Global health leadership training in resource-limited settings: a collaborative approach by academic institutions and local health care programs in Uganda

Human Resources for Health

Nelson Sewankambo⁶  Carey Farquhar⁴  Yohana Mashalla¹  Sarah Naikoba⁵  Sam Biraro²  Achilles Katamba⁶  John Bosco Ddamulira⁶  Joseph Sempa⁵  Joanitor Kigozi⁵  Aggrey Semeere⁵  Elizabeth Namagala³  Damalie Nakanjako⁶ 

[1] University of Botswana, Gaberone, Botswana;Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda;Ministry of Health, AIDS Control Program, Kampala, Uganda;Departments of Medicine, Global Health and Epidemiology, University of Washington, Seattle, WA, USA;Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda;Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda

关键词: Collaboration;    Uganda;    Sub-Saharan Africa;    Resource-limited settings;    Training;    Health leadership;    Global health;   

Others  :  1234441
DOI  :  10.1186/s12960-015-0087-2

 received in 2015-06-19, accepted in 2015-11-05,  发布年份 2015

【 摘 要 】

Introduction

Due to a limited health workforce, many health care providers in Africa must take on health leadership roles with minimal formal training in leadership. Hence, the need to equip health care providers with practical skills required to lead high-impact health care programs. In Uganda, the Afya Bora Global Health Leadership Fellowship is implemented through the Makerere University College of Health Sciences (MakCHS) and her partner institutions. Lessons learned from the program, presented in this paper, may guide development of in-service training opportunities to enhance leadership skills of health workers in resource-limited settings.

Methods

The Afya Bora Consortium, a consortium of four African and four U.S. academic institutions, offers 1-year global health leadership-training opportunities for nurses and doctors. Applications are received and vetted internationally by members of the consortium institutions in Botswana, Kenya, Tanzania, Uganda, and the USA. Fellows have 3 months of didactic modules and 9 months of mentored field attachment with 80% time dedicated to fellowship activities. Fellows’ projects and experiences, documented during weekly mentor-fellow meetings and monthly mentoring team meetings, were compiled and analyzed manually using pre-determined themes to assess the effect of the program on fellows’ daily leadership opportunities.

Results

Between January 2011 and January 2015, 15 Ugandan fellows (nine doctors and six nurses) participated in the program. Each fellow received 8 weeks of didactic modules held at one of the African partner institutions and three online modules to enhance fellows’ foundation in leadership, communication, monitoring and evaluation, health informatics, research methodology, grant writing, implementation science, and responsible conduct of research. In addition, fellows embarked on innovative projects that covered a wide spectrum of global health challenges including critical analysis of policy formulation and review processes, bottlenecks in implementation of national HIV early infant diagnosis and prevention of mother-to-child HIV-transmission programs, and use of routine laboratory data about antibiotic resistance to guide updates of essential drug lists.

Conclusion

In-service leadership training was feasible, with ensured protected time for fellows to generate evidence-based solutions to challenges within their work environment. With structured mentorship, collaborative activities at academic institutions and local health care programs equipped health care providers with leadership skills.

【 授权许可】

   
2015 Nakanjako et al.

【 参考文献 】

• [1]Mathauer I, Imhoff I. Health worker motivation in Africa: the role of non-financial incentives and human resource management tools. Hum Resour Health. 2006; 4:24. BioMed Central Full Text
• [2]Chen L, Evans T, Anand S, Boufford JI, Brown H, Chowdhury M et al.. Human resources for health: overcoming the crisis. Lancet. 2004; 364:1984-90.
• [3]Ssengooba F, McPake B, Palmer N. Why performance-based contracting failed in Uganda--an “open-box” evaluation of a complex health system intervention. Soc Sci Med. 2012; 75:377-83.
• [4]Farquhar C, Nathanson N. The Afya Bora Consortium: an Africa-US partnership to train leaders in global health. Infect Dis Clin North Am. 2011; 25:399-409.
• [5]Management Sciences for Health: Health systems in action: an ehandbook for leaders and managers. In Management Sciences for Health. Cambridge, MA; 2010. https://www. msh.org/resources/healthsystems-in-action-an-ehandbook-for-leaders-and-managers webcite
• [6]Potter C, Brough R. Systemic capacity building: a hierarchy of needs. Health Policy Plan. 2004; 19:336-45.
• [7]Elyanu P, Nakanjako D, Lukabwe I, Namagala E, Kiyaga C, Schellack C, et al. Gaps in linkage to antiretroviral therapy among HIV-infected infants and children in Uganda. Kuala Lumpur, Malaysia; 2013.
• [8]Mugasha C, Kigozi J, Muganzi A, Kiraga A, Sewankambo N, Coutinho A, et al. Intra-facility linkage of HIV-positive mothers and exposed infants into HIV chronic care: rural and urban experiences in a resource-limited setting In 7th IAS conference on HIV pathogenesis, treatment and prevention. Kuala Lumpur, Malaysia; 2013.
• [9]Bazira J, Boum Y, Sempa J, Iramiot J, Nanjebe D, Sewankambo N et al.. Trends in antimicrobial resistance of Staphylococcus aureus Isolated from clinical samples at Mbarara Regional Referral Hospital in Rural Uganda. Br Microbiol Res J. 2014; 4:1084-91.
• [10]Mugasha C, Kigozi J, Kiragga A, Muganzi A, Sewankambo N, Coutinho A et al.. Intra-facility linkage of HIV-positive mothers and HIV-exposed babies into HIV chronic care: rural and urban experience in a resource limited setting. PLoS One. 2014; 9:e115171.
• [11]Muhindo R, Okonya JN, Groves S, Chenault M. Predictors of contraceptive adherence among women seeking family planning services at Reproductive Health Uganda, Mityana Branch. Int J Popul Res. 2015; 2015:8.
• [12]Tumwesigye BT, Nakanjako D, Wanyenze R, Akol Z, Sewankambo N. Policy development, implementation and evaluation by the AIDS control program in Uganda: a review of the processes. Health Res Policy Syst. 2013; 11:7. BioMed Central Full Text
• [13]Conroy AL, Hawkes M, Hayford K, Namasopo S, Opoka RO, John CC et al.. Prospective validation of pediatric disease severity scores to predict mortality in Ugandan children presenting with malaria and non-malaria febrile illness. Crit Care. 2015; 19:47. BioMed Central Full Text
• [14]Sande M, Ronald A. The academic alliance for AIDS care and prevention in Africa. Acad Med. 2008; 83:180-4.
• [15]Manabe YC, Katabira E, Brough RL, Coutinho AG, Sewankambo N, Merry C. Developing independent investigators for clinical research relevant for Africa. Health Res Policy Syst. 2011; 9:44. BioMed Central Full Text
• [16]Talib ZM, Kiguli-Malwadde E, Wohltjen H, Derbew M, Mulla Y, Olaleye D et al.. Transforming health professions’ education through in-country collaboration: examining the consortia among African medical schools catalyzed by the Medical Education Partnership Initiative. Hum Resour Health. 2015; 13:1. BioMed Central Full Text
• [17]Mafigiri DK, Ayebare F, Baingana RK, Okello E, Sewankambo NK. Medical Education for Equitable Services for All Ugandans (MESAU) consortium: development and achievements. Acad Med. 2014; 89:S65-8.
• [18]Hagopian A, Thompson MJ, Fordyce M, Johnson KE, Hart LG. The migration of physicians from sub- Saharan Africa to the United States of America: measures of the African brain drain. Hum Resour Health. 2004; 2:17. BioMed Central Full Text