Scaling up malaria elimination management and leadership: a pilot in three provinces in Zimbabwe, 2016 -2018

Marr Chung, Amanda, Case, Peter, Gosling, Jonathan, Gosling, Roland, Madinga, Munashe, Chikodzore, Rudo, Hove, Macdonald, Viljoen, Greyling, Chitapi, Precious, Gumbi, Matsiliso, Mnguni, Peliwe, Murungu, Joseph, Dube, Musisani, Dhliwayo, Precious, and Mberikunashe, Jospeh (2020) Scaling up malaria elimination management and leadership: a pilot in three provinces in Zimbabwe, 2016 -2018. Malaria Journal, 19. 185.

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Background: Focus for improved malaria programme performance is often placed on the technical challenges, while operational issues are neglected. Many of the operational challenges that inhibit malaria programme effectiveness can be addressed by improving communication and coordination, increasing accountability, maintaining motivation, providing adequate training and supervision, and removing bureaucratic silos.

Methods: A programme of work was piloted in Zimbabwe with one malaria eliminating province, Matabeleland South in 2016-2017, and scaled up to include two other provinces, Matabeleland North and Midlands, in 2017-2018. The intervention included participatory, organization development and quality improvement methods.

Results: Workshop participants in Matabeleland South reported an improvement in data management. In Matabeleland North, motivation among nurses improved as they gained confidence in case management from training, and overall staff morale improved. There was also an improvement in data quality and data sharing. In Midlands, the poorly performing district was motivated to improve, and both participating districts became more goal-oriented. They also became more focused on monitoring their data regularly. Participants from all provinces reported having gained skills in listening, communicating, facilitating discussions, and making presentations. Participation in the intervention changed the mindset of malaria programme staff, increasing ownership and accountability, and empowering them to identify and solve problems, make decisions, and act within their sphere of influence, elevating challenges when appropriate.

Conclusions: This pilot demonstrates that a participatory, organization development and quality improvement approach has broad ranging effects, including improving local delivery of interventions, tailoring strategies to target specific populations, finding efficiencies in the system that could not be found using the traditional top-down approach, and improving motivation and communication between different cadres of health workers. Scale-up of this simple model can be achieved and benefits sustained over time if the process is imbedded into the programme with the training of health staff who can serve as management improvement coaches. Methods to improve operational performance that are scalable at the district level are urgently needed: this approach is a possible tactic that can significantly contribute to the achievement of global malaria eradication goals.

Item ID: 63241
Item Type: Article (Research - C1)
ISSN: 1475-2875
Keywords: Programme management, challenges, leadership, malaria elimination, capacity building, Zimbabwe, service delivery, operations
Copyright Information: © The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creat ivecommons .org/licen ses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creat iveco mmo
Funders: Malaria Elimination Initiative of the Global Health Group, Bill and Melinda Gates Foundation (BMGF)
Projects and Grants: BMGF OPP1160129
Date Deposited: 11 Aug 2020 01:27
FoR Codes: 35 COMMERCE, MANAGEMENT, TOURISM AND SERVICES > 3505 Human resources and industrial relations > 350503 Human resources management @ 60%
42 HEALTH SCIENCES > 4203 Health services and systems > 420312 Implementation science and evaluation @ 40%
SEO Codes: 91 ECONOMIC FRAMEWORK > 9104 Management and Productivity > 910402 Management @ 60%
92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920109 Infectious Diseases @ 40%
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