Leadership, Management & Governance: Our Impact

Justine during a home visit with a father and his son. {Photo credit: MSH}

Justine Mbombo, age 38, lives in a small village called Beya in Kasaï Occidental Province in Democratic Republic of the Congo (DRC), with a population of roughly 520 people. There are more than 100 children under age 5 in Justine’s village, and no doctor. Watching children suffer has affected Justine deeply and moved her to become more involved in the health of her community.“In January 2010, we were affected by a measles epidemic that caused the deaths of many children under age 5.

 {Photo credit: Overseas Strategic Consulting.}Frank Baraka (left) sews a bed net to use as a fishing net.Photo credit: Overseas Strategic Consulting.

It is 1 p.m. in the village of Kavimvira. The sun is high over Lake Tanganyika, at the foot of the Mitumba Mountain, in scenic Sud Kivu. Frank Baraka has packed the bounty of the morning fishing trip and folded his nets, when his cell phone chimes to signal an incoming text message: “Sleep every night under an Insecticide-Treated Net (ITN), to protect your family from malaria,” he reads out loud, amused, to his fishing companion. 

Mugo Kibati, Vision 2030 Secretariat, presents on day one of the conference. {Photo credit: MSH}Photo credit: MSH

Earlier this month, Kenya presidential candidate Ole Kiyapi was asked, during the country’s first ever televised presidential debate, what his plans were for the health sector. The former permanent secretary for the Ministry of Health replied without hesitating that he would emphasize strengthening leadership and management capacity in health workers.

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).

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.

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