional Hospital Center is among the busiest referral hospitals in the Bélier region, but as Dr. Kouadio acknowledged, she and her colleagues worked in a climate of mistrust before they participated in the Leadership Development Program (LDP+), an experiential learning and performance enhancement process developed by MSH.

Before LDP+, tension was palpable in the pediatric ward. Hospital staff gossiped and complained that Dr. Kouadio was too strict. In these challenging conditions, it was difficult for staff to create a shared vision and to make every effort possible to prioritize the well-being of their patients. Meanwhile, parents without money for their children’s medical care feared they would be unwelcome at the hospital, so they would wait until their children were terminally ill before bringing them in.

Recognizing the challenges at the hospital, the Ministry of Health and Public Hygiene and the Bélier Regional Health Director brought the Leadership, Management and Governance (LMG) Project’s LDP+ approach to the hospital, with financial support from the World Malaria Fund and technical support from MSH.

Through LDP+, hospital staff participated in a series of intensive trainings. They worked together as an improvement team, to create a common vision and implement an action plan: to reduce the number of child (0 to 5 years) deaths in the pediatric ward from 31 to 10 during the period from May 1 to December 31, 2016.

Dr. Kouadio involved the entire pediatric department in the goal to reduce child deaths. She created space for participatory discussion and charged everyone with the responsibility for making improvements, which included regular meetings and visits to colleagues’ offices. As a result of LDP+, colleagues achieved a more positive working environment. The reception of patients also improved: health workers greeted patients with a smile and reduced wait times.

"My vision is that the hospital should not be a mirror but a place where one feels confident and rejuvenated when leaving it. But how can we share this vision in a climate of mistrust at the  workplace?After our involvement in LDP+, my colleagues and I succeeded in moving from vision to action! This is just incredible.”

Most important, fewer children died at the hospital between April 2016 and 2017; under-5 child deaths in the pediatric department decreased from 31 to 12. Through improved collaboration and a proud commitment to their shared vision, Dr. Kouadio and her colleagues could focus on what they were there to do: save children’s lives.

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