Interventions
The ROLDP was implemented in two phases.
Phase I: March 2006 – February 2007, District Level
Phase I began with a Leadership Dialogue involving national level stakeholders from the government of Nepal, USAID/Nepal, and other donors and cooperating agencies, who committed to the shared vision of a healthy and happy Nepal. The central-level Leadership Dialogue was followed by a district level version involving representatives from seven potential pilot districts. This dialogue introduced participants to the ROLDP methodology, generated enthusiasm, and identified pilot districts.
As part of the ROLDP Facilitator Training, LMS trained, mentored, and supported a cadre of local facilitators to conduct the workshops and provide coaching in order to build sustainability and enable future scale-up of the program.
A total of 84 participants forming 31 teams from three districts participated in Phase I. During the four workshops and coaching visits, the teams worked with facilitators to identify and develop short-term projects addressing challenges they faced in achieving developmental or service goals through improved leadership and management practices. Over a period of seven months, facilitators led each team through the process of:
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Forming a vision for a healthy district,
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Analyzing their current versus desired situation,
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Defining their challenge with an emphasis on measurable results,
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Developing commitment within their team and home organization to carry out prioritized action plans,
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Implementing the action plans to achieve measurable results.
Phase I was evaluated by an independent consultant and results were disseminated at a seminar in March 2007. The results were clear and well evidenced causing the MOHP to extend the project into a second phase.
“ROLDP was found to have a high impact among participating organizations. All participants were enthusiastic, participatory, dedicated, and optimistic about the programs their teams were implementing.” - ROLDP Independent Evaluator
Phase II: March 2007 – March 2008, Community Level
The second phase concentrated on developing capacity of trainers, teaching materials, and community level participation. More than 70 Health Facility Operation and Management Committee (HFOMC) members were trained in leadership development and 30 government staff were trained as facilitators of the HFOMC capacity development modules. Reference materials in the Nepali language were designed, and MSH’s Managers Who Lead Handbook was translated into Nepali, for use in community level trainings, by facilitators and trainees. More than 400 copies of Managers Who Lead in Nepali have been distributed among donors, development partners, Governmental Agencies, and the general public.
The development of training modules during Phase II was an important step towards preparing the HFOMC for additional responsibilities under the decentralization mandate. The Nepali language HFOMC capacity development modules produced by LMS were used in Banke District workshops by recently trained facilitators, training more than 80 HFOMC members in leadership and management.
ROLDP Results
Phase I began and ended with the Work Climate Assessment using LMS’s WCA tool to measure improvement in work climate over the duration of the program. Team members from all three Phase I districts self-reported that staff attitudes had become more positive, that there is an increased willingness among staff to assist and cooperate with each other, and feedback is now more frequently provided.
Participants of the ROLDP were enthusiastic and involved throughout the six-month program. They commented that the coaching allowed for highly practical learning, providing a space for them to practice, fine-tune, and perfect their skills with supervision from experts. They appreciated the program’s participatory focus. The chairman of the Basudevpur HFOMC commented: “We have taken a lot of trainings but this one was very different. It was very participatory, we learned a lot, and we had fun.”
Many project teams reported continued use of ROLDP models and methodologies, including two teams from Phase I of the program who are currently using ROLDP concepts in their community-level capacity development programs.
" We have taken a lot of trainings but this one was very different. It was very participatory, we learned a lot, and we had fun." - Chairman of the Basudevpur HFOMC
UNESCO Banke: one ROLDP team's success
The UNESCO Banke Club is an NGO working at the district and community levels that has experienced challenges in communicating the health benefits of family planning use. Through the ROLDP, the team learned to apply techniques for scanning, focusing, mobilizing, aligning, and inspiring. Through the application of their new leadership practices the team was able to clarify the link between contraception and healthy families for community members. By the end of the program, the UNESCO team had increased CPR by 5% to 13%.
Project Sustainability and Scale-Up
The ROLDP facilitation team was composed of four organizations: ADRA/Nepal, ICA/Nepal, the NHTC, and MSH. Each has integrated the ROLDP methodology into their program offerings, allowing for the on-going use and eventual scale-up of the program. The continued use of ROLDP methodologies ensures that the project will last beyond LMS’ project life cycle and increases the value of USAID/Nepal’s original investment by enabling this intervention to reach more recipients than MSH would have been able to alone. Already ADRA/Nepal has trained seven organizations in ROLDP, ICA/Nepal has trained 400 participants and NHTC continues to hold decentralization workshops, aiming to reach at least 170 facilities in 2008. Members of the International Rescue Committee attended an HFOMC ROLDP training and were so impressed that they plan to replicate the program for six VDCs in Surkhet District.
These partnerships with cooperating agencies and donors will ensure that ROLDP methodologies continue to be included in handover preparation trainings throughout the health sector reform process.
