8th August, 2008
When Dr Willis Akwahle was appointed a District Medical Officer in 1993, he was elated but very apprehensive. “I went straight from being a medical officer in a surgical ward to managing medical services in an entire district. It was a totally different world. I was not prepared for it, and I learnt how to do the job mostly by accident.”
Like Dr Akwahle, who is now the director of Kenya’s Malaria Programme, many appointments to management positions of health institutions in Africa are made on the basis of professional qualifications in medicine rather than managerial competence.
Dr Peter Ngatia, Director of Capacity Building at AMREF, notes that although health care in Africa has become a multi-million dollar endeavour, those charged with leading health institutions have little or no formal preparation in management. Yet quality management and leadership are vital for the delivery of basic health care and attainment of the Millennium Development Goals.
“Health managers are crucial to pooling together the meagre resources available to African health systems to be able to deliver effective health care. They must be given the know-how and competencies to enable them to do this. As it is, with 25 per cent of the global burden of disease, 15 per cent of resources and three per cent of health workers, African health systems are characterised by less resources, more illness, and managers who are ill-prepared for the role they are supposed to undertake. Is it any wonder that our health institutions are not functional?” said Dr Ngatia.
A study done by AMREF in Liberia, he said, had found that these are the skills needed by health managers at all levels – from national right down to community level. “We must make leadership and management training part of the basic curriculum for health professionals to give them skills and competencies in planning and implementation of health services, management of resource, external relations, policy formulation and implementation and resource mobilisation.
To address the situation, AMREF has partnered with the University of California in Los Angeles’s (UCLA’s) Anderson School of Management, Johnson&Johnson (J&J) and the Global Business School Network (GBSN) to create a management development programme for managers and leaders of African HIV/AIDS organisations.
The Management Development Institute (MDI) provides a one-week intensive programme designed to enhance the management skills of the managers of organizations devoted to the care, treatment and support of people and families living with HIV. Dr Victor Tabbush, Director of the institute and a professor at the Anderson School of Management, said formation of MDI arose from a need caused by massive scale-up of ARVs, which provides many challenges in provision and management, particularly with diversification of health services to the district level.
The course’s curriculum consists of six pillars – organisational planning, financial management, human resource management, operations management, health management information systems, program monitoring and evaluation. The programme is held twice annually in Nairobi for the region and the cost of tuition is catered for with full scholarships provided by J&J. It is taught mainly by local Kenyan business school faculty (75 per cent), which is important for sustainability, technical assistance and contextual relevance. The other lecturers are from the US.
So far, 145 people from 15 countries have graduated from the programme, two-thirds of whom are employed by NGOs and one third by government.
Mr Rene Kiamba, who is in charge of J&J’s Corporate Contributions Department in sub-Saharan Africa, said his company was delighted with the results of the programme and was looking to establish a similar institute in Ghana by the end of August this year and is also considering going into the southern region.
One of the graduates of the school, Dr Nduku Kilonzo, Director of Liverpool VCT care and treatment centres, described how she and a colleague used what they had learnt at the institute to streamline the way the organisation works and to strengthen their management.
“The MDI is a catalyst for change. We learnt to negotiate, build consensus, allow a variety of ideas, be innovative and daring, networking skills and proposal writing.”
