Leadership, Management & Governance: Our Impact

Águida Curo Vican, at right, visiting a new community member to share information on healthy practices. {Photo credit: MSH}Photo credit: MSH

Peru’s maternal mortality rate remains among the highest in the Americas. Access to health care workers who speak indigenous languages such as Quechua is almost nonexistent. Chronic child malnutrition affects close to half of children under five years of age. And men pay little attention to areas considered "women's issues," such as maternal, child, and reproductive health. Fortunately, all of this is changing in the rural Peruvian community of Tutumbaru, thanks to Águida Vicaña Curo and the Local Development Committee (LDC).

A SARO participant explains how observed behaviors can demonstrate the practices of a leader. {Photo credit: MSH}Photo credit: MSH

In June 2010, USAID’s MEASURE Evaluation, phase III (MEval-III) launched a Leadership Development Program (LDP), led by Management Sciences for Health (MSH), in the Southeast Asia Regional Office (SARO) of International Planned Parenthood Federation (IPPF). IPPF is a global organization that works through a network of country member associations and select partnerships with local organizations to provide services and advocate for sexual and reproductive rights around the world.

Do leadership, management, and governance interventions result in improved service delivery outcomes (and therefore better health outcomes)?While there is ample evidence on what constitutes high-impact public health and service delivery interventions, there is little documented evidence on the outcomes and impact of leadership, management and governance interventions or programs.

How do you measure the overall health of an organization? Evaluating a person’s health is relatively easy – doctors around the world agree on the basic concepts of physical health, and measurements and standards have been well established for “ideal” height, weight, blood pressure, heart rate, and other components of health.

Dr. Jide Idris, Lagos State Commissioner for Health (middle), Dr. Barry Smith, MSH Nigeria Country Director (right), and Permanent Secretary, Lagos State Ministry of Health during an interactive session with participants at the ministry headquarters. {Photo credit: MSH.}Photo credit: MSH.

Many Nigerians are recognizing that community-based health insurance (CBHI) can increase access to healthcare services. Since 2008, Nigeria’s Lagos State Ministry of Health has been piloting CBHI schemes in Ikosi-Isheri and Ibeju-Lekki local government areas. Enrollment in the CBHI has grown, with more than 16,000 enrollees in Ikosi-Isheri alone. Out-of-pocket healthcare spending by low-income earners has been reduced. According to Lagos State Commissioner for Health Dr. Jide Idris, the pilot communities are responding positively, despite challenges in implementation.

The USAID-funded TB CARE I project, led by KNCV Tuberculosis Foundation (KNCV) in partnership with Management Sciences for Health (MSH), is conducting a pilot study in 28 health facilities in Ethiopia to roll out standard operating procedures (SOPs) for improved tuberculosis (TB) diagnosis, treatment, and care.The SOPs include instructions for TB screening, irrespective of the patient’s presenting illness or chief complaint.

Erik Schouten presents data on Option B+ in Malawi. {Photo credit: Sara Holtz/MSH.}Photo credit: Sara Holtz/MSH.

A Conversation with Dr Erik SchoutenWhen considering which public health intervention is best for a country or region for prevention of mother-to-child transmission (PMTCT) of HIV, the World Health Organization (WHO) provides a set of guidelines that provide options for various settings.

MSH South AfricaMSH South Africa

More than ten years after gaining independence and holding its first democratic elections, South Africa has made substantial development gains and boasts a growing economy. Despite these achievements, South Africa still faces the largest HIV-positive population in the world. Apartheid is no longer law, yet the health system still retains many inequities from that era. A major challenge for the government of South Africa is improving the accessibility and quality of basic health services.

The Oba (King) of Isanlu, Dr. A.A. Ikuborije, presents Comfort Abu with an award. {Photo credit: MSH Nigeria.}Photo credit: MSH Nigeria.

Until recently, people living with HIV & AIDS in Isanlu Community in Nigeria’s Kogi state had difficulty accessing health services to manage their illnesses. Today things are very different, and much of that is credited to the persistence and perseverance of one woman, Comfort Omadu Abu.Mrs. Abu is the program manager for the Kogi State AIDS Control Program.

Health care staff at Gurei Primary Health Care Center provide patients with drugs after attending their first Leadership Development Program (LDP) session. {Photo credit: MSH.}Photo credit: MSH.

Two years ago, the Gurei Primary Health Care Center (PHCC) in Juba, South Sudan was facing a number of operational challenges. In addition to needing a cold storage area for vaccinations, PHCC also had an insufficient number of trained vaccinators and morale was low among the available staff. Within the community they served, PHCC encountered many negative attitudes and incorrect ideas about vaccinations. Residents who brought their children to PHCC for care found that the needed vaccinations were only sporadically available. As a result, the number of children immunized in Juba remained low.

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