Leadership, Management and Sustainability (LMS) Program

Children outside the Masuika Health Center in Masuika Health Zone, Kasai Occidental Province. Photo by Kristin Cooney, 2008.

The Democratic Republic of Congo (DRC), formerly known as Zaire, is the third largest country in Africa by area, and has a population of approximately 66 million. In 1998 the Second Congo War began, devastating the country and killing over 5 million people, more than any other war since World War II. Many of the DRC health indicators are worse today than they were in 1990. From 1990 to 2004 infant mortality went from 96 to 129 cases per 1,000 live births, and the TB prevalence rate went from 226 to 551 per 100,000. Maternal mortality was measured at 870 per 100,000 live births in 1990, and went up to 990 per 100,000 by the year 2000, these rates are among the highest in the world.

In 2008 LMS received field support funding from USAID/DRC to implement a project to reduce infant, child, and maternal morbidity in 23 rural health zones in Kasai Oriental and Kasai Occidental, two provinces in west/central DRC.

RESULTS

LMS has been working to increase the quantity and quality of health services offered to about three million people in the Kasai Oriental and Kasai Occidental provinces, to increase the demand and service utilization in these areas, and to strengthen the local capacity of the Ministry of Health and NGO partners in management and delivery of health services.

As of December 2009, teams from the 23 health zones and three health districts have developed action plans to address challenges related to maternal and child health as part of their participation in LMS Leadership and Development Programs (LDPs). Teams will be working to achieve their chosen measurable results over the next six months, with a presentation of results to stakeholders planned for June 2010.
As of November 2009, the Fully Functional Service Delivery Point methodology was introduced to LMS and MOH staff in all the project’s zones, and guidelines and checklists used to measure quality of services were revised based on the local situation with input from district and zonal level Ministry of Health staff. The goal is to achieve significant improvement over the starting situation in key selected areas by June 2010.
LMS has trained well over 1,000 health care providers and health managers in various subjects relating to service delivery and management, including primary health care management, malaria treatment, family planning and health information systems.

EXPERIENCE IN COUNTRY

Strengthening Primary Health Care Service Delivery

At the health facility level, the LMS/DRC project will introduce a Fully Functional Service Delivery Point (FFSDP) methodology to give health facility staff the tools to improve the quality of service delivery and service management across a range of basic services. The project will also implement a Leadership Development Program (LDP) with teams of provincial and zonal health program staff to ensure a common vision and clear understanding of roles and responsibilities, and to build leadership and management capabilities. Key areas of technical focus will include: strengthening integrated management of childhood illness; providing education and training and developing a referral system for the treatment of obstetric fistula; strengthening and expanding prevention, treatment, and care for TB, malaria, and HIV; assisting provincial and health zone structures to develop a rapid response capability to identify, diagnose, and address infectious disease outbreaks; improving integration of RH/FP and HIV/AIDS services through education, training, and coordination with drug logistics and supply systems; and promoting access to clean water and improved hygiene and sanitation through the “village assaini” (clean/healthy village) model.