Building capacity for HIV/AIDS program leadership and management in Uganda through mentored Fellowships

Matovu, Joseph K. B.; Wanyenze, Rhoda K.; Mawemuko, Susan; Wamuyu-Maina, Gakenia; Bazeyo, William; Olico-Okui,; Serwadda, David

doi:10.3402/gha.v4i0.5815

Cited by 22 publications

(27 citation statements)

References 13 publications

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“…Although significant attention has been given to the development of clinical and public health skills for frontline providers in low-income settings, evidence for strategies to enhance the management and leadership capacities needed to strengthen health systems is more limited (4,6,21). Management training has shown improvements in quality in Uganda, as well as in various high-income settings (24)(25)(26). The FGH HMM program is uniquely designed in that it is housed within a vertically financed, HIV-specific commitment, yet striving to promote system-wide, horizontal impact.…”

Section: Introductionmentioning

confidence: 99%

Implementation of a health management mentoring program: year-1 evaluation of its impact on health system strengthening in Zambézia Province, Mozambique

Edwards

Moisés²,

Nzaramba³

et al. 2015

Int J Health Policy Manag

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Background: Avante Zambézia is an initiative of a Non-Governmental Organization (NGO), Friends in Global Health, LLC (FGH) and the Vanderbilt Institute for Global Health (VIGH) to provide technical assistance to the Mozambican Ministry of Health (MoH) in rural Zambézia Province. Avante Zambézia developed a district level Health Management Mentorship (HMM) program to strengthen health systems in ten of Zambézia's 17 districts. Our objective was to preliminarily analyze changes in four domains of health system capacity after the HMM's first year: accounting, Human Resources (HRs), Monitoring and Evaluation (M&E), and transportation management. Methods: Quantitative metrics were developed in each domain. During district visits for weeklong, on-site mentoring, the health management mentoring teams documented each indicator as a success ratio percentage. We analyzed data using linear regressions of each indicator's mean success ratio across all districts submitting a report over time. Results: Of the four domains, district performance in the accounting domain was the strongest and most sustained. Linear regressions of mean monthly compliance for HR objectives indicated improvement in three of six mean success ratios. The M&E capacity domain showed the least overall improvement. The one indicator analyzed for transportation management suggested progress. Conclusion: Our outcome evaluation demonstrates improvement in health system performance during a HMM initiative. Evaluating which elements of our mentoring program are succeeding in strengthening district level health systems is vital in preparing to transition fiscal and managerial responsibility to local authorities. Implications for policy makers• Health worker shortages and weak health systems threaten to undermine the ability to attain key health goals. • A strategy to deploy teams of mentors to build capacity by equipping district health managers with skills in planning, priority setting, and problem solving across eight target health management domains was implemented with some early success. • Mutual trust stemming from an open and collaborative relationship with provincial and district health authorities was key to program success. •In following best practice guidelines in global health by involving local stakeholders, our interventions were designed to target areas of joint priority and need, which encourages both relevance and sustainability of the program. This is particularly important as President's Emergency Plan for AIDS Relief (PEPFAR) seeks to fully transition authority to local entities, though we recognize that such a process can have precarious consequences if done too quickly or too cheaply. Implications for publicA health management mentoring initiative was implemented as part of a larger President's Emergency Plan for AIDS Relief-funded (PEPFARfunded) HIV care and treatment scale-up program, based on assumptions that improvements in overall system performance will eventually result in better clinical outcomes for patients. Our result...

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Section: Introductionmentioning

confidence: 99%

Implementation of a health management mentoring program: year-1 evaluation of its impact on health system strengthening in Zambézia Province, Mozambique

Edwards

Moisés²,

Nzaramba³

et al. 2015

Int J Health Policy Manag

View full text Add to dashboard Cite

show abstract

“…Ten studies were of programs in the United States [6, 8, 12, 16, 17, 24, 25, 34, 36, 37], and most were at least two years in length [2, 6, 8, 12, 17, 19, 20, 25, 34, 36, 37]. Six were evaluations of federal government-affiliated programs [2, 8, 12, 19, 20, 36], six were university-based [6, 17, 24, 25, 34, 37], and one had another affiliation [16]. The time period for examining career outcomes ranged from one year in several studies to up to 50 years.…”

Section: Resultsmentioning

confidence: 99%

Evaluating Postgraduate Public Health and Biomedical Training Program Outcomes:

et al. 2012

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To identify recent studies in the scientific literature that evaluated structured postgraduate public health and biomedical training programs and reported career outcomes among individual trainees. A comprehensive search of several databases was conducted to identify published studies in English between January 1995–January 2012 that evaluated career outcomes for trainees completing full-time public health or biomedical training programs of at least 12 months duration, with structured training offered on-site. Of the over 600 articles identified, only 13 met the inclusion criteria. Six studies evaluated U.S. federal agency programs and six were of university-based programs. Seven programs were solely or predominantly of physicians, with only one consisting mainly of PhDs. Most studies used a cohort or cross-sectional design. The studies were mainly descriptive, with only four containing statistical data. Type of employment was the most common outcome measure (n=12) and number of scientific publications (n=6) was second. The lack of outcomes evaluation data from postgraduate public health and biomedical training programs in the published literature is a lost opportunity for understanding the career paths of trainees and the potential impact of training programs. Suggestions for increasing interest in conducting and reporting evaluation studies of these structured postgraduate training programs are provided.

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“…[1] MUST's approach was unique in that they saw the importance of using the LDP for undergraduate students before these students practised in the community. As with the models of Matovu et al [4] and Sherk et al, [11] they also reinforced learning by having the students implement it immediately in the community with specific projects. Medical Education for Equitable Services for All Ugandans (MESAU) has emphasised the need for leadership skills to be taught to undergraduate students.…”

Section: Researchmentioning

confidence: 98%

“…These professionals were, however, often found lacking in critical leadership knowledge and skills. [2][3][4] Because of this deficiency, health workers may fail to deliver quality healthcare services, resulting in patients resorting to unsafe methods of treatment. Poor leadership and management skills have led to mishandling of resources, which has also impacted on the health sector.…”

Section: Researchmentioning

confidence: 99%

Multidisciplinary leadership training for undergraduate health science students may improve Ugandan healthcare

Najjuma

Ruzaaza

Groves

et al. 2016

AJHPE

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Background. Community-based education research and service (COBERS) is a platform for embedding progressive transformative leadership and research-related medical education in Uganda. The leadership development programme (LDP) developed at Mbarara University of Science and Technology (MUST), Uganda is a key component of COBERS. Health science students at MUST are equipped by means of the LDP with leadership knowledge and skills, and a positive attitude towards leadership and rural communities. The programme involves employing interactive learner-centred education techniques, with the opportunity to implement these skills in a community setting immediately after the training. Objective. To assess the students' self-reported perception and effectiveness of the precommunity placement LDP at MUST and its impact during the community clinical placement, and to measure the self-reported improvement of students' knowledge and their application of leadership skills in the community. The results of the evaluation will improve and build on this educational programme. The study also evaluated the effectiveness of the preplacement leadership training course for undergraduates at MUST, as reported by students. Methods. The programme evaluation of the LDP used quantitative pretest and post-test measures and qualitative data from focus group discussions to enrich the evaluation. Data were collected from students before and after the 1-week leadership training course using the same self-administered questionnaire. Variables were then compared to evaluate the impact of the LDP. Results. Prior to the intervention, only 14% of the participants had ever attended a leadership training session. There was significant self-reported change in the task accomplishment skills, interpersonal relationship skills and quality of leadership. Conclusion.The results suggest that the LDP may increase leadership skills among health science students to improve healthcare in Uganda. Our study recommends that this leadership programme be considered for use by Ugandan medical training faculties and similar environments elsewhere. This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0. Afr J Health Professions Educ

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Building capacity for HIV/AIDS program leadership and management in Uganda through mentored Fellowships

Cited by 22 publications

References 13 publications

Implementation of a health management mentoring program: year-1 evaluation of its impact on health system strengthening in Zambézia Province, Mozambique

Implementation of a health management mentoring program: year-1 evaluation of its impact on health system strengthening in Zambézia Province, Mozambique

Evaluating Postgraduate Public Health and Biomedical Training Program Outcomes:

Multidisciplinary leadership training for undergraduate health science students may improve Ugandan healthcare

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