leadership and management

{Photo Credit: Carmen Urdaneta/MSH}Photo Credit: Carmen Urdaneta/MSH

Strong, well-functioning health systems need strong leadership, management, and governance. Over the next couple of weeks, leading up to conversations that MSH is hosting at the Global Symposium on Health Systems Research next month in Vancouver, we will be sharing stories and insights about the role of leadership, management and governance in health systems strengthening.

Over the last five years at the MSH-led, USAID-funded Leadership Management and Governance Project, our experience has underscored the importance of good governance, management and leadership to achieve service delivery outcomes in all health areas — from family planning to maternal, newborn and child health to HIV and AIDS.

The Leadership, Management and Governance Project's activities range from strengthening leadership and management skills of staff at the centralized level of Haiti's Ministry of Public Health and Population to supporting midwife managers to deliver high-quality family planning and reproductive health services in their communities at the decentralized level in Malawi.

{Photo credit: Olumade Badejo/MSH}Photo credit: Olumade Badejo/MSH

Update, 1/11/16: Join MSH at the International Family Planning Conference, January 25-28, 2016, in Indonesia. Get ICFP2016 details here.

Original post continues:

This blog post is a web-formatted version of the Global Health Impact newsletter: Family Planning: The Win-Win-Win for Health (November 2015). (View or share the email version here.) We welcome your feedback and questions in the comments. On social media, use hashtag and tag .  Subscribe

 {Photo Credit: Joan Marshall-Missiye/MSH}A break-out session at the first ECOWAS Forum on Good Practices in Health, held July 29-31 in Ouagadougou, Burkina Faso.Photo Credit: Joan Marshall-Missiye/MSH

“If you want to go fast, go alone. If you want to go far, go together.”

This ubiquitous African proverb became the unofficial motto of the first ECOWAS Forum on Good Practices in Health, held July 29-31 in Ouagadougou, Burkina Faso. More than 300 health professionals, researchers, donors, implementing partners, and stakeholders gathered at the conference, hosted by the West African Health Organization (WAHO), a partner of Management Sciences for Health.

In his opening speech, USAID West Africa Regional Mission Director Alex Deprez reminded the assembly that most maternal and child health indicators in West Africa are “unflattering.” The average fertility rate remains the highest in the world at 5.7, while the contraceptive prevalence rate, at 10 percent, is the lowest. West Africa loses thousands of mothers and young children daily to preventable complications and diseases. More than 100 children in West Africa die per 1,000 live births, and there are between 438 and 888 maternal deaths per 100,000 live births.

The Improving Performance of Nurses (IPN) project in Upper Egypt celebrated the first Arabic publication of Management Sciences for Health's (MSH)'s “Managers Who Lead” handbook with an event last November. A delegation of prominent leaders from Egypt’s health sector---including representatives from the Ministry of Health and Population (MOHP), Egyptian universities and non-governmental organizations (NGOs), MSH, and USAID---attended the event in Cairo.

At the event, there was a feeling of hope for the future of the health sector in Egypt, and that this handbook is a small but important part of that future. Dr. Emad Ezat, director of health and nurses sector at MOHP, praised the book for helping to strengthen the performance of health organizations and improving health services. Dr. Abdo Al Swasy, IPN program manager, spoke of the work that had gone into the handbook and its importance. Dr. Gihan Fathy, IPN field manager, highlighted some of the tangible effects from the use of this book in the field, including building nurse leaders able to make decisions independently for positive changes in the health community.

Bolivian nurses. {Photo credit: MSH.}Photo credit: MSH.

Building local capacity is a pillar of the United States Agency for International Development's USAID Forward reforms. This post is one example of how USAID worked through Management Sciences for Health (MSH) to build, nurture, and support a local development stakeholder that is still thriving today. The story was written by global health writer John Donnelly, and first appeared in MSH’s book Go to the People in 2011. Cross-posted on Modernize Aid in the Modernizing Foreign Assistance Network (MFAN) blog field feedback series.

Video that highlights the work of thousands of Tanzanians---mostly women---working as accredited community drug sellers operating in rural areas.Video that highlights the work of thousands of Tanzanians---mostly women---working as accredited community drug sellers operating in rural areas.

Today is International Women’s Day, celebrated around the world as an opportunity to look back on women’s accomplishments and look forward to the realization of their full economic, political, and social rights. The United Nations theme for this year, “Empowering Rural Women,” is one that resonates powerfully with MSH’s work.

A midwife in Wau, South Sudan. {Photo credit: MSH.}Photo credit: MSH.

Josephine, a wife and mother of six living in rural Uganda, tried to soothe her 3-year-old daughter. The girl was suffering from diarrhea and a high fever and her crying filled the home. Recognizing that the girl's health was in danger, Josephine summoned the courage to ask her husband for permission to take their second-youngest child to the local health facility unit -- and pleaded for money to cover the travel and treatment expenses.

Requesting permission from her husband to travel to the facility was not her only choice, however: choosing to take her daughter for treatment also meant leaving her other children -- including her youngest -- unattended at home. Once at the health center, she continued to navigate the challenging road to treatment for her daughter, communicating her situation to the health providers and negotiating the financial and provider aspects of the health center system, without assistance. Relieved and exhausted, Josephine returned home safely with her daughter, oral rehydration salts, and knowledge.

Recognizing women leaders

What makes a person in the health system a good leader? Who determines that he or she is a leader? How do we empower leaders to improve the health of those around them?

Cross-posted from the Global Health Magazine blog.

How did Malawi control its brain drain?

The British Medical Journal issued a report last month estimating that nine African countries have lost $2 billion worth of investment in training and educating doctors who have subsequently migrated abroad. It needn't be this way. Doctors, nurses and other health professionals do not have to give up home, family and country to earn enough money to give themselves and their children a future, even a modest one. And it needn't cost low income countries billions of dollars to train the doctors and nurses who then leave for greener pastures.

Strong leadership, governance, and management are the cornerstones of successful global, national, and local efforts to save lives and achieve the  maximum impact from health investments. Yet effective leadership, management, and governance skills and practices too often are the vital missing elements in public, civil society and even private health organizations. Fortunately, these skills can be developed. They are best developed working in teams, in one’s own setting, over time, while facing real challenges.

With our partners, MSH works to build capacity at all levels within public and private organizations to improve leadership and management practices. Improved capacity ensures sound governance policies, creates a work climate that supports staff motivation, increases flexibility, and realigns staff to focus on common, achievable objectives.

Health Workers in Southern Sudan

A few weeks ago, I had the opportunity to visit Southern Sudan. For over five decades, Southern Sudan endured civil war, unrest, and several waves of forced displacement and refugees. The infrastructure of nearly every sector was mostly destroyed throughout the region. It is a classic fragile state situation.

Since the Comprehensive Peace Agreement was signed five years ago, the Government of Southern Sudan, donors, international organizations, nongovernmental organizations, private organizations, and, most importantly, health workers are coming together to rebuild a shattered health system.

Now the global community focuses attention on Southern Sudan as they prepare for a Referendum vote to decide if they will officially break away from Northern Sudan to become an independent state. The vote is scheduled to begin January 9, 2011.

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