Building National and Local Leadership for Health Development: MSH Kenya at Devex Partnerships Forum

Building National and Local Leadership for Health Development: MSH Kenya at Devex Partnerships Forum

 {Photo credit: Yvonne Otieno/MSH}Josephine Mbiyu of the USAID-funded LMS project discusses the localization of leadership for strengthening health systems in MSH Kenya projects.Photo credit: Yvonne Otieno/MSH

Effective leaders and institutions are the foundations of strong health institutions.

~ Dr. Daraus Bukenya, MSH country representative of Kenya

The Management Sciences for Health Kenya country office hosted a panel discussion on leadership at the Devex Partnerships Forum held in Nairobi. This was a unique opportunity for the over 120 participants who attended the session to discuss practical examples of how leadership translates to better health outcomes within and beyond the panel session. The right to health, efficiency in delivery of services, leadership training, and informed decision-making emerged as key themes during the panel discussion. Some of the key questions raised during the session included:

  • How does leadership help address patient’s rights to health?
  • Does training lead to workshop fatigue? 
  • How sustainable are interventions?
  • How can better leadership translate to funding?

Right to health

The Kenyan constitution singles out health as a right that Kenyans must demand, while Kenya’s Vision 2030 recognizes good health as a prerequisite for attaining the development goals. Recognition of the role of health as a right also presents the need for stronger leadership and management at every level of the health system to enable equitable access to quality health by all.

[Ben Ngoe, founding director of the Institute of Healthcare Management at Strathmore.] {Photo credit: Yvonne Otieno/MSH.}Ben Ngoe, founding director of the Institute of Healthcare Management at Strathmore.Photo credit: Yvonne Otieno/MSH.

“We don't need more resources, we need better leaders and managers in the health sector for improved services," argued panelist Ben Ngoe, founding director of the Institute of Healthcare Management at Strathmore.

"Healthcare workers need both medical and soft skills to ensure patients rights are respected,” explained panelist Elizabeth Oywer of the Nursing Council of Kenya.

Panelists presented examples of how various institutions' investment in leadership training resulted in efficient delivery of services. For instance, one of the challenges faced by the Nursing Council of Kenya was the less than adequate hours allocated to leadership training. Through the USAID-funded Leadership Management and Services (LMS) program, members of the Nursing Council of Kenya enrolled in the Leading High-Performing Healthcare Organizations (LeHHO) program, resulting in an appreciation of leadership as a skill and consequently revision of the Nursing curricula.

[Elizabeth Oywer of the Nursing Council of Kenya.] {Photo credit: Yvonne Otieno/MSH.}Elizabeth Oywer of the Nursing Council of Kenya.Photo credit: Yvonne Otieno/MSH.

“Initially, the nursing curricula allocated only four hours to leadership training. The training sensitized us to the need for leadership competencies required by nurses; so we revised the current curricula to dedicate 90 hours to leadership training," explained Owyer.

Another panelist, Prof. Zipporah Ngumi, a member of the Kenya Medical Board, also gave examples on how the same training had influenced the performance of the medical board.

“Renewal of medical licenses at the board used to take 3 to 5 months due to delays in postage and volume of paperwork. The training empowered us to develop a work plan with identified priorities, including the renewal of licenses. The system has since been automated and renewal of medical licenses now takes 5 minutes,” explained Professor Ngumi.

[Professor Zipporah Ngumi of the University of Nairobi presents at the panel.] {Photo credit: Yvonne Otieno/MSH}Professor Zipporah Ngumi of the University of Nairobi presents at the panel.Photo credit: Yvonne Otieno/MSH

Josephine Mbiyu explained that the approach of working with the institutions to incorporate thematic areas into their curriculum ensures that the interventions continue after the programs lifetime.

“Fifty years from now it will take a lot to convince the University of Nairobi why leadership and management training for nurses shouldn’t be in the curricula for Bachelor of Science Nursing,” Mbiyu adds.

Participants and panelists both concurred that besides training, leaders require information that will inform their decision-making, ensure sustainability, and attract funding.

[Dr. Daraus Bukenya of MSH (with microphone) and panelists.] {Photo credit: Yvonne Otieno/MSH.}Dr. Daraus Bukenya of MSH (with microphone) and panelists.Photo credit: Yvonne Otieno/MSH.

Building capacity at national level

Panelists shared additional examples of building leadership and organizational capcity for health systems strengthening success, including the USAID-funded Health Commodities and Services Management (HCSM) program. HCSM works with national- and county-level partners to strengthen the capacity of the Ministry of Health to make informed decisions that lead to uninterrupted access to HIV, malaria, and TB medicines, and reproductive health commodities. These are priority programs that receive a significant amount of funding from international development partners.

In October 2012, Kenya‘s overall Global Fund (GF) grant performance was rated "unacceptable" (i.e. C rating), due, in part, to low reporting of malaria commodities data by health facilities (which averaged only 40 percent from January to September 2012). HCSM supported the Division of Malaria Control (DOMC)--tasked with malaria control in Kenya--to incorporate malaria commodities data into the District Health Information System 2 (DHIS2) as one of the interventions towards improving the global fund programmatic indicator performance for people treated appropriately for malaria.

“Reporting through DHIS2, alongside facilitated supportive supervision by district pharmacists, led to an increase of the GF core programmatic indicator to 92 percent in December 2012. By early 2013, Kenya was rated 'meets expectations' (i.e. A2 rating),” explained Joseph Warero, a senior management information systems technical advisor.

Capacity building of civil society organizations

[Mike Mutungi, CEO of I Choose Life.] {Photo credit: Yvonne Otieno/MSH.}Mike Mutungi, CEO of I Choose Life.Photo credit: Yvonne Otieno/MSH.

Chief Executive Officer Mike Mutungi of I Choose Life Africa, panel moderator, gave an example of how USAID's FANIKISHA Institutional strengthening program is working to improve leadership and other skills of civil society organizations to improve local organizations' access funding capacity.

“There is nothing as fulfilling for a local organization to sign a check to another local organization engaged in development activities. For me, that is the clearest demonstration of localization of development,” said Mutungi.

Watch interview with Mike Mutungi.

At the end of the panel discussion, there was agreement that leadership, one of the building blocks of health systems, is key to ensuring sustainable interventions in health service delivery. For successful implementation of programs, private and public partnerships are necessary.

“Funding is key; however, saving patients lives should be at the center all health programs,” argued Ndinda Kusu, the HSCM deputy chief of party for health systems strengthening.

And indeed, as the African proverb goes, reiterated by Ben Ngoe at the panel: "If you want to go fast, go alone. If you want to go far, go with someone."

Learn more about MSH in Kenya

View photos from MSH Kenya panel

View photos from MSH Kenya booth