The LMS Goal: All current and future health managers are well prepared to lead and manage health services for results
After decades of work and trillions of dollars spent on foreign aid, we still live in a world where millions die each year from preventable causes. Medically we know what to do to save these lives. The key to preventing these deaths and achieving large-scale improvements in health is scaling up these known interventions and proven best practices. Scale up does not happen without inspired leadership and skilled management. Doctors and nurses throughout the developing world receive medical/clinical preparation, but they tell us that very few receive the necessary skills to successfully lead and manage. We must move from a system of health management by default, and instead focus on Health Leadership and Management (LM) by Design.
Become part of our efforts by joining the LM by Design Global Community of Action on LeaderNet.
Our worldwide survey and a more focused survey conducted in Kenya show that the majority of pre-service and in-service education and training programs do not prepare doctors and nurses for leadership and management positions. In response, LMS is focused on three strategies:
Pre-Service: Integration of Leadership and Management Approaches LMS works to get practical, job related skills in leadership and management education incorporated into pre-service education and training programs in health so that graduates are prepared to face the challenges they will encounter on the job.
For example, LMS has worked with Makerere University in Uganda since 2006 to integrate and institutionalize the Leadership Development Program (LDP) into the medical school curriculum. Beginning in July 2009, the integrated leadership curriculum will be implemented as a part of the medical school’s field curriculum. There will be 250 medical students working in more than 20 sites around the country enrolled in the program, which will use LMS’ leadership practices to help students identify and address the challenges they face in their field sites.
In-Service: Leadership Development Program for Sustainable Health Improvements Health managers tell us they want to engage in continuous learning in leadership and management to enable them to address the challenges they face and improve health outcomes in the populations they serve. In 2002, the Aswan Governorate—a rural, underdeveloped area in Upper Egypt—launched an LDP to improve the quality and accessibility of health services in three districts by increasing the capacity of managers to produce organizational results. Doctors, nurses, and midwives worked as teams to create shared visions and frame specific challenges to overcome. They then applied the leadership and management principles and practices they were learning to implement their action plans.
The program was so successful that the MOHP expanded the LDP to 185 teams covering the entire Aswan Governorate using no outside funding. Additional local facilitators were trained and the program further expanded to multiple governorates. Significant reductions in maternal and infant mortality and an increase in contraceptive prevalence occurred during the period from 2003 – 2006.
Career Paths for Health Management Respondents to our survey say that a clear career path for all health managers is a key to improving leadership and management in health. This career path will value the role of management and leadership in health and fosters collaboration between health professionals with a clinical background and professionals with management backgrounds.
For example, LMS is working with the Kenya Ministry of Medical Services and the Ministry of Public Health and Sanitation to develop policies to create a career path for health managers. This work includes promoting competitive and merit-based hiring processes and promotions as well as improvements in learning approaches that include practical skills.
“I remember when I was appointed a District Medical Officer in 1993, straight from a surgery ward as a medical officer, and within a week I had to manage an entire district…It was a totally different world.”
—Dr. Willis Akwahle, Director of the Malaria Control Program, Kenya
