Across Africa, there is a growing recognition that fostering a new cadre of leaders with strong management and leadership expertise will help strengthen the capacity of health systems, boost the quality, quantity and access to health services for underserved populations, and help countries achieve their national health priorities. As Julio Frenk, Dean of Faculty at the Harvard T.H. Chan School of Public Health points out, “Professionals are falling short on appropriate competencies for effective teamwork, and they are not exercising effective leadership to transform health systems.”
While there has been a consistent call to recruit new health care professionals, there is room to improve efforts to retain and develop existing workers, notes Michael Bzdak, Executive Director, Corporate Contributions, who is responsible for driving the Johnson & Johnson strategy around efforts to strengthen the health care workforce.
In 2005, Johnson & Johnson partnered with world-class management faculty from the UCLA Anderson School of Management and leaders of the African Medical and Research Foundation (AMREF) to design and launch the Management Development Institute (MDI). Subsequent programs have been implemented by the Ghana Institute of Management and Public Administration and the Graduate School of Business at the University of Cape Town.
MDI aims to improve the effectiveness and responsiveness of health care systems across sub-Saharan Africa by training leaders and managers within national Ministries of Health and other organizations devoted to delivering health care services to underserved populations. The curriculum is designed to improve management skills in areas including organizational planning, developing and managing health information systems, financial administration and health economics.
Participants report a significant increase in their knowledge, skills, abilities, and leadership/management behaviors, with nearly all participants indicating that the new skills they acquired were directly applicable to their workplace and organizational responsibilities. Post-program evaluations also reveal that MDI graduates have assumed greater levels of responsibility after completing the program; with more than half confirming they received a promotion.
Many of the Community Health Improvement Plans developed by participants to apply lessons learned from the program, have resulted in initiatives that strategically address specific national health issues. Some successes include:
- Gertrude’s Children’s Hospital in Nairobi, Kenya increased enrollment in their comprehensive HIV care program from nine children in 2004 to 500 children in 2010 and expanded pediatric treatment sites to three new locations.
- The AIDS Information Centre of Uganda completed HIV testing and counseling for more than 255,000 clients from 2007 to March 2012, and linked all clients identified as living with HIV to appropriate care and treatment.
- The Center for HIV/AIDS and STD Research of Nigeria successfully trained 130 teachers within the Nigerian school systems on the basics of HIV/AIDS counseling, testing and prevention, and reached over 35,000 students with accurate information.
- The Keiskamma Trust in the Eastern Cape, South Africa increased early utilization of antenatal care services before 20 weeks by 18% and rates of exclusive breastfeeding by 42% by strengthening its prevention of mother-to-child transmission of HIV and aligning their data with the Department of Health’s own reporting.
- In 2014, the Kadoma City Council in Zimbabwe increased treatment utilization and decreased patient waiting time from 40 minutes to 15 minutes by opening two new integrated HIV and TB centers.
Two MDI alumni, Dr. Gordon Ordundo and Judy Maye (MDI Keyna, Class of 2009) credit the successes and growth of Gertrude’s Children’s Hospital to their MDI experience: “Our participation at the MDI was very timely as we were just embarking on starting our clinic…what we learned was the bedrock of our achievements to date.”
Celebrating its 10th anniversary this year, MDI programs at rotating locations in Eastern, Western and Southern Africa, have trained more than 830 health care leaders from health care institutions, clinics, hospitals and health-related NGOs from 32 countries.
“In post-Ebola West Africa, it is now apparent that governments and health systems must do more to prepare for extreme health crises,” says Bzdak. The enormous amount of developmental aid pouring into Africa in recent years combined with dramatic health care gaps is focusing more attention on sustainable improvements to health systems. As part of the Global Health Workforce Alliance, the Task Force for Scaling Up Education and Training for Health Workers identified “Effective management and leadership” among the nine critical success factors for building education and training capacity.
“International support to rebuild health systems through financial investments and effective reform, including the establishment of a well-trained and remunerated health workforce, is more critical than ever before,” adds Bzdak. “The MDI Program is one solution helping to improving health systems in Africa by enhancing the management and decision-making capacity of health leaders in the region.”