OCTOBER 2013 - pdf.usaid.govpdf.usaid.gov/pdf_docs/PA00MZT2.pdfFurther gratitude goes to AMREF DCB...

AMREF VIRTUAL TRAINING SCHOOL (AVTS) FACULTY, NAIROBI

OCTOBER 2013

Contact Person: Dr. Peter Ngatia, [email protected] or [email protected]

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ACKNOWLEDGEMENT

The development of midwives leadership, Governance and management (LMG) curriculum was made possible by contribution of several individuals and organizations at different levels of the process. We express our heartfelt appreciation to them for their support, suggestions and hard work towards completion of the curriculum.

First and foremost, our gratitude goes to the ministries of health (MOHs) and midwives’ regulatory bodies in Kenya, Tanzania, Uganda, Malawi and Ethiopia for the support and views shared regarding this training. Further gratitude goes to AMREF DCB faculty particularly the Virtual School lecturers Micah, Felarmine, Ruth and Emma for facilitating the process technically and in logistics. Special thanks go to MSH team (Lourdes & Sasha), Kenya’s Division of Reproductive Health (DRH) and the Midwives chapter representatives for providing the necessary material and collaborative support to bring the process to fruition; their resources supported convening of working sessions and reviews.

We are also grateful to the leadership of both MSH and AMREF especially the leadership from the Directorate of Capacity Building for mutually negotiating on this transformative course that will see midwifery managers acquire appropriate and competent LMG knowledge, skills and practices. The list is long but thanks to you all who helped this process in one way or the other through the strength of individual effort. We wish to acknowledge all those individuals who helped and supported this process in one way or another.

Funding was provided by the United States Agency for International Development (USAID) under Cooperative Agreement AID-OAA-A-11-00015. The contents are the responsibility of the Leadership, Management, and Governance Project and do not necessarily reflect the views of USAID or the United States Government.

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Contents

ACKNOWLEDGEMENT 1

Acronyms and abbreviations 4

1.0 Introduction 5

1.1 Background 5

1.2 Rationale 5

1.3 Target group 6

2.0 The Goal of the course 6

2.1 Broad course objectives 6

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3.0 Teaching and Learning methods 6

4.0 Expected Competencies that participants will acquire 7

4.1 Guiding principles for implementing this curriculum 7

5.0 Course structure 8

6.0 Learners’ evaluation (Theory and practice) 9

7.0 Course delivery; Training methods and facilititation skills 9

8.0 Certi!cation 10

9.0 Course descriptions 10

9.1 Module One: Leadership, management & governance practices 10

9.1.1 Unit One: Leadership and Management practices 10

9.1.2 Unit Two: Governance practices 11

9.2 Module Two: Strategic problem solving 11

9.2.3 Unit Two: The challenge model 12

9.3 Module Three: Leading people 15

9.4 Module Four: Managing Human Resource for health (HRH) 10

References 20

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ACRONYMS AND ABBREVIATIONS

AMREF African Medical and Research FoundationDCB Directorate of Capacity BuildingDRH Division for Reproductive HealthHMIS Health Management Information SystemHRH Human Resource for HealthHSS Health systems StrengtheningICT Information, Communication and TechnologyLMG Leadership, management and governanceLMIC Low and middle income countriesM & E Monitoring and EvaluationMNCH Maternal, Newborn and Child HealthMSH Management Sciences for HealthNCK Nursing Council of KenyaSSA Sub-Saharan AfricaSWOT Strengths, Weaknesses, Opportunities and ThreatsWHO World Health Organization

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1.0 INTRODUCTION

1.1 BACKGROUND8LI�'IVXM½GEXI� GSYVWI� MR� 0IEHIVWLMT�� +SZIVRERGI� ERH�1EREKIQIRX� �01+ � EHHVIWWIW� XLI� RIIH� XS� TVSZMHI�continuous professional development and train midwifery service managers in public and private health sectors in Sub Saharan Africa (SSA) in these important practices. Despite the preliminary leadership and management MRTYX�XLEX�EPP�QMH[MZIW�VIGIMZI�MR�FEWMG�XVEMRMRK��MRWYJ½GMIRX�ORS[PIHKI�ERH�WOMPPW�MR�01+�LEW�PIH�XS�[IEO�LIEPXL�W]WXIQW��PMQMXIH�½RERGMEP�VIWSYVGIW�QSFMPM^EXMSR�ERH�QEREKIQIRX��[IEO�1)�WXVYGXYVIW�MR�LIEPXL�JEGMPMXMIW��PMQMXIH�innovative use of ICT in health services delivery and demotivated service providers in various working contexts in SSA. It is for this reason that the Africa Medical and Research Foundation (AMREF) and Management Sciences for Health (MSH) are seeking to bridge the gap by providing theory and practice in LMG through blended HMWXERGI� PIEVRMRK� ETTVSEGL��%16)*� MW� ER� MRHITIRHIRX� RSR�TVS½X� SVKERMWEXMSR�[LSWI�QMWWMSR� MW� XS� MQTVSZI�health and healthcare in Africa. AMREF and MSH aim to ensure that every African midwifery services manager can be an agent of transformative leadership in their service delivery workplaces. To achieve this mission, the Directorate of Capacity Building at AMREF has a vision to develop and deliver quality practical training, ensure access to expertise and information for community development and contribute to effective health training and research in Africa. In addition, the Directorate’s mission is to strengthen capacity and capability of health and health-related professionals and institutions through human resource training and development.

Upon completion of this training, the midwifery service managers will form respective country networks to provide mentorship and coaching to the newly recruited/employed midwifery care providers especially the fresh entries into the profession. This will provide an avenue for a lasting change in provision of midwifery services in the continent thus improving the MNCH indicators.

1.2 RATIONALEEffective leadership is the greatest enabler for good governance and management of resources in health systems. 8LI�GIVXM½GEXI�MR�0IEHIVWLMT��QEREKIQIRX�ERH�KSZIVRERGI��01+ �MW�FEWIH�SR�XLI�VEXMSREPI�XLEX�XLIVI�MW�RIIH�XS�

To build the capacity of midwifery services managers to improve their capacity to deal with health workforce challenges that are a common issue in SSA

Provide lower levels of the health systems with effective leaders and managers especially now that health services are being heavily decentralised.

Improve resource mobilization strategies among midwifery services managers thus bridging the gap on limited capacity to mobilize and absorb funds.Improve the M&E skills among midwifery services managers for better reporting of MNCH constraints, needs and outcomes in SSA

Increase the application of LMG knowledge and skills among midwifery services managers in SSA to improve WIVZMGI�UYEPMX]�ERH�IJ½GMIRG]��8LIVI�MW�IZMHIRGI�XLEX�PIEHIVWLMT�ERH�QEREKIQIRX�HIZIPSTQIRX�[SVOW��IJJIGXMZI�managerial leadership will help bridge the gap of poor and inequitable health indicators especially MNCH indicators across various countries in SSA.

1.3 TARGET GROUPThe LMG course is designed for midwifery service managers in public and private health facilities.

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1.4 ENTRY REQUIREMENTSThe course targets leaders and managers in the area of midwifery. Selection criteria include;i) Mid level midwives managing midwifery programmes in both public and private institutions within SSA

ii) Individuals who are committed to long term mentorship in LMG practices in midwifery.

2.0 THE GOAL OF THE COURSEThe goal of this course is to strengthen L+M+G practices required to help midwifery managers in LMICs to sustainably improve the health status of their populations to achieve national and global health targets.

2.1 BROAD COURSE OBJECTIVESThe broad objectives are to:�� Improve leadership and management skills and practices of midwifery services managers�� Improve governance of health programmes and institutions�� Produce measurable results through team projects that support organizational mission and vision�� %HETX�VIPMEFPI�XSSPW�ERH�TVSGIWWIW��JSV��HI½RMRK�ERH�EHHVIWWMRK�GLEPPIRKIW�� Improve teamwork and work climate

2.2 SPECIFIC OBJECTIVES8LI�WTIGM½G�SFNIGXMZIW�EVI� i) To equip learners with knowledge and skills in elements of LMG practices.ii) To equip learners with knowledge and skills in strategic problem solving iii) To build the learner’s capacity on MNCH resources mobilization and managementiv) To provide the necessary knowledge and skills to plan and evaluate health information systems in

relation to MNCH services deliveryv) To provide learners with knowledge, skills and attitudes necessary for monitoring and evaluating

delivery of MNCH services in local contexts.

2.3 TRAINERS AND FACILITATORSThe trainers and facilitators will be drawn from different experts in the health system. They will undergo training on facilitation of the curriculum prior to its implementation. The facilitators will mainly be drawn JVSQ�XLI�½ZI�GSYRXVMIW�XLEX�XLI�XVEMRMRK�MW�XEVKIXMRK��

3.0 TEACHING AND LEARNING METHODSThe LMG course is a competency based training and will be delivered through highly participatory teaching and learning methods. A blended approach to teaching will be used to include;i) 5 day face to face sessions during which participants will interact with the facilitators. The face to face

sessions will offer opportunities to the facilitators to introduce the course content to participants and also allow participants to share their experiences on LMG practices. Case studies drawn from the practice contexts will be used during face to face sessions to build on the theoretical principles delivered by the facilitators.

ii) Coaching and mentoring for a period of 6 months after the 5 day training to support each individual participant in the application of the LMG theory into practice.

iii) Distance Learning (DL) model where participants will be given the course content in CD ROMs and will have opportunities to interact with their facilitators using email and mobile technologies.

MZ � ;SVO� FEWIH� TVSNIGXW� [LIVI� PIEVRIVW� [MPP� HIZIPST� E� XVERWJSVQEXMSREP� TPER� XS� WSPZI� ER� MHIRXM½IH�challenge in their workplace within 6 months after the 5 day training.

v) Supportive supervision to the participants. Facilitators will travel to the sites at least twice in 6 months to give on site follow up and supervision

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4.0 EXPECTED COMPETENCIES THAT PARTICIPANTS WILL ACQUIRE

1. Demonstrating leadership Qualities 1.1 Develops Self-Awareness 1.2 Manages oneself and others1.3 Continue Personal Development1.4 Acts with Integrity

2. Working with Others 2.1 Develops Networks 2.2 Displays e!ective interpersonal communication skills2.3 Builds and Maintains Relationships 2.4 Encourages Contribution 2.5 Works within Teams

3. Managing Services 3.1 Plans e!ectively3.2 Mobilizes resources3.3 Manages Resources3.4 Manages People3.5 Manages Performance3.6 Works with Schedules anchored in priority setting

4. Improving Services 4.1 Ensures Patient Safety 4.2 Critically Evaluates 4.3 Encourages Improvement and Innovation 4.4 Facilitates Transformation

5. Setting Direction 5.1 Identi"es the Contexts for Change 5.2 Applies Knowledge and Evidence 5.3 Makes Decisions 5.4 Evaluates Impact

6. Creating the Vision 6.1 Develops a Vision for the Organization 6.2 In#uences a Vision of the Wider Health Care System 6.3 Communicates the Vision 6.4 Embodies the Vision

4.1 GUIDING PRINCIPLES FOR IMPLEMENTING THIS CURRICULUM

The following principles should be considered in the adaptation and implementation of this curriculum:�� Evidence-informed: The curriculum and its implementation should be informed by evidence with

VIWTIGX�XS�GSYVWI�GSRXIRX�ERH�HIPMZIV]��8LI�GSRXIRX�HIZIPSTIH�WLSYPH�VI¾IGX�GYVVIRX�XVIRHW�EW�QYGL�EW�possible.

�� Gender responsive: The curriculum and associated training should be gender responsive in terms of language, content, and selection of participants.

�� Focus on health outcomes: The curriculum should orient participants toward the achievement of priority health outcomes.

�� Team focus: The curriculum focuses on individual and group empowerment to achieve enhanced teamwork, because large-scale changes in health service delivery call for team approaches. The participants

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should therefore be encouraged to work in teams/groups during face to face session Relevance to local GSRXI\X�ERH�RIIHW��8LI�GYVVMGYPYQ�GSRXIRX�VI¾IGXW�PSGEP�GSRXI\XW�ERH�I\TIVMIRGIW��8LI�WGIREVMSW�YWIH�MR�teaching should be contextualized as much as possible. Projects picked by students should be very relevant to the context the midwifery managers work in Value for the investment and sustainability: The curriculum and associated training should include a focus on value for the money and on sustainability.

�� Stakeholder alignment, mobilization and engagement: The curriculum and associated training should leverage the input of relevant stakeholders. Stakeholders should be appropriately aligned to get their support and ownership.

�� Application of LMG to priority health challenges: The curriculum will be implemented in a way that prepares participants to apply what they learn in addressing priority health challenges including in midwifery services delivery; family planning and reproductive health; maternal, newborn, and child health. Application can be achieved through the use of appropriate examples and by encouraging participants to select projects focusing on these priority health areas

5.0 COURSE STRUCTURE8LI�01+�GSYVWI�MW�WXVYGXYVIH�MRXS�½ZI�� QSHYPIW�IEGL�[MXL�MRHMZMHYEP�YRMXW��8LI�YRMXW�[MPP�FI�GSZIVIH�through a face to face introduction and thereafter the learners will engage in self directed Learning using the prepared content

Modules Units Time (hrs)Module 1: L+M+G Practices (8 hours)

Unit 1: Leadership and Management de"nition and practices 3

Unit 2: Governance practices (Transparency, accountability, stakeholder’s involvement, steward resources etc.)

3

Module2:Strategic problem solving(8 hours)

Unit 1: Creating a vision of success 2

Unit 2: The challenge model as a tool for management and leadership 1

Unit 3: Analyzing current situation 1

Unit 4: De"ning a measurable result 1

Unit 5: Identifying obstacles and conducting root-cause analysis 2

Unit 6: Selecting interventions and making a plan 2

Module3:Leading People(14 hours)

Unit 1: Interpersonal communication 2

Unit 2: Assertiveness and con#ict management 4

Unit 3: Team work, recognition and motivation 2

Unit 4: Coaching and mentoring 4

Unit 5: Advocacy and public relations 3

Module4:Managing Resources(6 hours)

Unit 1: Human resources development 2

Unit 2: Mobilizing resources 2

Unit 3: Managing Change 2

Module5: Monitoring and Evaluation(4 hours)

Unit 1: Introduction to monitoring and evaluation 2

Unit 2: Health information for decision making 3

Total 42 hours

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6.0 LEARNERS’ EVALUATION (THEORY AND PRACTICE)Course evaluations will combine both theoretical and practical assessments.i) A pre-training questionnaire will be given to prospective participants to assess the level of knowledge

on LMG practices prior to joining the programmeii) A post-training questionnaire will be given to participants 6 months post the 5 day training to assess

the acquisition of knowledge and skills from the trainingiii) Participants will have an opportunity to evaluate each of the sessions during the face to face week.iv) Facilitators will work with individual participants to develop and monitor implementation of

transformational plans

7.0 COURSE DELIVERY; TRAINING METHODS AND FACILITITATION SKILLSThis curriculum is built around real work related challenges that midwifery managers face on a day to day basis. The content addresses cross-cutting issues in various countries in health programmes especially in MNCH services delivery, different cultures and geographical settings notwithstanding. From the training onset, learners will be expected to identify a leadership, governance or management gap that affects delivery of MNCH services in individual work station/facility/district and start designing a transformative project to address it. In every module, the learners will be expected to apply, in a selected relevant transformative project, the challenge model using problem solving approach to implement the project

Training methodologies will mainly entail experiential learning; action based learning; challenge, feedback and support. Participants will be provided with opportunities to take up challenges, receive feedback and support thus enabling them develops leadership and management capabilities

Fig 1; Kolb’s experiential learning cycle

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Facilitators for this course are expected to minimise use of lectures and employ other facilitation skills such as questioning, paraphrasing,summarising and encouraging. The facilitators are expected to use the JSPPS[MRK�WTIGM½G�XVEMRMRK�QIXLSHW�� Small-group discussions�� Plenary discussions�� Role playing�� Case studies�� Team presentations�� Learning by doing through a team project�� Lectures�� Coaching�� 6I¾IGXMSRWThe course will be delivered using a blended approach; participants will be introduced to the critical components in all units through a 5 day face to face session. Later, they will receive a CD-ROM with all the content for self directed learning at their respective work stations. During the face to face portion of each unit, learners will be IRKEKIH�MR�VI¾IGXMZI�PIEVRMRK�WGIREVMSW�EQSRK�SXLIV�PIEVRMRK�EGXMZMXMIW��0IEVRIVW�[MPP�FI�VIUYMVIH�XS�GEVV]�SYX�ER�EGXMSR�FEWIH�PIEVRMRK�TVSNIGX�TVMSV�XS�GSQTPIXMSR�SJ�XLI�GSYVWI��8LI�TVSNIGX�MHIRXM½IH�[MPP�FI�PMQMXIH�XS�XLI�PIEHIVWLMT�ERH�QEREKIQIRX�GLEPPIRKIW�SV�KETW�MHIRXM½IH�EX�XLI�TEVXMGMTERXW´�VIWTIGXMZI�[SVO�WIXXMRKW��

8.0 CERTIFICATION4EVXMGMTERXW�[MPP�FI�KMZIR�E�GIVXM½GEXI�SJ�TEVXMGMTEXMSR�YTSR�WYGGIWWJYP�GSQTPIXMSR�SJ�XLI�01+�GSYVWI��8LI�GIVXM½GEXMSR�[MPP�FI�HSRI�NSMRXP]�F]�%16)*�ERH�17,�

9.0 COURSE DESCRIPTIONS9.1 Module One: Leadership, management & governance practices Performance objective; Upon successful completion of this module the learner will be able to apply leadership, management and governance practices in managing maternal and child health services

9.1.1 UNIT ONE: LEADERSHIP AND MANAGEMENT PRACTICES

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By the end of the unit the learner will be able to;

1. Describe leadership & management theories Explain the qualities of effective leadership Describe concepts of leadership and management Describe the leading & managing practices (scanning,focusing,aligning,mobilizing & inspiring)

2. Explain the integrated L&M results model in MNCH services delivery 3. Apply appropriate L&M practices in delivery of MNCH services4. Apply LMG knowledge & skills in managing gender issues in MNCH services delivery

CONTENT;

Leadership:� HI½RMXMSR� SJ� PIEHIVWLMT�� XLISVMIW� SJ� PIEHIVWLMT�� PIZIPW� SJ� PIEHIVWLMT�� VSPIW� SJ� E� PIEHIV��PIEHIVWLMT�WX]PIW�� PIEHIVWLMT�WOMPPW�� PIEHIVWLMT� JVEQI[SVOW��UYEPMXMIW�SJ�E�KSSH� PIEHIV��KVS[MRK� MR¾YIRGI��leader shifts; gender issues in leadership and management.1EREKIQIRX��(I½RMXMSR�SJ�QEREKIQIRX��1EREKIQIRX� XLISVMIW�� TVMRGMTPIW�SJ�QEREKIQIRX�� JYRGXMSRW�SJ�management; managerial roles; management skills; management approaches; result based management; management by objectives; an over view on quality management.

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9.1.2 UNIT TWO: GOVERNANCE PRACTICES

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At the end of the unit, the learner will be able to;

1. Explain the basic concepts of governance2. Describe dimensions of health sector ethics3. Describe roles and responsibilities of legal & regulatory frameworks4. Identify governance gaps in the local health system context

CONTENT;

Governance: WHO health system blocks; Delivery of health services in the region; Global & national MNCH health issues; Key global and national MNCH policies; Global and national MNCH trends; (I½RMXMSR�SJ�KSZIVRERGI�XIVQW�MR�LIEPXL�GSRXI\X��GSQQMXQIRX��GSQTPMERGI��,MWXSVMGEP�TIVWTIGXMZIW�SJ�governance in health and non health sectors; principles of governance; characteristics and enablers of good governance; impediments to effective governance; governance structures and functions in health; health laws and regulations on governance; governance frameworks and practices.

MODULE ONE IMPLEMENTATION GUIDELINE

Step Content Learning methods

Competencies Training materials

Time

Unit 1 Leadership & management practices; De"nitions, principles, styles, values, leader shifts, practices, competencies, leading & managing for results model, LMG F/work, integrated leading & management

Interactive lectures; brainstorming, group discussions, vibes, case studies, scenarios etc

Developing self awareness, managing self and others’ , acting with integrity, leading an organization & people to produce good outcomes

Power point presentation, Flip chart, MSH facilitators’ guide, video tape

3

Unit 2 Good governance practices in health sector; what is good governance, governance practices, good governance model, governance bodies in health sector, enablers & impediments to good governance

Interactive lectures; brainstorming, group discussions, vibes, case studies, scenarios etc

3

9.2 MODULE TWO: STRATEGIC PROBLEM SOLVING

10.2.1 MODULE OBJECTIVE:Performance objective; At the end of the module the learner will be able to develop and implement plans XS�WSPZI�MHIRXM½IH�SVKERMWEXMSREP�GLEPPIRKIW�YWMRK�WXVEXIKMG�TVSFPIQ�WSPZMRK�WOMPPW�

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9.2.2 UNIT ONE; CREATING A VISION OF SUCCESS

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At the end of the unit the learner will be able to;1. (I½RI�SVKERMÊXMSREP�ZMWMSR�ERH�QMWWMSR�GSRGITXW2. Explain the steps of strategic problem solving3. Describe strategic problem solving models4. %TTP]�WXVEXIKMG�TVSFPIQ�WSPZMRK�TVSGIWW�XS�EHHVIWW�MHIRXM½IH�SVKERMÊXMSREP�GLEPPIRKIW�

Content:�(I½RMXMSR�SJ�XIVQW�ERH�GSRGITXW��ZMWMSR�ZW��QMWWMSR��GVIEXMRK�SVKERMÊXMSREP�ZMWMSR�ERH�QMWWMSR��WXITW�& models; the power of a vision; creating a personal vision statement; barriers to implementing a vision for success; strategic problem solving process.

9.2.3 UNIT TWO: THE CHALLENGE MODEL


At the end of the unit the learner will be able to:1. (I½RI�XLI�GLEPPIRKI�QSHIP2. Describe the steps of the challenge model3. Apply use of challenge model in addressing challenges at the work place

CONTENT;

(I½RMXMSR� SJ� XIVQW�� MHIRXMJ]MRK� � SVKERMÊXMSREP� GLEPPIRKIW� MR� VIPEXMSR� XS� XLIMV� S[R�QMWWMSR� ERH� ZMWMSR��Differences between challenges and problems; problem solving vs. challenge model; Steps of the challenge model; using challenge model to resolve leadership challenges

9.2.4 UNIT THREE: SITUATION ANALYSIS (ANALYSIS OF THE CURRENT SITUATION)

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At the end of the unit the learner will be able to; 1. (I½RI�XLI�WMXYEXMSR�EREP]WMW�GSRGITXW2. Describe the tools and techniques used in situation analysis3. Describe the steps for carrying out a situation analysis 4. Apply situation analysis knowledge to identify LMG gaps in own working context

CONTENT;

(I½RMXMSR�SJ�XIVQW��WGERRMRK�SJ�I\XIVREP��MRXIVREP�IRZMVSRQIRXW��WXITW�JSV�GSRHYGXMRK�E�WMXYEXMSR�EREP]WMW��factors to consider when scanning an environment; tools for carrying out a situation analysis e.g. SWOT analysis tool; identifying opportunities and obstacles.

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9.2.5 UNIT FOUR: DEFINING MEASURABLE RESULTS

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At the end of the unit the learner will be able to; 1. Explain results measurement concepts; output, outcome & impact2. Set measurable outputs , outcomes and goals3. Apply knowledge acquired to set measurable results in own designed project

CONTENT;

(I½RMXMSR�SJ�GSRGITXW��KYMHIPMRIW�XS�WIXXMRK�QIEWYVEFPI�VIWYPXW��WIXXMRK�71%68�KSEPW��SYXTYXW�ERH�SYXGSQIW��relationship between a problem, results and solution; practicum to set own project measurable results; case study/scenario9.2.6 UNIT FIVE: ROOT CAUSE ANALYSIS

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At the end of the unit the learner will be able to; 1. (I½RI�VSSX��GEYWI�EREP]WMW�GSRGITXW�2. Describe the root cause analysis (RCA) techniques/methods3. Describe the tools and approaches used in root cause analysis4. %TTP]�VSSX�GEYWI�EREP]WMW�ORS[PIHKI�XS�MHIRXMJ]��XLI�VSSX�GEYWIW�SJ�E�TVSFPIQ�MHIRXM½IH�MR�S[R��[SVO�TPEGI�

context

CONTENT;

(I½RMXMSR�SJ�GSRGITXW��SFWXEGPIW�XS�EGLMIZMRK�SVKERM^EXMSREP�KSEPW��6'%�XSSPW�ERH�XIGLRMUYIW��WXITW�JSV�GSRHYGXMRK�E�6'%��ETTVSEGLIW�JSV�GSRHYGXMRK�E�6'%�I�K��=W�ETTVSEGL��&IRI½XW�SJ�GSRHYGXMRK�E�VSSX��GEYWI�EREP]WMW��6'% ��TVEGXMGYQ�SR�6'%�JSV�ER�MHIRXM½IH�S[R�[SVOMRK�GSRXI\X�TVSFPIQ��

9.2.7 UNIT SIX: SELECTING INTERVENTIONS AND MAKING A PLAN


At the end of the unit, the learner will be able to;1. 4VMSVMXM^I�WIPIGXMSR�SJ�MRXIVZIRXMSRW�EGXMSRW�XS�EHHVIWW�ER�MHIRXM½IH�TVSFPIQ2. Describe the process of a developing a plan (action plan) to implement an intervention3. %TTP]�XLI�ORS[PIHKI�EGUYMVIH�XS�WIPIGX�ER�MRXIVZIRXMSR�ERH�HIWMKR�ER�EGXMSR�TPER�JSV�E�TVSFPIQ�MHIRXM½IH�

in own working context.

CONTENT;

(I½RMXMSR�SJ� GSRGITXW�� TVMSVMXM^MRK�SJ� MRXIVZIRXMSRW�� XLI�TPERRMRK�TVSGIWW�� LIEPXL�TPERRMRK�� X]TIW�SJ�LIEPXL�planning; critical success factors in health planning; application of priority setting & planning process in own working context.

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MODULE 2 IMPLEMENTATION GUIDELINE

Step Content Learning methods Competencies Training

materialsTime(hr)

Unit 1 Creating a vision of success; De"nition, di!erence btw mission & vision, example of a vision, process of creating a shared vision; creating a personal vision; communicating a vision; strategic problem solving process

Interactive lectures, group discussions, brainstorming

Developing an institutional/organizational and personal vision statements, solving identi"ed facility gaps using the challenge model, conducting a situation & root cause analysis towards strategic problem solving, setting measurable results

Power point presentation, Flip charts, MSH facilitators’ manual/handbook

2

Unit 2 Challenge model; challenge & problem concepts, challenge model steps, practical use of challenge model tool

Interactive lectures, group discussions & brainstorming

As above PowerPoint presentations, Flip chart, colored markers, AMREF/JICA HSS manual, MSH eHandbook

1

Unit 3 Situation analysis; External & internal environment scanning, factors to consider when scanning an environment, tools used, identifying opportunities & obstacles


As above

As above

As above

As above

As above

As above

As above

1

Unit 4 De"ning measurable results; De"ning a measurable result, examples of measurable results, the SMART criteria, types/levels of results, Barriers to achieving desired health program/project results


1

Unit 5 Analyzing root causes; De"nition of root-cause analysis, examples of root causes, techniques of root cause analysis, tools for determining root causes


2

Unit 6

Selecting interventions & making a plan; identifying a key challenge, criteria for de"ning a challenge; selecting priority actions using the priority matrix; developing an action plan; implementing, monitoring & evaluating an action plan


2

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9.3 MODULE THREE: LEADING PEOPLE

9.3.1 Objective: Performance objective; At the end of the module the learner should be able to effectively lead the available human resources using appropriate practices

9.3.2 Unit One: Interpersonal communication At the end of this unit, the learner should be able to,1. Describe the interpersonal communication process2. Explain factors that affect organizational communication3. Describe channels of communication4. Apply interpersonal communication skills to build trustful workplace relationships.5. Describe components of a balanced team, roles and characteristics

CONTENT;

Interpersonal communication process; channels of communication; organizational communication strategies; verbal communication skills; elements of non-verbal communication; listening skills; building workplace trusting relationships.

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At the end of the unit the learner should be able to;1. Describe assertiveness communication model 2. Explain assertive communication skills 3. (IWGVMFI�XLI�ETTVSEGLIW�SJ�GSR¾MGX�QEREKIQIRX4. %TTP]�ORS[PIHKI��WOMPPW�KEMRIH�XS�QEREKI�[SVOTPEGI�GSR¾MGXW

CONTENT;

%WWIVXMZI� GSQQYRMGEXMSR� ERH� GSR¾MGX� QEREKIQIRX� GSRGITXW�� EWWIVXMZIRIWW� GSQQYRMGEXMSR�QSHIP��8SSPW� XS�MQTVSZI�EWWIVXMZIRIWW��X]TIW�SJ�GSR¾MGXW��ETTVSEGLIW�SJ�GSR¾MGX�QEREKIQIRX��2IKSXMEXMSR�WOMPPW�9.3.4 Unit Three: Team work, recognition and motivation


At the end of the unit the learner should be able to;1. Describe motivational theories2. Identify factors that demotivate human resource for health3. Explain how to create a motivating work climate for staff4. Describe individual vs. collective staff motivators

CONTENT;

Motivation theories, group dynamics; supporting a team (individual vs. collective motivation); commitment & compliance; a working climate; rewards of a positive work climate; causes & effects of a work climate; approaches of staff motivation (monetary vs. non monetary approaches);acknowledging a team; teamwork; developing a conducive work climate.

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9.3.5 Unit Four: Coaching and mentoring


At the end of the unit the learner will be able to; �� (I½RI�ZEVMSYW�GSRGITXW��TVMRGMTEPW�YWIH�MR�QIRXSVWLMT�ERH�GSEGLMRK�2. Describe mentoring and coaching techniques3. Apply mentorship and coaching skills to provide learner support to upcoming midwives in the clinical area.

CONTENT;

Concepts and principals of coaching and mentorship; Coaching to support others; phases of coaching; qualities of a good coach; qualities of a good mentor (self assessment tool); coaching and mentorship techniques; Facilitating coaching conversations; planning a clinical teaching; Giving feedback.

9.3.6 Unit Five: Advocacy and public relations


At the end of the unit the learner should be able to;�� (I½RI�ZEVMSYW�GSRGITXW�ERH�XIVQW�YWIH�MR�EHZSGEG]��TYFPMG�VIPEXMSRW2. Describe the role of advocacy and public relations in improvement of MNCH services delivery3. Plan and implement advocacy activities4. Develop advocacy tools4. Use the knowledge and skills acquired to advocate for improved MNCH services delivery

CONTENT;

Terms and concepts of advocacy and public relations; behavior change theories; behavior change communication; VSPIW�SJ��EHZSGEG]��XSSPW�SJ�EHZSGEG]��MHIRXMJ]MRK�ERH�HI½RMRK�01+�EHZSGEG]�MWWYIW��TPERRMRK�ERH�MQTPIQIRXMRK�advocacy activities; designing advocacy strategy; principles of public relation; customer care.

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1SHYPI��MQTPIQIRXEXMSR�KYMHIPMRI

Step Content Learning methods Competencies Training materials Time

Unit 1 Interpersonal communication; conversation skills, communication skills, listening skills, Habit change process and conversational circles, giving feedback

Interactive lectures, group discussions, brainstorming sessions

Developing positive interpersonal working relationships, e!ective use of assertiveness in negotiation, con#ict management skills, coaching & mentorship skills, Building & sustaining productive working teams

Power point presentation, MSH facilitation manual (MSH eHand book). AMREF/JICA HSS manual

2

Unit 2 Assertiveness and con"ict management; assertive commun’cn skills, assertive communication model, causes of con#icts, approaches of con#ict resolution (ORID) method, types of con#icts, Negotiation skills


4

Unit 3 Teamwork,recognition and motivation; motivation theories, work climate, knowing your sta!, sta! motivation approaches, Building &maintaining trust, members of a team (roles & characteristics)


3

Unit 4 Coaching &mentoring;Concepts, principals, approaches/techniques, qualities of a good coach and mentor, mentorship & coaching models, enablers & barriers


2

Unit 5 Advocacy & public relations; de"nition of concepts, approaches, tools, role of advocacy in MNCH services


3

9.4 MODULE FOUR: MANAGING HUMAN RESOURCE FOR HEALTH (HRH)

9.4.1 Overall objective/learner outcomePerformance objective; At the end of the module the learner will acquire knowledge and skills in management of available HRH resources

9.4.2 Unit One: Human resource management


By the end of the unit the learner should be able to;1. Explain HR policy essentials2. Describe the key components of an effective HRM system3. Explain the process of staff recruitment, orientation, supervision and performance management

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CONTENT:

Challenges of HRH in SSA especially in MNCH services delivery; current trends in Global HRH crisis; emerging HRH issues; common HRH policies and planning; Human resources for health action framework (HAF); pillars of effective HRM; staff recruitment, supervision and management to optimize performance ; staff retention; Gender dimensions in the health sector.

9.4.3 Unit Two: Mobilizing resources


At the end of the unit the learner will be able to;1. Describe the process of resource mapping2. Describe how a resource mobilization strategy is developed (overview)3. Explain various resource mobilization methods4. Describe essential commodities supply chain management5. Describe the process of developing a budget6. %TTP]�ORS[PIHKI��WOMPPW�KEMRIH�XS�QSFMPM^I�VIWSYVGIW�JSV�ER�MHIRXM½IH�TVSNIGX

CONTENT;

(I½RMXMSR� SJ� XIVQW� ERH� GSRGITXW� JSV� VIWSYVGI� QSFMPM^EXMSR�� JYRHVEMWMRK�� QIXLSHW� SJ� JYRHVEMWMRK�� [VMXMRK� E�fundraising concept and proposal; components of a fundraising proposal; essential MNCH commodities supply chain management; developing and monitoring a budget.

9.4.5 UNIT THREE: MANAGING CHANGEAt the end of the unit, the learner will be able to,1. (I½RI�GLERKI�GSRGITXW2. Describe the process of change3. Recognize types of change in an organization4. Deal with peoples’ reaction to change process5. Incorporate critical success factors into a change process

CONTENT;

Terms and concepts of change; the change process; types of change; change management; dealing with peoples’ reaction to change process; critical success factors for change process.

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materials Time

Unit 1 Managing Human resource; setting job responsibilities & work priorities, encouraging good performance with feedback, making work meaningful, improving fairness at the work place & o!ering sta! opportunities to grow

Interactive lectures, role plays, scenarios, case studies

Resource mobilization skills, managing available resources, managing sta! performance, identifying change contexts, initiating & implementing change

Facilitation guides, power point presentations, Flip charts, colored markers, AMREF HSS manual, MSH eHandbook

2

Unit 2 Mobilizing resources; fundraising; approaches; concepts & proposals resource mobilization strategy, essential commodities supply chain monitoring

Interactive lectures, role plays, scenarios, case studies

3

Unit 3 Managing change; de"nition of concepts, types of change, change process, managing resistance to change

Interactive lectures, role plays, case studies, scenarios

2

9.5 MODULE 5: MONITORING AND EVALUATIONPerformance objective; At the end of the module, the participants should be able to plan and implement health services (MNCH) monitoring & evaluation frameworks

9.5.1 Unit One: Introduction to monitoring and evaluationAt the end of the unit, the learner will be able to;1. Describe basic monitoring and evaluation concepts2. Describe monitoring and evaluation system3. Develop simple M&E framework.4. Monitor and evaluate midwifery services.

CONTENT:

&EWMG� 1SRMXSVMRK� ERH� IZEPYEXMSR� GSRGITXW�� (I½RMXMSR� SJ� XIVQW�� VEXMSREPI� JSV� QSRMXSVMRK� ERH� IZEPYEXMSR��comparison of monitoring and evaluation; Setting results indicators; Types of monitoring; Methods used in monitoring; Types of evaluation; developing a basic M &E plan; M &E framework; types of M & E frameworks.

9.5.2 UNIT TWO: HEALTH INFORMATION FOR DECISION MAKINGAt the end of the unit, the learner will be able to,1. Explain basic concepts in health information management 2. Describe Health Management Information Systems (HMIS) 3. Generate process, disseminate and use strategic information.

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CONTENT

Basic concepts in HIM;�HI½RMXMSR�HEXE��MRJSVQEXMSR��MRJSVQEXMSR�W]WXIQ��LIEPXL�QEREKIQIRX�MRJSVQEXMSR�W]WXIQW��7YFW]WXIQW�SJ�,1-7��HIXIVQMRERXW�SJ�ER�IJ½GMIRX�,1-7Components of HMIS: Resources; Indicators; data sources; data management-collection, analysis, interpretation, presentation, storage; data quality; Information dissemination and use; Role of the midwife manager in health information management.



materials Time

Unit 1 Introduction to monitoring and evaluation; De"nition of terms, rationale for M&E, setting indicators for results, developing basic M & E & logical plans for program activities

Interactive lectures, group work, presentations, discussions, brainstorming

Using evidence based results to in#uence decision making, case studies

Power point presentations, Flip charts,

3

Unit 2 Health information for decision making; De"nitions, concepts, HMIS components, data collection, analysis & use

2

REFERENCESCovey, Stephen R. 2004. The Seven Habits of Highly Effective People: Powerful Lessons in Personal Change. New York: Simon & Schuster. Daloz Parks, Sharon. 2005. Leadership Can Be Taught: A Bold Approach for a Complex World. Boston: Harvard Business Press.Daloz, L. A. (1990) Effective Teaching and Mentoring, an Francisco: Jossey-BassHealth Systems Strengthening curriculum (AMREF &JICA,2012) Howard, G.A., Adams, H.G., 2004, mentoring for professional growth and development; SACNAS National conference, Austin, TX.Kotter, J. P. 1990. “What Leaders Really Do.” Harvard Business Review 68(3): 103–11. (Reprinted by Harvard Business Review December 2001.)Leadership, Management, and Governance (LMG) Project. 2013. Web portal. http://www.lmgforhealth.org Management Sciences for Health. 2009. Leadership Development Program Facilitators Guide. Cambridge, MA: MSH.Management Sciences for Health. 2010. Health Systems in Action: An eHandbook for Leaders and Managers. Cambridge, MA: MSH. http://www.msh.org/Documents/upload/msh_eHandbook_complete.pdfMashalla, Y., 2010. Practical Tips for MentoringNursing Council of Kenya (NCK ) basic KRCHN training curriculum (2008) Quinn, F., & Hughes, s., 2007. Quinn’s Principles and Practice of Nurse Education.5th Edition. Nelson Thorne’sWorld Health Organization. 1994. Indicators to Monitor Maternal Health Goals. Geneva: WHO. http://whqlibdoc.who.int/HQ/1994/WHO_FHE_MSM_94.14.pdfWorld Health Organization. 2013. Website. Geneva: WHO. http://www.who.int/en/

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